“Breath work is the foundation for stress management,” says Alistair Hawkes, a licensed professional counselor and certified Clarity Breathwork practitioner in Lakewood, Colorado.
What Is Breath Work?
Breath work refers to deep, diaphragmatic breathing or belly breathing, which research suggests may trigger relaxation responses in the body, according to a study published in June 2017 in Frontiers in Psychology. Breath work encompasses a range of breathing exercises designed to enhance physical, spiritual, and mental health, according to Yogapedia. Within published research, breath work is commonly referred to in terms of “interventions” such as diaphragmatic breathing, breathing techniques, or even breathing rehabilitation, which we’ve reviewed below. Breath work includes specific breathing practices like Clarity Breathwork and holotropic breathing, which are used more as mind-body therapy, and are associated with particular theories and varying degrees of supportive evidence, according to GoodTherapy.
A Brief Synopsis: The Potential Health Benefits of Breath Work
Research shows a variety of health and wellness benefits and quality of life improvements that intentional breathing (including diaphragmatic breathing, yogic breathing, and other breathing exercises) may provide for people experiencing certain health conditions and concerns. Breath work may:
Reduce stress and aid in stress-related medical illnesses, anxiety, depression, and substance abuse, according to a review in the Journal of Alternative and Complementary MedicineAlleviate post-traumatic stress disorder (PTSD), according to a study in the Journal of Traumatic StressImprove immune response, according to a study published in PLoS OneMitigate asthma symptoms, according to a meta-analysis published in March 2020 in Cochrane Database of Systematic ReviewsDecrease hypertension in adults, according to a review published in May 2021 in Complementary Therapies in Clinical PracticeAid with COPD rehabilitation, according to a review published in March 2022 in the International Journal of Chronic Obstructive Pulmonary DiseaseAid glycemic control in people with type 2 diabetes, according to a study in the January 2021 International Journal of Yoga TherapyImprove the quality of life in people with cardiovascular disease and cancer, according to a study published in May 2020 in International Journal of Yoga (IJOY)
Many recent studies, including a systematic review published September 2018 in Frontiers in Human Neuroscience, have found that breath work reduces anxiety, sharpens memory, treats symptoms of depression, promotes more restful sleep, and even improves heart health. By the way, breath work isn’t new. As Hawkes points out, “Western science is patting itself on the back for saying breath work works, whereas [some] people have been doing this for [millennia].” “Each tradition has a different aim for the meditation practices it introduces, so each will have associated ways of offering techniques for working with the breath,” says Lodro Rinzler, a Buddhist meditation teacher and a cofounder of MNDFL, a chain of meditation studios in New York City.
The Science of Breath
“We all breathe all the time. The way that we breathe is what makes the difference — how we breathe,” says Jessie Taylor, a cofounder and the director of education at the Mindfulness Center, an online wellness platform primarily based in Washington, DC, Maryland, and Virginia, with services like training programs, telehealth, classes, and workshops worldwide. One well-researched breath work technique is diaphragmatic breathing. What makes it special is the way it can influence the entire body, especially the nervous system, according to a study published in June 2018 in Cureus. When we are under stress — whether running from a predator or dealing with a particularly frustrating email — the brain turns on the sympathetic nervous system (SNS), which governs the flight, fight, or freeze response. You’ll notice the activation of your SNS if you have shallow breathing, tense shoulders, increased blood pressure, or an upset stomach. Countering the SNS is the parasympathetic nervous system (PNS), or the rest-and-digest response: essentially, your body in a state of calm. Hawkes and Taylor both describe a process called thalamic gating, which according to the Encyclopedia of Clinical Neuropsychology is when the executive functions of the brain get turned off to aid in escaping danger. These functions may also be deactivated by diaphragmatic breathing, according to a study published in October 2020 in Medicines, which posits that deep breathing may act as a manual switch to move your system from the SNS into the PNS. In other words, from a state of stress to a state of calm. For example, when you release tension with a big sigh or exhalation, you may be able to reverse the fight-or-flight response and slip into a state of relaxation. “A sigh of relief releases carbon dioxide and literally changes the biochemistry in your brain,” explains Taylor.
