Breathwork: How It Works, Effectiveness, & Tips for Getting Started

What Is Breathwork?

Breathwork is a practice that has evolved over thousands of years. Pranayamic breathing, or intentional breath control, has been a facet of yoga since its origins over 2000 years ago, and it has long existed outside of formal yoga practice.¹ People still study and practice it today, and formal types of breathwork programs continue to be developed as people seek to harness its healing potential in specific ways.

The underlying philosophy of breathwork is that intentionally changing the way you breathe can directly affect your autonomic nervous system: deactivating the sympathetic nervous system (SNS) responsible for the fight-or-flight reaction and activating the parasympathetic nervous system (PNS) associated with the rest-and-digest, calm response.⁴ Controlled, intentional breathing, often in the form of slow, deep breaths, leads to greater awareness of our emotions and thoughts, improves our flow of energy, and can improve both physical and mental health.

How Breathing Affects the Brain & Body

The human brain constitutes a mere 2% of our total body weight yet consumes about 20% of the oxygen we take in when we breathe.⁶ It needs a consistent and plentiful oxygen supply to operate smoothly for our physical and mental health. The brain interprets a low oxygen supply—the result of shallow, rapid breathing—as a threat or danger, and it activates the sympathetic nervous system (SNS).

When we breathe improperly—breathing too shallowly and rapidly, which is referred to as chest breathing—our oxygen and carbon dioxide levels become unbalanced, and our sympathetic nervous system remains activated. Voluntary, controlled slow and deep breathing, which is one method of breathing enhanced by breathwork, resets the autonomic nervous system, boosts the brain’s oxygen supply, lowers carbon dioxide levels in the blood, slows brain wave activity, and facilitates coordinated, calm activity throughout the systems of the body.^2,8

What Conditions Can Breathwork Help With?

Consistently practicing breathwork affects our entire physiology and not only helps us feel calm temporarily but can keep us calm and composed even in stressful moments.³

Breathwork can help with a variety of conditions, including:^2,3,4,7

• Stress
• Anxiety
• Post-traumatic stress disorder (PTSD)
• Depression
• Anger
• Agitation
• Grief
• General mood management
• Performance (such as athletics or public speaking)
• Mental clarity, focus, concentration
• Chronic pain

What Are the Benefits of Breathwork?

Practicing breathwork brings physical, cognitive, emotional, and spiritual benefits, thus improving overall functioning.¹⁰ Because your breath directly impacts the way your nervous system operates, learning to control how you breathe can help you experience greater well-being.

Coomer stresses that the benefits of breathwork are extensive: “Some of the most commonly researched and reported benefits are reduction in stress, better sleep, improved digestion, improved athletic performance, improved focus, improved sex life, and improved heart rate variability. Your breath is connected to nearly every other aspect of your health and wellness, so it has a plethora of benefits.”

Physical Benefits of Breathwork

When you practice slow, deep breathing, you improve the way your body functions. Practicing breathwork is also linked to relief from chronic pain.³ When we experience pain, we don’t breathe deeply using our primary breathing muscles (the diaphragm and intercostal muscles), but instead use our secondary breathing muscles (located in the chest, shoulders, and neck). Employing breathwork to intentionally use our primary breathing muscles reverses the process and helps us better manage chronic pain.⁹

Here are just some of the physical benefits of breathwork:⁸

• Allows your body to use oxygen more efficiently
• Boosts cardiovascular and respiratory health
• Improves hormone and neurotransmitter functioning
• Facilitates healthy gut functioning
• Increases motor control

Mental Benefits of Breathwork

Breathwork has been found to have a positive impact on mental health. It can regulate mood, sharpen attention and concentration, and improve neuroplasticity, or the ability of brain cells to adapt and change in response to situations we encounter.⁸

Neuroplasticity improves our psychological flexibility, allowing us to pause and respond thoughtfully to problems and challenges rather than reacting emotionally or trying to control life circumstances.¹⁸ Also, breathwork enhances mindfulness and anchors people in the present moment, away from negative thoughts and feelings about the past or the future that contribute to anxiety and depression.

