Summer Cool Down: Breathing with Sitali and Sitkari

Summer 2025 is already a scorcher and we are only halfway through the season. This May ranked as the planet’s second hottest since 1850.(14) The New York Times is tracking daily heat waves around the globe, while the UK Met Office has predicted that 2025 will be one of the hottest years on record.(7)(8)

Heat-related illnesses can affect anyone, but older adults, children, pregnant individuals, and those with heart or lung conditions are especially vulnerable. Signs of heat exhaustion include muscle cramping, excessive sweating, shortness of breath, headaches, weakness, dizziness, and nausea. Two of the best ways to stay safe during the heat are to drink plenty of water and seek shade or air-conditioned spaces.(2)(3)

Another simple way to cool the body is through the pranayama techniques of sitali and sitkari. These are among the eight classical Hatha pranayamas and are the only ones that involve inhaling through the mouth.(12) Also known as Sheetali and Sheetkari, they are cooling pranayamas and are essentially the same, with one key difference.

Due to variations in human anatomy, sitali uses a rolled tongue during the inhale, while sitkari does not. The original yogis recognized that not everyone can roll their tongue, which is why sitkari was developed as a complementary practice. In both techniques, the exhale is through the nose with the mouth closed, and they can even be practiced in an alternate nostril breathing pattern.

While generally safe, sitali and sitkari do come with a few precautions. Those with low blood pressure should avoid them, and they should only be practiced in clean air, ideally indoors. Because the inhale bypasses the nose’s natural filtration system, the practitioner is more exposed to airborne contaminants.

Sitali and Sitkari Pranayama

The purpose of any pranayama is to guide our awareness to “where the breath is in the body.” The act of intentionally directing our attention strengthens the brain, which in turn enhances “the physical effects of whichever pranayama technique we are practicing.”(5)

For example, sitali typically is translated to mean “cool” while sitkari is translated to “that which causes cold.” The main physical effect we are creating with these practices is to cool the body.(5)(6) Interestingly, they are believed to help reduce the sensation of thirst.(6)

Like many pranayamas, sitali and sitkari calm the sympathetic nervous system, bringing a sense of ease to both body and mind. Not only are they effective for cooling down, but they also serve as wonderful breathing techniques to prepare for meditation. Another benefit is their potential to help lower blood pressure.

These pranayamas are also ideal for post-workout recovery. They cool the body, center the mind, and slow the breath; supporting a smooth transition from exertion to rest.(9)

It’s recommended to practice sitali and sitkari while seated, rather than reclining or standing. They’re versatile techniques that can be done with or without breath retention, and be combined with alternate nostril breathing. The practice doesn’t need to be long; just 3 to 5 minutes is often enough to feel their cooling effects.

How to Breathe with Sitali

To breathe in sitali pranayama, begin by sitting tall with a long spine. Let the shoulders soften away from the ears, creating space through the neck. The body should feel upright yet relaxed.

For the inhale, extend the tongue slightly out of the mouth and curl the sides upward to form a straw-like shape. It may resemble the letter “O” or “U.” 

Inhale slowly through the curled tongue. As the air flows over the moist surface, it cools before entering the body. You may hear a gentle “ssssss” sound as you breathe in. 

For the exhale, draw the tongue back into the mouth, close the lips, and breathe out through the nose. Pressing the tongue gently against the upper palate can help prevent dryness. If the mouth begins to feel dry, swallow naturally or take a sip of water.

How to Breathe with Sitkari

Sitkari is very similar to sitali, with one key difference: the shape of the tongue.

For the inhale, part the lips slightly while keeping the upper and lower teeth gently touching but not clenched. The tongue remains flat inside the mouth or forms a subtle “V” shape.

Inhale through the teeth and tongue. As with sitali, the air is cooled as it passes over the moist surfaces, and a soft “ssssss” sound may accompany the breath.

Exhale through the nose with the mouth closed, placing the tongue against the upper palate to retain moisture.

Risks of Sitali and Sitkari Pranayama

Even though sitali and sitkari pranayama are considered safe, beginner breathing techniques, there are some cautions. They are not recommended for those with low blood pressure (also known as hypotension), lung or respiratory conditions (short- or long-term), or those with a cold, nasal/sinus congestion, or conditions affecting the tonsils or throat. 

If the practitioner has a heart condition, then there should be no breath retention performed with either of the pranayamas. Iyengar cautions that “those with high blood pressure may find greater strain with sitkari than sitali.”(6)

Those with severe anxiety or uncontrolled blood pressure also shouldn’t use a breath retention phase. The Cleveland Clinic defines uncontrolled blood pressure as above 140/90 mm Hg and/or when the condition has either been untreated or treatments are ineffective.(4)

Sitali and sitkari should not be practiced in cold, damp environments. This could lead to respiratory discomfort or a sense of overcooling or coldness. 

And because they are mouth-breathing techniques, the air and environment should be clean. Both practices should be avoided by those with allergies or asthma, as breathing unfiltered air could aggravate the conditions. 

The cooling breath may cause discomfort if you have sensitive teeth, gums, ulcers, or wear dentures. 