4 Diaphragmatic Breathing Tips for Beginners
As you prepare to try deep-breathing practices, here are a few things to keep in mind.
1. Take It Easy at the Start
“The most important thing is to start slow, start small, and work your way up. You want to condition your nervous system,” explains Hawkes. “You can’t go run a marathon when you haven’t run a mile.” She says beginners should set a timer for one minute and avoid long meditations. Increase the time as you get used to breath work.
2. Move the Breath to the Belly
Deep breathing won’t make your shoulders or upper chest move dramatically. A sign that you’re engaging your diaphragm is that your lower abdomen is filling and emptying. Place a hand on your belly and practice pushing it in and out.
3. You Can’t Really Do It Wrong
“Whatever technique it is, just the fact that we are paying attention to our breath bridges the gap from the sympathetic and parasympathetic nervous systems,” says Taylor. At its most basic level, breath work floods the brain with oxygen and removes larger amounts of carbon dioxide — you can’t mess that up.
4. Find a Breath Work Practice That Resonates With You
The ultimate goal of your breath work practice is to activate the PNS, and there are many techniques that can help you achieve that. Hawkes says it’s all about finding the one you like and can use consistently.
Breath Work Practices for Beginners
Here are a handful of meditative breathing techniques and how they may help you promote health and relaxation in your body, no matter what’s going on around you.
1. Dirga Pranayama, aka Diaphragm Breathing
What it is: The most basic breath work practice Hindu in origin, pranayama is the type of breathing you might learn in a yoga class or with a licensed breath work practitioner. It refers to slow, deep breathing. Located at the bottom of your lungs, the diaphragm is the most efficient muscle for breathing, and for people with healthy lungs, it does about 80 percent of the work it takes to breathe, according to the American Lung Association. A systematic review published in August 2020 in IJoY found that pranayamic breathing helped reduce the frequency of attacks and medication required by people with asthma. Another study, published in the International Journal of Preventive Medicine, showed this breathing technique reduced stress and anxiety, improved autonomic and higher neural center functioning, and even improved the physical health of cancer patients. How to do it: This type of breathing can be performed sitting up or lying on your back.
2. Sama Vritti Pranayama With Antara Kumbhaka and Bahya Kumbhaka, aka Box Breathing
What it is: Intermittent breath retention Kumbhaka pranayamas are a type of breathing exercise in which you hold your breath after inhaling and exhaling. Holding air in the lungs after inhaling is called antara (inner) kumbhaka, and momentarily holding the breath after exhaling is called bahya (outer) kumbhaka. According to Forbes, some Navy SEALs use this technique, referred to as box breathing, to stay calm when in physical peril. A study published in the International Journal of Health Sciences & Research found that 4-7-8 breathing, a type of intermittent breath retention where, in general, you inhale for the count of four through your nose, hold your breath to the count of seven, and exhale through your mouth for a count of eight, was effective in reducing breathlessness, anxiety and depression in people with moderate COPD. How to do it: You will find a variety of counting patterns if you research box breathing — for example, 4-7-8 or 4-4-4-4 — but beginners should find their own pace, says Taylor. “Count slowly as you inhale and see whatever number you come to and match that at your exhale.” The counting gives the analytical part of your brain something to do that’s focused on the breath. Beginners may find that their number pattern changes each day depending on what your nasal passages will allow.