Scientific studies help shed light on the mental health benefits of breathwork:^4,10,14

• A 2017 study published in Frontiers in Psychology involved 40 participants randomly assigned to a breathing intervention group or a control group that did not engage in breathing exercises. In 20 sessions held over 8 weeks, participants learned to deepen and slow their breathing to achieve a rate of four breaths per minute. Upon completion, the majority showed an increase in their ability to concentrate and a decrease in negative moods. Furthermore, blood tests revealed lower cortisol levels in the blood.
• In an article published in 2011 in the Journal of Contemporary Psychotherapy, Lalande and colleagues cited numerous studies demonstrating the effectiveness of breathwork for decreasing the symptoms of anxiety and depression and increasing people’s ability to handle stressful problems.
• Researchers in 1996 compared two groups of people currently receiving psychotherapy for anxiety. One group engaged only in talk therapy while the other engaged in talk therapy and received breathwork training. Those participants who received the extra breathwork training reported greater reduction in anxiety symptoms.

Spiritual Benefits of Breathwork

While breathwork can be a secular practice, it is believed to offer spiritual benefits as well, and many people engage in breathwork primarily for its spiritual component. Largely because of the theta waves it induces, deep breathing is associated with enhanced intuition and creativity, connection with the subconscious mind, and a heightened sense of spiritual connection to something greater than ourselves.¹⁷

People who regularly engage in breathwork often report feeling more aware of and attuned to their inner, true selves.¹⁶ They also describe feeling a sense of awakening and deeper connection to their breath as their life force that is part of the greater world around them.⁷

Breathwork Vs. Meditation

While deep breathing is often a part of meditation practice, the key distinction lies in control. While breathwork focuses on practicing specific breathing patterns to promote health and wellness, meditation discourages controlling the breath in favor of mindfully observing it. Instead of manipulating breathing patterns, during meditation you are encouraged to just breathe, becoming nonjudgmentally aware of your breath, in addition to your thoughts, feelings, and surroundings. You might choose to focus on your breath during meditation, or a mantra or visualization, to guide your practice.

When we’re anxious, we often take shallow breaths, limiting our oxygen supply and leaving us with a headache or dizziness. Breathwork allows you to intentionally affect the autonomic nervous system by shifting the balance between oxygen and carbon dioxide in the body.

Breathwork Techniques to Try

Breathwork can be general or specific, practiced on your own or as part of a group program. Broadly speaking, breathwork refers to any type of breathing exercise that involves intentionally changing or controlling your breathing pattern, while specific breathwork programs involve learning particular exercises in a special setting or for a targeted purpose.

Here are some of the most common types of breathwork exercises:

Pranayama Breathing

Pranayama is part of the yogic tradition and simply means intentional breath control. If you practice yoga on your own or as part of a class and you are prompted to breathe in a certain way, you are engaging in pranayama to enhance the flow of energy and release energy blocks.¹⁶

You can also use yogic breathing outside of yoga and entirely on your own to reap numerous physical, mental, and spiritual benefits. It can be as simple as noticing when you’re stressed, anxious, or otherwise out-of-sorts and pausing to close your eyes and take a few slow, deep breaths.

Diaphragmatic Breathing

Also called belly breathing, with diaphragmatic breathing you relax your shoulders and inhale fully so that your abdomen expands outward. Feel your belly expand with each in breath, and feel tension leave your body with each out breath. You might count as you breathe, either inhaling and exhaling for the same count, or exhaling for a few more counts than you inhale. The breath count can be four breaths, or adjusted based on your comfort level and experience.

Alternate Nostril Breathing

To practice alternate nostril breathing, place one hand over your nose, with your thumb gently hovering over one nostril and a finger gently over the other. Hold one nostril shut and inhale slowly through the other. Pause when you’ve inhaled fully, pinch that side shut, and exhale through the other nostril. Pause briefly and inhale through that same nostril, switching once again before exhaling.

