The Valsalva Maneuver

A controlled exhale against a closed airway to stimulate the vagus nerve and reset cardiac rhythm.

Cardiology / Emergency Medicine for vagal response; adapted in movement for physiological regulation. · Valerius Cordus (16th Century, though detailed by Antonio Valsalva and modernly applied in vagal maneuvers) · Rapid heart rate, anxiety, dysregulation, need for immediate physiological deceleration. · Perform 1-3 repetitions as needed, with 60 seconds of normal breathing in between. Start with shorter holds (5 seconds) and gradually increase to 10 seconds as comfortable. Not recommended for daily, sustained practice without specific medical guidance; rather, it is a targeted intervention.

Why it works

The Valsalva Maneuver increases intrathoracic pressure, which initially increases blood pressure and then, upon release, causes a compensatory drop in blood pressure and heart rate. This pressure change activates baroreceptors, subsequently stimulating the vagus nerve. Vagal nerve activation is a primary mechanism for shifting the autonomic nervous system towards a parasympathetic (rest and digest) state, promoting physiological calm. This physiological braking mechanism helps to re-establish cardiac rhythm and reduce sympathetic overdrive.

How to practice

1. Preparation: Sit comfortably with a straight spine or lie down. Ensure your airway is clear.

2. Inhale: Take a normal to slightly deeper breath through your nose.

3. Hold and Strain: Exhale gently against a closed glottis (the vocal cords are closed, as if you are trying to blow up a balloon or bear down for a bowel movement). Do not exhale forcefully or for an extended period if you are new to this practice. Aim for a gentle strain.

4. Duration: Hold this gentle strain for 5-10 seconds. You should feel pressure in your chest and possibly your head.

5. Release: Gently release the breath and relax. Do not gasp for air.

6. Recovery: Breathe normally for 30-60 seconds, observing the sensation in your body, particularly your heart rate.

7. Preparation: Sit comfortably with a straight spine or lie down. Ensure your airway is clear.

8. Inhale: Take a normal to slightly deeper breath through your nose.

9. Hold and Strain: Exhale gently against a closed glottis (the vocal cords are closed, as if you are trying to blow up a balloon or bear down for a bowel movement). Do not exhale forcefully or for an extended period if you are new to this practice. Aim for a gentle strain.

10. Duration: Hold this gentle strain for 5-10 seconds. You should feel pressure in your chest and possibly your head.

11. Release: Gently release the breath and relax. Do not gasp for air.

12. Recovery: Breathe normally for 30-60 seconds, observing the sensation in your body, particularly your heart rate.