Even though some sources say the pranayamas can help with digestion, they can also have a negative effect on those experiencing bloating or constipation.(9)(10)

Sitali and Sitkari: Healing the Heart

While scientific studies confirming the cooling effects of sitali and sitkari are still limited, there is growing research on their impact on high blood pressure, also known as hypertension. In 2020, the journal Complementary Therapies in Clinical Practice published a randomized controlled study examining the effects of sitali pranayama on individuals diagnosed with high blood pressure. Hypertension not only places added strain on the heart but also activates the sympathetic nervous system (the fight-flight-freeze response), which increases inflammation and stress.

A total of 100 participants were divided equally into two groups. The control group only followed their prescribed medical regimen while the experimental group also followed a prescribed sitali pranayama regimen. There is no mention of sitkari pranayama; one can only assume that everyone in the study can roll their tongue. The abstract of the study does not mention how long each sitali session was nor how often it was practiced (daily, weekly, etc.).

Over the course of three months, researchers measured blood pressure and heart rate variability before and after the intervention. The results were promising:

• Participants who practiced sitali showed a significant reduction in blood pressure.

• Heart rate variability improved, indicating better autonomic balance.

• There was a marked shift toward parasympathetic nervous system dominance, suggesting reduced stress levels.

• No adverse effects or conflicts of interest were reported.

The researchers concluded that when used alongside conventional medication, sitali pranayama can be an effective complementary therapy for managing hypertension.(13)

A 2017 study published in Integrative Medicine: A Clinician’s Journal further supports these findings. This randomized controlled trial included 60 individuals with hypertension, ages 25 to 65. Unlike the previous study, this one incorporated both sitali and sitkari pranayamas. 

The participants were also divided equally into control and experimental groups. The experimental group practiced either sitali or sitkari for 10 minutes daily over 30 days. The results also showed reductions in blood pressure and an increase in parasympathetic dominance, plus an improved respiratory rate.(11)

These findings reinforce the value of these practices for cardiovascular health. However, because of the effect these pranayamas have on reducing blood pressure, those with low blood pressure (hypotension) should not practice sitali nor sitkari. 

Concluding Thoughts 

Extreme heat can have a devastating impact on our health. The cooling pranayamas of sitali and sitkari offer a gentle, accessible way to cool the body down and bring ease to the heart space. By toning the parasympathetic nervous system, they help reduce the body’s stress response while cultivating a calm, grounded presence that supports us through the intensity of summer.

There are many yogic ways to stay cool in the heat. Other cooling pranayamas include Bhramari (humming bee breath) and Chandra Bhedana (left nostril breathing). Meditation offers an introspective path to cooling the body from within, while yin and restorative yoga provide movement without generating excess heat.

Sitali and sitkari are the perfect pairing of summer pranayamas. They’re not only ideal on hot days, but also after vigorous activity; offering a moment to cool down and recover.

Sitali and sitkari remind us that breath is more than just air. Breath is awareness, healing, and presence. Through pranayama, we explore the subtle relationship between body, breath, and mind while discovering that even in the heat, we can find ways to chill.

Explore sitali and sitkari pranayama with Cultivating Chill’s guided practice.

Bibliography

1 - Bhavanani, Ananda B. “Basic Practice of Some Pranayamas.” Yoga Life, International Centre for Yoga Education and Research (2003): 1-7.

2 - Center for Disease Control and Prevention. “About Heat and Your Health.”

3 - Center for Disease Control and Prevention. “Protect Yourself From the Dangers of Extreme Heat.”

4 - Cleveland Clinic. “Resistant Hypertension.”

5 - Desikachar, T.K.V. The Heart of Yoga, 61-62. Inner Traditions International, 1995.

6 - Iyengar, B.K.S. Light on Yoga, 451-453. Schocken Books, 1979. 

7 - The Met Office (UK). “2025 Outlook: In Top Three Warmest Years on Record.”

8 - The New York Times. “Tracking Heat Across the World.”

9 - Prana Sutra. “Sheetali Pranayama | Cooling Breath in Yoga.”

10 - Prana Sutra. “Sitkari Pranayama (Hissing Breath) in Yoga – How to Practice, Benefits, and Safety Tips.”

11 - Shetty, Prashanth, Kiran Kumar Reddy, D.R. Lakshmeesha, Shiva Prasad Shetty, Selva Kumar, and Ryan Bradley. “Effects of Sheetali and Sheetkari Pranayamas on Blood Pressure and Autonomic Function in Hypertensive Patients.” Integrative Medicine: A Clinician’s Journal 16, no. 5 (2017): 32-37.

12 - Swami Satyananda Saraswati. Asana Pranayama Mudra Bandha, (Digital copy, PDF Pages 399, 401). Bihar Yoga Bharati, 1996.

13 - Thanalakshmi, J., K. Maheshkumar, R. Kannan, L. Sundareswaran, V. Venugopal, and S. Poonguzhali. “Effect of Sheetali Pranayama on Cardiac Autonomic Function Among Patients with Primary Hypertension - A Randomized Controlled Trial.” Complementary Therapies in Clinical Practice 39 (2020).

14 - Yale Climate Connections. “May 2025 was the Planet’s Second-Warmest on Record.”

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