Pursed Lip Breathing

This technique involves exhaling through tightly pursed lips and inhaling through the nose with the mouth closed. This slows down the breathing and may help people with lung conditions, like asthma or COPD.¹⁹

Box Breathing

Also known as four-square breathing, box breathing involves inhaling and exhaling for equal counts of four, as if creating a box with four equal sides. For example, you’ll begin by exhaling for four counts, holding your breath as you count to four, then slowly inhaling for four counts, holding your breath for four counts, and so on. Slow breathing techniques like this have many psychophysiological benefits, including regulating the nervous system, boosting emotional control, and promoting psychological well-being.²⁰

4-7-8 Breathing

4-7-8 breathing involves inhaling through your nose for four seconds, holding your breath for seven seconds, and exhaling through your mouth for eight seconds. Holding the breath is the most key component of this technique, allowing the body to replenish its oxygen supply, promoting wellness and relaxation. Research shows that this technique might help people improve their heart rate variability and blood pressure.²¹

Five-Finger Breathing

This multisensory approach to deep breathing incorporates the sensation of one hand touching the other as you slowly trace the fingers on your hand in rhythm with your breath. Starting with your thumb, use your opposite hand’s pointer finger to trace your hand, inhaling as you go up each finger, and exhaling as you trace down toward the next finger. This exercise can be easily taught to children as well.

Buteyko Breathing Technique

The Buteyko Breathing Technique (BBT) is a form of breathing re-education and lifestyle management developed in the 1950’s by Konstantin Buteyko, a Ukrainian physician. This technique involves promoting slower, calmer, more efficient breathing through the nose, particularly for those with asthma and other respiratory conditions, as a complementary therapy. BBT encourages patients to exhale fully and plug their nose for as long as possible before inhaling and breathing normally again, before repeating the process. The aim is to regulate breathing by controlling the breath in this way.²²

Breath of Fire & Bellows Breathing

Two rapid-breathing techniques are often used in yoga: breath of fire and bellows breathing. These are controlled-breathing techniques done to improve digestive and respiratory health and reduce stress. While the opposite of slow, deep breathing, rapid breathing techniques can also positively affect the brain and body. Breath of fire focuses on the exhale as you breath out sharp, quick puffs of air. Bellows breath involves quick, forceful inhalations and exhalations.

Sudarshan Kriya Yoga Breathwork (SKY)

Sudarshan kriya involves manipulating the breath in a variety of different patterns to inhibit the sympathetic nervous system and activate the parasympathetic nervous system, thus changing brain waves, improving heart rate and blood pressure, and replacing stress hormones with relaxing, feel-good hormones.^23,24

SKY boasts over 70 studies supporting its effectiveness for mental health conditions like anxiety, depression, and PTSD.^11,25,26 The breathing techniques can be done on your own, but learning them involves participating in classes offered in-person, online, or via an app.

Holotropic Breathwork

One of the most common formal breathwork approaches, holotropic breathwork involves a 20-60 minute session of rapid, rhythmic breathing.¹⁵ It was created as a drug-free alternative to LSD and designed to induce an altered state of consciousness and emotional catharsis in a group setting.¹⁶

It is led exclusively by practitioners certified by the Grof Transpersonal Training Program, an international organization led by the creators of this breathwork approach, Stanislav and Christina Grof.²⁷

Rebirthing Breathwork

Driven by the belief that people hold subconscious memories of their childbirth, which is a process considered by practitioners to be emotionally traumatic, rebirthing breathwork involves specific breathing techniques often done in water.¹⁶ Like holotropic breathwork, rebirthing techniques are done as part of a dedicated program, in this case through Rebirthing Breathwork International.

Shamanic Breathwork

Spiritual in nature, shamanic breathwork involves circular breathing and chanting, and is paired with smudging and intention-setting in order to connect people with their inner healer, or shaman.^15,28 It is done in a group setting led by a certified shamanic practitioner.

Wim Hof Breathwork

Done to enhance well-being and connection to the natural world, the Wim Hof technique uses meditation and intentional, controlled breathing in cold conditions, often in snow and ice.^15,29 People can learn this method by taking courses offered in person, online, or with a dedicated app, and can then practice on their own or join structured activities offered by the Wim Hof Method.

Biodynamic Breathwork

Developed for releasing and healing trauma, biodynamic breathwork is a structured program based on breathing techniques and enhanced by movement, meditation, sound, touch, and emotional release.^15,30 Done with a practitioner certified by the Biodynamic Breathwork Trauma Release System, biodynamic breathwork is usually a group format with classes held in person or online.

7 Tips for Starting a Breathwork Practice

Coomer shares his #1 tip for those wanting to start a practice: “The most important thing that I wish I had done years ago when I started was to find a teacher. This is because most of us have breathing pattern dysfunctions that we have picked up throughout life, and these can get in the way of us really getting the most out of a practice. Invest early in your breath, and you’ll see fuller and faster results.”

