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Nadi shodhana

Nadi shodhana, also called alternate nostril breathing or anulom vilom, is a yogic breathing practice in which breath moves through one nostril at a time while the other is closed by hand. Randomised trials, mostly small and unblinded, report lower blood pressure, lower stress measures and better scores on lung function and cognitive tests after practice, and the yoga tradition regards it as a practice for mental calm and balance. No claim reaches moderate or high certainty because the trials are small, mostly unblinded, vary widely in technique and results, and were largely run in one country.

  • Mind

Evidence retrieved up to

What the research shows

Regular alternate nostril breathing practice was followed by lower systolic and diastolic blood pressure than no intervention in a meta-analysis of randomised trials in adults, although results varied widely between trials.

Low certaintyFurther research is likely to change this.
No known concerns at usual amountsBenefit

Who this is about

adults taking part in randomised trials of alternate nostril breathing

Practical note

Graded low: a 2024 meta-analysis pooled 6 randomised trials (525 participants) and found mean differences of about 7 mmHg systolic and 5 mmHg diastolic, downgraded two levels for very high heterogeneity (I2 87-93%) and risk of bias from unblinded trials. A 2026 crossover trial saw systolic pressure fall during a single 15-minute session.

Safety note

The trials used seated practice; the abstracts reviewed here do not report on harms, and variants with long breath holds were not separately assessed.

Sources

Alternate nostril breathing has been followed by lower stress and anxiety scores in small randomised trials of adults, but in a controlled pilot trial the difference from sitting quietly was not statistically significant.

Very low certaintyThis is uncertain; treat it as a lead, not a finding.
No known concerns at usual amountsBenefit

Who this is about

adults, mostly young and healthy, in small randomised trials

Practical note

Graded very-low: evidence is a narrative systematic review without pooling and small trials, inconsistent against quiet-rest controls, with populations that were mostly Indian and male. Trials used sessions of about 15 minutes.

Safety note

A systematic review described the practice as carrying minimal risk.

Sources

A systematic review of randomised trials, mostly in healthy people, reported better scores on cognitive measures after alternate nostril breathing, but the technique was not standardised across trials.

Very low certaintyThis is uncertain; treat it as a lead, not a finding.
No known concerns at usual amountsBenefit

Who this is about

healthy children and adults aged eight to seventy in randomised trials

Practical note

Graded very-low despite the review author's description of high-level evidence: 44 trials were summarised without pooling, ten were judged at high risk of bias, the technique varied, and a later crossover trial found that effects of nostril-regulated breathing on mood depended on which nostril was dominant at rest.

Sources

Yogic breathing programmes that include nadi shodhana or anulom vilom were followed by improved lung function measures such as forced vital capacity and peak expiratory flow in healthy adults.

Very low certaintyThis is uncertain; treat it as a lead, not a finding.
No known concerns at usual amountsBenefit

Who this is about

healthy adults

Practical note

Graded very-low: the 2026 meta-analysis pooled 11 studies of mixed yogic breathing practices, so the effect of nadi shodhana alone is not separable (indirectness), heterogeneity was very high for two outcomes (I2 99%), and non-randomised studies were included. Programmes ran four weeks to four months with sessions of at least 10 minutes.

Sources

What the tradition holds

The yoga tradition holds that alternate nostril breathing relieves mental unrest and promotes physical and mental balance, and traditional texts describe different effects depending on which nostril is dominant at rest.

No known concerns at usual amountsBenefit

Who this is about

people practising yogic breathing

The tradition's frame

Yoga

In yoga, nadi shodhana (channel cleansing) is a pranayama in which breath alternates between the left and right nostrils, and the tradition links the flow through each nostril with different physical and mental states.

Practical note

This is what the tradition holds; the scientific claims in this entry give the trial evidence, which is low to very low in certainty.

Sources