Authors: Therabody Scientists: Tim Roberts, MSc; Kyle Silvey, PhD; Michelle Darian, MS, MPH, RD, LDN

Breathing is essential to life — you can only survive for a few minutes without it. Breathwork is gaining popularity as an approachable tool with numerous health benefits. In fact, regular breathwork has been shown to improve stress and mood, lower resting heart rate and blood pressure, and more. Read on to discover the benefits of targeted breathing exercises.

What is Breathwork? 

Breathwork refers to the practice of using targeted, intentional breathing exercises. It is scientifically shown to induce relaxation and improve stress and mood. [1, 12] There are many ways to practice breathwork, ranging from timed inhales and exhales to deep belly breaths.

Controlled breathwork has been a staple in Eastern cultures for thousands of years and was often combined with yoga and or meditation sessions. [2, 3] In the late 1800s, these types of breathing exercises became common in Western societies. Fast forward to the present day, breathwork is discussed on health and science podcasts, dedicated breathwork apps enter the market, and wellness technologies leverage breathwork’s benefits. 

There are many use cases for breathwork. At work, breathing exercises like box breathing can sharpen focus while under pressure. And when it’s time to unwind for the evening, 4-7-8 breathing can relax and prepare the body for sleep. Everyone can reap the stress-relieving and mind-focusing benefits of slow-breathing exercises. Breathwork provides accessible tools to reduce anxiety, improve concentration, and promote wellness when practiced regularly. 

How Does Breathwork Work? 

To understand how breathwork provides health benefits, it’s important to understand the fundamentals of breathing. 

Breathing is essential to survival. It is so important that it takes place without thought, as it is dictated by the autonomic nervous system, much like your heartbeat. [4] But what’s interesting about breathing is that while it happens automatically, you can intentionally control it at any moment. Breathing is one of the few processes that occurs both consciously and unconsciously. 

When you inhale, your diaphragm muscle contracts and moves downward. This expands your lung capacity, allowing you to take air into your lungs. As you breathe in, you inhale oxygen, which travels down your airways. The oxygen makes its way to tiny air sacs in your lungs called alveoli and diffuses into the blood vessels surrounding them. This replenishes your blood with fresh oxygen. At the same time, waste carbon dioxide diffuses out of your blood and into the alveoli, releasing carbon dioxide from your body. [4]

When you exhale, your diaphragm muscle relaxes and moves upward. As you breathe out, the carbon dioxide collected in your lungs from your blood is expelled along with the breath. Your blood, now replenished with oxygen, can circulate to deliver oxygen to cells throughout your body. And the cycle repeats with each new breath. [4]

Breathwork Can Switch a Stress State to a Relaxation State

The autonomic nervous system controls functions in the body that occur unconsciously, like breathing, digestion, and the heartbeat. However, the autonomic nervous system has two branches: the parasympathetic and sympathetic nervous systems. [5]. Due to the different types of effects breathwork can have, certain modalities can activate and downregulate both the parasympathetic and sympathetic branches of the nervous system. While many nervous system functions occur automatically, the duration and intensity of breathing can be controlled at any point. 

Parasympathetic nervous system: This is often referred to as the “rest and digest" system. The parasympathetic nervous system is responsible for calming the body; for instance, it slows the heart rate and lowers blood pressure, relaxing the body. Breathing deeply and slowly, allowing the diaphragm to expand and contract on each inhale and exhale, stimulates the parasympathetic system. As you inhale deeply through the nose, receptors send signals via the brain to activate parasympathetic relaxation pathways, lowering stress in the body. [5]

Sympathetic nervous system: This is often referred to as the “fight-or-flight response," which prepares the body to take action against a stressor. The sympathetic nervous system raises heart rate, increases blood pressure, and primes the body for action. Quick, shallow mouth breathing is linked to sympathetic activation. Short inhales signal the brain to release adrenaline, preparing the body to take quick action. This is beneficial in instances like during exercise to propel you forward. But this can also heighten the stress response. [5]
In times of stress, breathwork can consciously switch the body from a sympathetic to a parasympathetic state. You can do so by intentionally exhaling longer than inhaling, breathing deeply and slowly from the diaphragm. [5]

What Are the Benefits of Slow Breathwork? 