If you are interested in starting your own breathwork practice to enhance your mental health and well-being, use these seven tips to begin:

1. Define Your Reason

Knowing why you want to develop a breathwork practice can help you stick to it.²⁶ Having a purpose helps solidify any new goal or habit because it teaches your brain that the activity is important and helps motivate you to stick with it.

2. Make It a Routine

Dedicating some time every day to practice intentional breathing will help you turn it into a healthy habit. Practicing breathwork occasionally during times of stress can reduce stress in the moment, but making it a part of your life can help keep your nervous system balanced. Doing it once or twice daily can help make your practice consistent.^2,3

3. Attach Your Practice to an Established Routine

Developing any new habit can feel like yet another chore on your to-do list. Avoid this by adding breathwork to an existing routine, such as making it part of your morning or bedtime activities or incorporating it into a hobby by doing breathing exercises as you engage in something relaxing or fun.⁷

4. Be Comfortable

Sit or lie comfortably with your shoulders relaxed.⁹ If you are uncomfortable or in pain, you’ll be less likely to stick with it. Also, it is harder to breathe when you are uncomfortable. Whatever position you choose, ensure that your spine is straight to allow for the deepest inhalations and exhalations.

5. Breathe in Through Your Nose

Many experts recommend inhaling through your nose rather than your mouth, as it fills your lungs more completely and the nasal passageways are designed to warm the air and kill germs before the air reaches your lungs.⁷

6. Practice Mindfully

Mindful breathing simply refers to paying attention to the act of breathing, and noticing how the air sounds and feels as it enters and leaves your body.² Mindfulness helps focus and calm the mind because you are paying attention on purpose to what you are doing rather than multitasking, zoning out, or remaining caught up in troublesome thoughts.

Many mindfulness meditations involve sitting in stillness and paying attention to breathing. Your mind will wander, and when it does, simply notice it and return your attention to your breath.

7. Be Open & Non-Judgmental

There is no “wrong” way to engage in breathwork. Allow yourself to experiment with different techniques and different times of day to practice. Know that the benefits accumulate over time, so rather than feeling frustrated that your anxiety doesn’t instantly disappear when you practice breathwork.

For example, acknowledge that you are taking positive action for your mental health and congratulate yourself for it, gently reminding yourself that like any approach to mental health. Breathwork is a gradual process.

Breathwork in Psychotherapy

Some therapists use breathwork in their work with clients. Therapeutic breathwork involves purposeful breathing exercises conducted by a trained practitioner and combined with mental-health therapy techniques.¹³ It often is as simple as the therapist instructing or encouraging a client to breathe slowly and deeply during the session and at home.

Integrated breathwork therapy is an approach sometimes used in mental health therapy for anxiety and depression.⁷ Involving slow, deep, intentional breathing, mindfulness, and relaxation techniques guided by the therapist, it can be added to any therapeutic approach used for depression and anxiety.

Breathwork, even integrated breathwork therapy, is different from other mental health therapy in that it isn’t a stand-alone therapy. While you can find a therapist who practices cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), or solution-focused therapy (SFT), for example, breathwork isn’t a separate type of therapy on its own.

Some therapists will indicate on their website that they use breathing techniques in their work with clients. If you are interested in using breathwork as part of your therapy but a therapist you are interested in doesn’t mention it, you can ask them if they are willing to help you learn breathing techniques.

Is Breathwork Dangerous?

Slow, deep breathing practiced regularly for mental health purposes is generally considered to be a safe and cost-effective addition to any mental health efforts. Some breathwork programs, however, such as holotropic or rebirthing programs, may not be safe for all people. While practitioners are certified in breathing techniques, not all are licensed mental health therapists. Bringing up traumatic memories or other strong emotions without the support of a therapist may cause further damage.

What to Do When Breathwork Isn’t Enough

If you’ve practiced breathwork but still find yourself struggling with anxiety, depression, or trauma-related symptoms, finding a licensed therapist can help. Many therapists are familiar with breathwork, and can supplement your at-home practice while utilizing other evidence-based interventions to help you find relief from your symptoms. Processing what lies beneath feelings of anxiety, depression, or other mental health concerns can provide deeper healing, and empower you with plenty of tools for managing your mental health so that you can live your fullest, most meaningful life.