The breathing cycle is intimately connected to both sympathetic and parasympathetic action of the autonomic nervous system.19 Bowel and bladder function is also mediated by the autonomic nervous system.10 Conscious deep diaphragmatic breathing is one of the best ways to quiet the autonomic nervous system. This breathing effectively initiates a cascade of visceral relaxation responses. The aim of this exercise is to make the shift from thoracic breathing to abdominal breathing.19 Patients are instructed to slowly inhale through the nose while protruding the abdomen outward as if the abdomen is a balloon being inflated or allowing the abdomen to rise. This maneuver is followed by slow exhalation through the mouth as the abdominal balloon deflates or as the abdomen falls. Patients are encouraged to practice this in a slow, rhythmical fashion. Visualization and progressive relaxation techniques in conjunction with diaphragmatic breathing may be used to accomplish lowering sympathetic nervous system tone, promoting quiet emotions and relaxed muscles, and ultimately promoting a quiet body.20
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