Effect of Short‑Term Practice of Left Nostril Breathing on Various Sleep Parameters in the Medical Students

Himanshu A. Gajbhiye, Vinu Vij, Dhananjay Raje


Background: Various recent studies have reported that exclusive right nostril breathing (RNB) and left nostril breathing (LNB) has an immediate and sustained effect under various medical conditions. In the present study, we evaluated the effect of short‑term left nostril breathing on various sleep parameters in medical students.

Methods: We hypothesized that the increase in vagal tone because of LNB can help in improving the quality of sleep. The baseline sleep quality was documented before the start of study in the case and the control group using the ‘Pittsburgh Sleep Quality Index’ (PSQI) questionnaire. A PSQI global score of more than 5 indicates poor sleep quality. The case group practiced LNB in a graduated manner for a period of 4 weeks. Thereafter, sleep quality was documented for both the groups using the PSQI questionnaire.

Results: Practicing LNB significantly lowered all the seven component scores (p < 0.05) and the global PSQI score in the case group (p‑value < 0.0001), suggesting that this practice effectively improved the sleep quality in the individuals of this group.

Conclusions: Overall, this study suggested that exclusive LNB practice could serve as an important lifestyle modification that can be incorporated in the routine of medical students for improving their sleep quality.


Medical students,; questionnaire; sleep deprivation; sleep quality

Full Text:



Léger D, Partinen M, Hirshkowitz M, Chokroverty S, Hedner J.

Characteristics of insomnia in a primary care setting: EQUINOX

survey of 5293 insomniacs from 10 countries. Sleep Med


Veldi M, Aluoja A, Vasar V. Sleep quality and more common

sleep‑related problems in medical students. Sleep Med


Hershner SD, Chervin RD. Causes and consequences of

sleepiness among college students. Nat Sci Sleep 2014;6:73‑84.

Ranasinghe AN, Gayathri R, Vishnu Priya V. Awareness of

effects of sleep deprivation among college students. Drug Invent

Today 2018;10:1806‑9.

Azad MC, Fraser K, Rumana N, Abdullah AF, Shahana N,

Hanly PJ, et al. Sleep disturbances among medical students:

A global perspective. J Clin Sleep Med 2015;11:69‑74.

Arora RS, Thawani R, Goel A. Burnout and sleep quality:

A cross‑sectional questionnaire‑based study of medical and

non‑medical students in India. Cureus 2015;7:e361. doi: 10.7759/

cureus. 361.

Wong JGWS, Patil NG, Beh SL, Cheung EPT, Wong V,

Chan LC, et al. Cultivating psychological well‑being in Hong

Kong’s future doctors. Med Teach 2005;27:7‑15.

Harrison Y, Horne JA. The impact of sleep deprivation on

decision making: A review. J Exp Psychol Appl 2000;6:236‑49.

Cramer H, Lauche R, Klose P, Langhorst J, Dobos G. Yoga for

schizophrenia: A systematic review and meta‑analysis. BMC

Psychiatry 2013;13:32. doi: 10.1186/1471‑244X‑13‑32.

Jain N, Srivastava RD, Singhal A. The effects of right and left

nostril breathing on cardiorespiratory and autonomic parameters.

Indian J Physiol Pharmacol 2005;49:469‑74.

Raghuraj P, Telles S. Immediate effect of specific nostril

manipulating yoga breathing practices on autonomic and

respiratory variables. Appl Psychophysiol Biofeedback


Bhavanani AB, Madanmohan SZ. Immediate effect of chandra

nadi pranayama (left unilateral forced nostril breathing) on

cardiovascular parameters in hypertensive patients. Int J Yoga


Bell KA, Kobayashi I, Chen Y, Mellman TA. Nocturnal

autonomic nervous system activity and morning proinflammatory

cytokines in young adult African Americans. J Sleep Res


Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The

Pittsburgh sleep quality index: A new instrument for psychiatric

practice and research. Psychiatry Res 1989;28:193‑213.

Bal BS. Effects of Chandra nadi pranayama on hematological

parameters. Adv Phys Educ 2015;5:128‑35.

Bankar M, Chaudhari S, Chaudhari K. Impact of long‑term

yoga practice on sleep quality and quality of life in the elderly.

J Ayurveda Integr Med 2013;4:28‑32.

Ebrahimi M, Guilan‑Nejad TN, Pordanjani AF. Effect of

yoga and aerobics exercise on sleep quality in women with

type 2 diabetes: A randomized controlled trial. Sleep Sci


Soni R, Singh K, Munish K, Singh S. Study of the effect of yoga

training on diffusion capacity in chronic obstructive pulmonary

disease patients: A controlled trial. Int J Yoga 2012;5:123‑7.

Pal GK, Velkumary S, Madanmohan A. Effect of short‑term

practice of breathing exercises on autonomic functions in normal

human volunteers. Indian J Med Res 2004;120:115‑21.