Breathing exercises are techniques that involve intentionally changing the way you breathe to promote relaxation and reduce stress.
For individuals withanxiety disorderslikegeneralized anxiety, these exercises can be a powerful tool for bothimmediate reliefand long-term management.
By focusing on slowing down and deepening the breath, breathing exercises activate the body’s natural relaxation response, helping to calm the mind and reduce physical symptoms of anxiety in the moment.
When practiced regularly, these techniques can also help to improve overall emotional regulation and resilience to stress over time.
As part of a comprehensivetreatment plan, they can be a valuable strategy for anyone looking to better manage their anxiety and improve their quality of life.
Breathing exercises offer a simple, accessible, and effective way to cope with anxiety symptoms and cultivate a greater sense of control and well-being.
Key Points
Rationale
Breathwork has emerged as a potential mind-body intervention for well-being, but there is limited comparative data on the effects of different breathing techniques and how they compare to mindfulness meditation (Lavretsky & Feldman, 2021).
Previous research shows breathing impacts emotional and cognitive states (Boiten et al., 1994; Yilmaz Balban et al., 2021), so directly comparing structured breathing exercises to mindfulness meditation, which does not control breath, can elucidate their differential effects on mood and physiology.
Method
The study employed a repeated-measures,randomized controlled designconducted entirely remotely during the COVID-19 pandemic.
Procedure
Participants completed baseline trait anxiety and sleep questionnaires.
Participants were randomized into a mindfulness meditation control group or one of three breathwork interventions (cyclic sighing, box breathing, or cyclic hyperventilation with retention). They were then mailed a wearable device to monitor physiological data.
Over the 28-day intervention period, participants completed their assigned 5-minute exercise once daily. Self-report mood and anxiety measures were collected daily before and after the exercises. Text message reminders were sent daily.
Physiological data (heart rate, heart rate variability, respiratory rate) was continuously monitored using a wearable device. After the intervention period, participants again completed the trait anxiety and sleep questionnaires.
Sample
The 108 participants included healthy English-speaking males and females ages 18 and up. Most were recruited from an undergraduate psychology class at Stanford University. Those with moderate to severe psychiatric, medical, or substance use disorders were excluded.
Measures
Statistical Analysis
Average daily change scores were compared between groups using linear mixed effects models.
Changes in physiological measures were calculated as the slope of daily values over the 28 days and compared between groups using Mann-Whitney U tests.
Pre-post changes in trait anxiety and sleep impairment were compared using Wilcoxon tests.
Results
Insight
This study demonstrates that even brief daily breathwork practice can have a meaningful impact on mood and physiology compared to mindfulness meditation.
The findings suggest the importance of the specific mechanics of breathing, with an emphasis on extended exhalation in the cyclic sighing technique producing the greatest improvements in positive affect and respiratory rate.
This aligns with previous research on the psychological and physiological impacts of sighing.
The results also show these effects can occur with minimal daily practice of 5 minutes, increase with more practice over time, and can be captured using remote study designs and wearable monitoring devices.
Further research should explore the brain mechanisms underlying these different breathing practices and their long-term effects.
Strengths
This study had several methodological strengths, including:
Limitations
Despite its strengths, this study also had several limitations, including:
Implications
This study provides evidence that voluntary controlled breathing exercises, especially those emphasizing prolonged exhalation, can have meaningful effects on mood and physiology even with very brief daily practice.
This offers a highly accessible tool for stress management andemotional regulationthat could be easily incorporated into daily life or clinical practice.
The fact that these effects were found in a non-clinical sample also suggests potential for prevention and wellness promotion.
Remote study designs using wearable devices to monitor outcomes are a feasible way to study these practices that can enable more diverse participant recruitment.
Future studies should prioritize more mechanistic measures to understand how these practices impact the nervous system, as well as longer-term follow-up to assess the durability of effects. Research in clinical populations is also needed.
References
Boiten, F. A., Frijda, N. H., & Wientjes, C. J. (1994). Emotions and respiratory patterns: review and critical analysis.International Journal of Psychophysiology, 17(2), 103-128.https://doi.org/10.1016/0167-8760(94)90027-2
Lavretsky, H., & Feldman, J. L. (2021). Precision medicine for breath-focused mind-body therapies for stress and anxiety: are we ready yet?.Global Advances in Health and Medicine, 10, 2164956120986129.https://doi.org/10.1177/2164956120986129
Yilmaz Balban, M., Cafaro, E., Saue-Fletcher, L., Washington, M. J., Bijanzadeh, M., Lee, A. M., Chang, E. F., & Huberman, A. D. (2021). Human responses to visually evoked threat.Current Biology, 31(3), 601-612.https://doi.org/10.1016/j.cub.2020.11.035
Keep Learning
Here are some reflective questions related to this study that could prompt further discussion:
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