There are many scientifically supported benefits of breathwork. There are instances when slow breathing is preferred, and certainly instances when shorter, quicker, and more forceful inhales and exhales, may be more optimal to prime the body for activity. For the purposes of this article, the health benefits of slow breathwork, defined as taking less than ten breaths per minute, are covered. 

Studies show that slow breathing can lower heart rate and blood pressure, reduce stress and symptoms of anxiety, improve energy and focus, and more. Here are the health benefits of slow breathwork. 

Lower Heart Rate 

Slow, deep breathing exercises can stimulate the parasympathetic nervous system and lower heart rate. A reduction in heart rate can immediately reduce mental and physical stress and benefit heart health long-term. [6] 

Increased Heart Rate Variability

Heart rate variability (HRV) refers to the variation in time between each heartbeat. HRV is often thought of as a marker of stress, where higher HRV levels are generally associated with better stress management. Increased variability between heartbeats indicates that the heart is better able to adapt to changing conditions and stressors. This is critical, as you can change from a relaxed state to a stressed one quickly — and the heart’s ability to compensate can help strengthen it. 

Slow, deep breathwork stimulates the parasympathetic nervous system, which facilitates HRV. Through breathing exercises, people can improve HRV, which promotes stress resilience, self-regulation, and heart function. [7]

Lower Blood Pressure 

Slow, deep breaths can also lower both systolic and diastolic blood pressure levels. Deep breaths increase the amount of oxygen that enters blood vessels, widening blood vessels and improving blood flow and circulation, lowering blood pressure. Slow breathwork switches the body from a fight-or-flight sympathetic state to a relaxed one. A study of 24 healthy men found that slow and controlled breathing (six deep breaths per minute) was associated with a significant reduction in blood pressure compared with spontaneous breathing. [8]

Regular conscious breathwork can be a simple yet effective way to promote heart health through improvements in heart rate, heart rate variability, and blood pressure. [9] 

Lower Stress Levels

Slow, deep breaths stimulate relaxation, which counters the fight-or-flight stress response. Studies show that conscious slow breathing reduces common markers of stress like blood pressure, heart rate, and heart rate variability. [9] 

Experiencing stressful scenarios is inevitable, and increasing focused awareness of the breath helps build resilience against stress. The body can be trained to maintain awareness and control as stress arises. 

In one study, a group of police officers used biofeedback training, a technique that trains people to improve their health by controlling certain bodily processes that normally happen involuntarily, to understand how slow, deep breathing could improve the stress response during a stress-inducing virtual reality game. As breathing slowed and deepened, the less constrained participants’ vision became, facilitating accurate and controlled responses. [10]  

Reduced Symptoms of Anxiety

Slow deep breathing can reduce symptoms of anxiety and depression in those who experience these conditions. [11] A meta-analysis (a study that analyzes multiple studies) of breathwork interventions found that controlled breathwork was associated with lower stress levels than their respective control groups. The same analysis also found that breathwork was associated with reduced self-reported symptoms of anxiety and depression. [12]

Improved Mood

Breathing exercises have been demonstrated to improve mood meaningfully. The conscious regulation of breathing enhances awareness and triggers a relaxation response, which boosts mood. A 2023 randomized-controlled trial found that breathwork, specifically five minutes of cyclic sighing (prolonged exhalations) daily, significantly improved mood, even more so than mindfulness meditation. [13]

Increased Attention and Focus

Studies have found conscious breathwork practices can increase attention levels and focus. Deep, diaphragmatic breathing increases oxygen intake, delivering more oxygen to the blood. This fuels the body’s cells, leading to natural boosts in physical and mental energy.

A study found that practicing deep breathing (four breaths per minute) for 20 sessions over eight weeks effectively improved sustained attention, affect, and salivary cortisol levels (a marker of stress). [14] 

How To Practice Breathwork Effectively 

When practicing breathwork, aim to engage the diaphragm in each breath. Diaphragmatic breathing, also known as “belly breathing" or “abdominal breathing," is an efficient breathing method. Engaging the diaphragm expands lung capacity, allowing air to flow easily to the lungs. 

To get started with breathwork, try practicing in a comfortable setting. 

