Immediate Effect of Modified Bhramari Pranayama on Salivary Nitric Oxide Level among Type 2 Diabetes Mellitus with Xerostomia: A Randomized Controlled Trial.

Abstract

Background: Type 2 diabetes mellitus (T2DM) is frequently associated with xerostomia, a condition characterized by reduced salivary flow and a sensation of dry mouth. Nitric oxide (NO) plays a vital role in vasodilation and immune modulation. Modified Bhramari Pranayama (MBhrP), a specific yogic breathing technique, has been reported to enhance endogenous NO production.

Objective: The primary aim of this study was to assess the immediate effect of MBhrP on salivary NO levels in T2DM individuals with xerostomia. The secondary objective was to evaluate its effect on heart rate variability (HRV), an indicator of autonomic nervous system activity.

Methodology: Sixty-eight eligible participants were randomized into two groups: MBhrP group (n = 34) and the control group (n = 34). Participants were assessed using a close-ended questionnaire, including the Fox test and Xerostomia Inventory, to confirm the presence and severity of xerostomia. The intervention group performed MBhrP for 20 min between 6 AM and 7 AM, while the control group engaged in slow breathing for the same duration. Salivary NO levels and HRV parameters were assessed at baseline and immediately postintervention.

Results: The MBhrP group showed a statistically significant increase in salivary NO levels compared to the control group (P < 0.05). HRV parameters SDRR (P = 0.02), root mean square of successive differences (P < 0.001), and pRR50 (P = 0.004) also showed significant improvement.

Conclusion: MBhrP appears to have an immediate beneficial effect on salivary NO levels and autonomic function in T2DM patients with xerostomia, suggesting its potential as a nonpharmacological therapeutic tool.