3. Nadi Shodhana Pranayama, aka Alternate-Nostril Yoga Breathing (ANYB)
What it is: Controlled breathing The name of this Hindu practice can be translated as “channel purifying,” and it’s a gentle exercise that’s good for people who don’t want to simply sit still during meditation. This technique involves breathing through one nostril at a time, while manually closing the other nostril, to facilitate alternate breathing and airflow. According to a study published in July 2019 in Journal of Education and Health Promotion, participants with hypertension who used ANYB exercises twice a day (10 minutes each time) for five days saw a marked reduction in systolic and diastolic blood pressure, and improved heart rate, compared with a control group. In a small randomized controlled trial of 30 people published in May 2020 in Frontiers in Psychiatry, ANYB was a component of the yoga respiratory practice bhastrika pranayama, taught to healthy young adult participants. At the beginning and end of the study, researchers assessed participants’ anxiety and mood, and conducted MRIs to analyze their brain activity. The results suggested significant reductions in anxiety and improvements in mood levels after breathing exercises. Researchers also found that after four weeks of bhastrika pranayama practice, participants showed changes in the activity of brain regions involved in emotional processing. How to do it: In this practice, you will breathe through just one nostril at a time. No breath will come in or out of your mouth.
4. Ujjayi Pranayama, aka Ocean Sounding Breath
What it is: Audible breath Sanskrit for “victorious breath,” ujjayi is another pranayama (yoga breathing) technique. Ujjayi generates a “haaa” sound on the exhale. How to do it: It’s recommended that you do ujjayi pranayama while sitting up, according to the National Center on Health, Physical Activity, and Disability (NCHPAD).
5. Buteyko Breathing Technique (BBT)
What it is: Nasal breathing retraining to repair hyperventilation Created in the 1950s by a Ukrainian doctor named Konstantin Buteyko, this technique is a good option for those who experience asthma or panic attacks. It focuses on creating “air hunger” to normalize breathing — basically relaxing the diaphragm until you feel the lack of air. The goal is to breathe more gently and slowly and through the nose. A study published in the Egyptian Journal of Chest Diseases and Tuberculosis showed a significant decrease in daily asthma symptoms for participants. Another study, published in Respiratory Medicine, found that participants were able to reduce their use of corticosteroids for their asthma treatment after using BBT for six months. How to do it: There are more advanced versions of BBT, but consider working with a certified Buteyko practitioner to deepen your understanding of the technique and develop your at-home practice.
6. Hasyayoga, aka Laughter Yoga
What it is: Intentional, manufactured laughter It’s been said laughter is the best medicine, and a study published in May 2021 in Current Research in Physiology found that laughter uplifted participants’ mood, improved respiratory function, improved circulation, and lowered stress levels. Laughing releases feel-good brain chemicals like dopamine, oxytocin, endorphins, and serotonin. Popularized by Madan Kataria, a physician in India, laughter yoga is perhaps one of the more playful breath work techniques. In the same way that the brain can’t sort perceived danger from real danger, it can’t tell the difference between manufactured laughter and real laughter, so even if you’re faking it, you may still receive benefits like:
Reduced anxiety, improved self-esteem, and increased happiness, according to a study published in October 2019 in International Journal of Environmental Research and Public HealthRelief from gastrointestinal issues, according to the results of a trial published in October 2019 in the Middle East Journal of Digestive DiseasesPossibly even reduction in body weight, according to a study of 235 mostly female Japanese participants ages 43–79 published in April 2022 in BMC Geriatrics
How to do it: You could simply start spontaneously laughing, smiling, and clapping to get the benefits of this practice, but if you’d like to follow a more regimented approach, try these steps.
7. Heart Rate Variability Biofeedback (HRVB With Breathing Awareness)
What it is: Biofeedback therapy training If seeing is believing for you, HRVB is a biofeedback tool that can show you that your breathing is getting deeper. The goal of HRVB is to have your breathing match your heart rate patterns. A study published in March 2021 in the International Journal of Environmental Research and Public Health found HRVB may help reduce symptoms of depression, stress, and anxiety. Other recent findings, like this review published in June 2021 in Complementary Therapies in Medicine and this meta-analysis published in March 2021 in Scientific Reports, have found improvements in quality of life for those with chronic diseases, in addition to overall increased mental health. How to do it: If you’re working with a biofeedback specialist, you’ll be hooked up to a few monitoring devices, but you can do an at-home version as well. You’ll need a tool that will measure your heart rate — many smart watches and apps have this feature.