1. Find a comfortable seated position and sit up straight. 
2. Put one hand on your chest and the other on your belly. 
3. Inhale slowly through your nose, feeling your belly push out against your hand. 
4. Exhale slowly through the mouth, feeling your belly come back in towards your spine. 
5. Repeat for at least five deep, slow breaths.

Diaphragmatic breathwork is a scientifically proven way to reduce stress levels. [15]

Type of Breathing Exercises

There are many different ways to practice breathwork through various breathing exercises. The duration and intensity of breathing can alter the state of the mind and body, offering health benefits.

Here are five common breathing exercises, how to implement them, and the optimal scenarios to implement them in. 

Box Breathing Exercise 

The box breathing exercise follows the pattern: inhale, hold, exhale, hold; each for four seconds. Visualizing the breath moving from one box’s corner to the next can be helpful. [13]

To implement the box breathing exercise: 

1. Breathe in for four seconds 
2. Hold your breath for four seconds 
3. Breathe out for four seconds 
4. Hold for four seconds 
5. Repeat 

The box breathing method can be used as stressful moments arise to bring you back to a more relaxed state. 

4-7-8 Breathing Exercise 

The 4-7-8 breathing exercise follows an inhale, hold, exhale pattern for the durations of its name. 

To implement the 4-7-8 breathing exercise: 

1. Breathe in for four seconds 
2. Pause for seven seconds 
3. Exhale for eight seconds 
4. Repeat

The 4-7-8 breathing exercise can be used to relax the body and prepare for sleep. 

0.1Hz Breathing Exercise

The breathing exercise known as 0.1Hz follows the idea that through breathing, one’s respiratory rate can slow down to a frequency around 0.1Hz, which can calm the body. [16] 

To implement the 0.1Hz breathing exercise: 

1. Breathe in for five seconds 
2. Breathe out for five seconds 
3. Repeat 

The 0.1Hz breathing exercise can be used during and after a workout to return the body to a relaxed state. When used during a workout, 0.1Hz breathing can help the body recover before the next burst of exercise. After a workout, 0.1Hz breathing can improve post-workout recovery. [16] 

Cyclic Physiological Sighing 

Cyclic physiological sighing involves taking deep breaths and then breathing out slowly. This breathing exercise is characterized by having exhales that are longer in duration than inhales. [17]

To implement the cyclic physiological sighing breathing exercise: 

1. Take a deep breath in 
2. Breathe out slowly, for a longer duration than the inhale
3. Repeat

Research shows that sighing is linked to feeling relieved, changes in automatic body functions, and resetting breathing rates to a slower baseline. [13, 17]

Key Takeaways

• Breathwork refers to the practice of using targeted, intentional breathing exercises.
• Breathing is an automatic process, yet it can be controlled at any time through intentional breathwork to induce relaxation. 
• Breathing exercises have a range of benefits, from lowering heart rate and blood pressure to reducing stress and anxiety symptoms. 
• There are many ways to practice breathwork, ranging from timed inhales and exhales to deep belly breaths.

References

1. https://pubmed.ncbi.nlm.nih.gov/36630953/ 
2. https://pubmed.ncbi.nlm.nih.gov/16624497/ 
3. https://pubmed.ncbi.nlm.nih.gov/15750381/ 
4. https://www.nhlbi.nih.gov/health/lungs/body-controls-breathing
5. https://pubmed.ncbi.nlm.nih.gov/30245619/  
6. https://pubmed.ncbi.nlm.nih.gov/29209423/ 
7. https://pubmed.ncbi.nlm.nih.gov/24063918/ 
8. https://pubmed.ncbi.nlm.nih.gov/15201553/ 
9. https://pubmed.ncbi.nlm.nih.gov/27193228/ 
10. https://pubmed.ncbi.nlm.nih.gov/35222194/ 
11. https://pubmed.ncbi.nlm.nih.gov/36831799/ 
12. https://pubmed.ncbi.nlm.nih.gov/36624160/ 
13. https://pubmed.ncbi.nlm.nih.gov/36630953/ 
14. https://pubmed.ncbi.nlm.nih.gov/28626434/ 
15. https://pubmed.ncbi.nlm.nih.gov/31436595/ 
16. https://pubmed.ncbi.nlm.nih.gov/30010195/ 
17. https://pubmed.ncbi.nlm.nih.gov/24746045/