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Year : 2016  |  Volume : 4  |  Issue : 2  |  Page : 49-50

Immediate effect of cyclic meditation on heart rate variability in patients suffering from type 2 diabetes mellitus

Division of Yoga and Life Sciences, S-VYASA Yoga University, Bengaluru, Karnataka, India

Date of Web Publication1-Nov-2017

Correspondence Address:
Pailoor Subramanya
Associate Professor, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana [SVYASA Yoga University], No. 19, Eknath Bhavan, Gavipuram Circle, K.G.Nagar, Bengaluru - 560 019, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijny.ijoyppp_17_15

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How to cite this article:
Umashankar K, Subramanya P. Immediate effect of cyclic meditation on heart rate variability in patients suffering from type 2 diabetes mellitus. Int J Yoga - Philosop Psychol Parapsychol 2016;4:49-50

How to cite this URL:
Umashankar K, Subramanya P. Immediate effect of cyclic meditation on heart rate variability in patients suffering from type 2 diabetes mellitus. Int J Yoga - Philosop Psychol Parapsychol [serial online] 2016 [cited 2023 Jun 5];4:49-50. Available from: https://www.ijoyppp.org/text.asp?2016/4/2/49/217476

Dear Sir,

Previous studies conducted to evaluate the immediate effects of cyclic meditation (CM) have reported 32.5% reduction in oxygen consumption,[1] suggestive of decreased in basal metabolic rate. Studies have also reported enhancement in auditory-evoked potential amplitudes and reduced latency (indicative of increased alertness)[2] along with improvement in heart rate variability (HRV) (suggestive of increased parasympathetic activity and reduced sympathetic tone).[3],[4]

Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by chronic hyperglycemia. Autonomic imbalance in terms of increased sympathetic and reduced parasympathetic activity has been reported in T2DM patients.[5] Thus, the current study was aimed at evaluating the immediate effect of CM on HRV of patients with T2DM.

We performed a pilot study on 30 T2DM patients with an age of 51.23 ± 6.68 years. Patients of both genders, diagnosed with T2DM for more than 1 year, were included in the study. Patients having Type 1 diabetes mellitus, hypertension, coronary artery disease, renal dysfunction, diabetic retinopathy and neuropathy, major depression, or any other severe medical illness were excluded from the study. Written informed consent was obtained from all the participants before the intervention.

All participants underwent daily training of CM and supine rest (SR) for 6 days before data collection. After training, sessions of CM and SR were administered (with random allocation) on two consecutive days for the same duration in a silent dark room. HRV was assessed immediately before and after the two interventions using noninvasive RMS Polyrite D HRV device with a sampling rate of 1024 Hz. The device was manufactured by Recorders and Medicare Systems, Chandigarh, India. Artifacts were eliminated by computer-based artifact detection, and beats were rejected if they varied by more than 40% from the preceding beat.

Data extraction was conducted using Kubios software and data were analyzed using SPSS version 20.0 (IBM, Chicago). Repeated-measures analysis of variance was performed with two within-participant factors, i.e., (1) sessions with two levels: CM and SR and (2) states with two levels: pre and post. Post hoc tests with Bonferroni adjustment for multiple comparisons were used to detect significant differences between mean values recorded pre and post (for both “CM sessions” and “SR sessions” separately).

We found a significant decrease in low-frequency (LF) domain (P = 0.018, −9.68%), significant improvement in high-frequency (HF) domain (P = 0.018, 24.28%), and LF/HF ratio (P = 0.005, −33.84%) of HRV following CM practice as compared to the baseline. Whereas, no significant change was found in any of HRV domains following SR. Between-group comparison showed no significant difference in any of the HRV domains [Table 1].
Table 1: Comparisons for heart rate variability domains within and between the two sessions: Cyclic meditation and supine rest

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Previously, a study by Sarang and Telles [4] tested the immediate effect of CM on HRV in healthy individuals. They found that there was a significant reduction in LF power and LF/HF ratio along with an increase in HF power during CM, and the effects were significantly better than SR. Although these findings are similar to our results, in our study, we did not find any significant difference in between group comparison. This might suggest that CM exerted better effect in healthy volunteers as compared to T2DM patients. This may be because of the higher efficiency of healthy individuals in performing CM technique as compared to T2DM patients, as recent findings suggest that cognitive deterioration is higher in diabetics as compared to healthy individuals [6],[7] of the same age, and this may hamper their learning abilities.

CM technique is a moving meditation which includes a set of postures interspersed with brief periods of relaxation, which leads to deepening of relaxation in a step-by-step manner.[8] This is the reason CM technique induces the “relaxation response,” which leads to parasympathetic dominance. This parasympathetic dominance induced by CM is responsible for the reduction of LF power and LF/HF ratio and increment in HF power in HRV immediately after CM technique.

The LF band of the HRV is mainly related to sympathetic modulation when expressed in normalized units, and efferent vagal activity is a major contributor to the HF band.[9] The LF/HF ratio is correlated with sympathovagal balance.[10]

It was observed in our study that the state of relaxation after CM resulted in parasympathetic dominance in T2DM patients as evidenced by a reduction in LF component of frequency domain and significant improvement in HF domain and LF/HF ratio of HRV. However, these findings need to be generalized with caution due to several limitations of the current study such as (1) small sample size, (2) lack of randomized controlled design, and (3) the lesser duration of CM training. These findings need confirmation from studies with a larger sample size and randomized controlled design, which are implicated in the future.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Vempati RP, Telles S. Yoga-based guided relaxation reduces sympathetic activity judged from baseline levels. Psychol Rep 2002;90:487-94.  Back to cited text no. 1
Subramanya P, Telles S. Changes in midlatency auditory evoked potentials following two yoga-based relaxation techniques. Clin EEG Neurosci 2009;40:190-5.  Back to cited text no. 2
Subramanya P, Telles S. A review of the scientific studies on cyclic meditation. Int J Yoga 2009;2:46-8.  Back to cited text no. 3
[PUBMED]  [Full text]  
Sarang P, Telles S. Effects of two yoga based relaxation techniques on heart rate variability (HRV). Int J Stress Manag 2006;13:460-75.  Back to cited text no. 4
Fakhrzadeh H, Yamini-Sharif A, Sharifi F, Tajalizadekhoob Y, Mirarefin M, Mohammadzadeh M, et al. Cardiac autonomic neuropathy measured by heart rate variability and markers of subclinical atherosclerosis in early type 2 diabetes. ISRN Endocrinol 2012;2012:168264.  Back to cited text no. 5
Cukierman T, Gerstein HC, Williamson JD. Cognitive decline and dementia in diabetes – Systematic overview of prospective observational studies. Diabetologia 2005;48:2460-9.  Back to cited text no. 6
Ali S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of co-morbid depression in adults with Type 2 diabetes: A systematic review and meta-analysis. Diabetic Medicine 2006;23:1165-73.  Back to cited text no. 7
Chinmayananda S. Mandukya Upanisad. Bombay, India: Sachin Publication; 1984.  Back to cited text no. 8
Heart Rate Variability. Standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Eur Heart J 1996;17:354-81.  Back to cited text no. 9
Malliani A, Pagani M, Lombardi F, Cerutti S. Cardiovascular neural regulation explored in the frequency domain. Circulation 1991;84:482-92.  Back to cited text no. 10


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