Chronic Obstructive Pulmanory Disease (COPD)_Lungs

Question about Chronic Obstructive Pulmanory Disease (COPD) from MIKE:

I may be in a catch-22 situation with Bikram Yoga. I am an Alpha 1-Antitrypsin sufferer; my lungs are getting worse and I now have COPD. I’ve read that Bikram Yoga is good for improving one’s breathing, which I really do need help with, but I worry about practising yoga in a heated room. When I’ve tried sitting in a sauna after a workout at the gym, I’ve found myself struggling with my breathing. Would the heat associated with Bikram Yoga have the same affect on me as the sauna?

We’ve asked two experts (both doctors) from our community – Roxana Mavai and Divi Chandna – to weigh in on your question. Here are their thoughts:*

DIVI Answers:

Chronic Obstructive Pulmanory Disease (COPD) – where the lungs constrict, making it challenging to breathe – is a condition that, unfortunately, worsens with time. The good news, however, is that Bikram Yoga gives you an amazing opportunity to open your lungs to their full capacity – so what you have read is correct. I often see patients with asthma or chronic bronchitis who have been able to discontinue their puffers as a direct result of a regular yoga practice.

In terms of the heat, it’s actually very different than the conditions in a sauna (i.e., not as intimidating). Not only that, breathing is vastly different in a hot Bikram Yoga studio compared with a sauna or steam room. The heat / humidity in the yoga room is actually what aids healing. You will not experience the same reaction as in a sauna; it is a very, very different experience.

Finally, you CAN seek out cooler spots in the hot Bikram Yoga room; just ask the front-desk staff or the teacher to show you where these spots are before class. The hot room and the practice will help open your lungs and assist your condition in the long run. While it may take you a few classes (even up to a week) to get used to the heat, it is very different than a sauna and I don’t think you will have any problems. As mentioned, other clients with COPD have been just fine.

Roxy Answers:

First, some background: Alpha 1-Antitrypsin Deficiency (A1AD) is a genetic condition where an enzyme deficiency results in a form of emphysema (called panacinar emphysema) – a Chronic Obstructive Pulmonary Disease (COPD). The liver can also be affected depending on the deficiency. In some sufferers (depending on whether the patient carries one or two copies of the affected gene), the gradual destruction may require eventual lung / liver transplantation. 

The most evident issue in A1AD sufferers is the early manifestation of COPD / emphysema. The small alveolar air cells are gradually destroyed in areas, creating larger bullae (ball-shaped air sacs). The air exchange becomes less efficient and overall lung capacity decreases (with healthy alveoli, small air cells, there’s more surface area for oxygen exchange from inhaled air into the circulation; with larger air sacs, the bullae, the surface area relative to volume of air decreases and the oxygen exchange is less efficient). The sufferer can’t exchange oxygen as efficiently as someone with normal lungs (roughly, for e.g., with 20% alveolar destruction, lung capacity drops from 100% to 80%).

The most likely reason you had difficulty breathing in a sauna is that the air is highly saturated with moisture (humidity is essentially 100% in a sauna). With so many water molecules in the air, a displacement of oxygen occurs and the oxygen saturation is relatively lower. With lungs that don’t assimilate oxygen as efficiently, you’ll have more difficulty with breathing in any environment where relative oxygen saturation is lower.

The difference in a Bikram Yoga class is the humidity is around 40% (give or take). This is quite different than the 100% humidity in a sauna. However, the humidity from yoga class to yoga class changes slightly, with some classes more humid than others. The more humid the class, the more challenging you may find it (as we all do, but more pronounced in your case).

On the other hand, doing Pranayama Breathing, increasing the elasticity of the lungs and respiratory system and learning to exercise breath control in Bikram Yoga class will improve the efficacy with which you can use your lungs. With regular practice you may find your overall respiratory and cardiovascular conditioning improving, allowing you to experience less difficulty in general in all of your activities. However, in more humid classes where you may have more trouble getting through all the postures, you may need to rest on occasion. Just do the best you can and don’t get discouraged if you find you can’t do all the postures without rest. Many people aren’t able to get through the entire class without rest until they condition themselves to the task at hand in the given conditions of heat and humidity.

Woman doing Pranayama Breathing Bikram Yoga

I believe any exercise that would improve your respiratory and cardiovascular conditioning, as Bikram Yoga does, is to your advantage; you only need to recognize that some classes may be more humid than others and that this may not be predictable. In those situations, simply adjust your level of effort according to what you can tolerate, and rest assured that the conditioning of this yoga practice will improve your stamina, endurance and breathing ability in all types of demanding situations. As a genetic condition, A1AD is not reversible; however, with a regular Bikram Yoga practice your lungs will be better conditioned (relative to not practising yoga) and better able to oxygenate the circulation as more of the lung cells are recruited on a regular basis.

*Please note: This website / blog contains general information about medical conditions and treatments. The information is not advice, and should not be treated as such. The medical information on this website / blog is not meant as an alternative to medical advice from your doctor or other professional health-care provider. Please consult your doctor or other professional health-care provider to determine the best course of action for your health condition.

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