Diaphragmatic Breathing: Definition, Benefits, & Techniques

What Is Diaphragmatic Breathing?

Diaphragmatic breathing, also known as belly (or abdominal) breathing, is a breathing exercise for anxiety type of breathwork and mindfulness that uses the diaphragm to increase lung capacity. Typical breaths are shallow and use the chest muscles, which does not fill lungs to max capacity. Diaphragmatic breathing is also a grounding technique that can be used to calm anxiety as it encourages one to focus on taking slow, deep breaths. Tai Chi and yoga also include diaphragmatic breathing in their practices.

A foundational study on the relationship between respiration and chest muscles established that the diaphragm is closely connected to the vagus nerve.¹ This nerve can be stimulated by deep breaths, resulting in decreased anxiety and stress. Diaphragmatic breathing can also positively impact cardiovascular, respiratory, and gastrointestinal systems.²

Diaphragmatic breathing works by:

• Strengthening the diaphragm
• Decreasing oxygen demand
• Increasing postural stability
• Increasing lung capacity
• Engaging the vagus nerve to promote relaxation
• Decreasing cortisol levels
• Increasing postural stability

Benefits of Diaphragmatic Breathing

Diaphragmatic breathing is a great practice to add to a mindfulness routine–not only for a person’s mental health, but also their physical health. Diaphragmatic breathing exercises encourage relaxation, which can in turn improve sleep quality, focus, and core muscle stability.

Benefits of diaphragmatic breathing may include:

• Better stress management skills: Diaphragmatic breathing improves stress management skills by disengaging a person’s “fight or flight” response by strengthening the body’s relaxation response.
• Improved muscle functioning: Diaphragmatic breathing can increase oxygen flow to the muscles, helping them grow stronger.
• Reduced blood pressure: Practicing diaphragmatic breathing stabilizes blood flow and dilates blood vessels, improving blood pressure
• Reduced heart rate: Diaphragmatic breathing engages the parasympathetic nervous system, in turn decreasing heart rate
• Improved chronic breathing conditions: Individuals with COPD or asthma who practice diaphragmatic breathing can increase airflow and strengthen their lungs (under medical supervision).
• Strengthened diaphragm: The diaphragm is responsible for 80% of one’s breathing. Engaging it can build diaphragmatic strength and positively impact other areas of the body such as the pelvic floor.³
• Improved core stability: A strong diaphragm helps stabilize inner core muscles for better balance.⁴
• Improved symptoms of PTSD: Diaphragmatic breathing is a form of mindfulness and can help a person manage PTSD symptoms by increasing relaxation during moments of anxiety, hypervigilance, or PTSD flashbacks.

Conditions Diaphragmatic Breathing Can Improve

There are many benefits of controlled breathing in general, but diaphragmatic breathing has certain advantages that make it particularly effective. For starters, diaphragmatic breathing can be used to improve symptoms of anxiety, athletic performance, and respiratory function for those with breathing conditions.⁵

Conditions that may be improved by diaphragmatic breathing include:

Anxiety Disorders

Regularly practicing diaphragmatic breathwork engages the parasympathetic nervous system (PNS), alleviating symptoms of anxiety by disengaging “fight or flight” responses. Although it’s normal to react negatively to stress, those with anxiety often spend more time in a stressful state, which can cause both emotional and physical distress.

While practicing diaphragmatic breathing, the vagus nerve is engaged and automatic bodily functions–such as blood pressure, digestion, and heart rate–become more regulated. Because anxiety disorders are often accompanied by physical symptoms, this can be very beneficial.

Benefits of diaphragmatic breathing for regulating anxiety symptoms include:

• Lowered heart rate and blood pressure: A common symptom of anxiety is an increased heart rate. Diaphragmatic breathing increases oxygen in the blood, dilating the blood vessels to lower blood pressure. This increases relaxation and lowers one’s heart rate.
• Decreased production of cortisol: Cortisol is a hormone released during times of stress. Diaphragmatic breathing is a technique that can lessen stress and therefore decrease cortisol production.
• Improved sleep quality: Diaphragmatic breathing increases relaxation and allows a person to feel more calm, making it easier to fall (and stay) asleep.
• Decreased racing or worrying thoughts: Someone with anxiety can struggle with racing thoughts or constant worrying. Diaphragmatic breathing brings them back to the present moment to focus on the here and now, not other concerns.

Cardiovascular Conditions

A recent study found that practicing deep breathing exercises for five minutes a day, six days per week could lower blood pressure.⁶
COPD often occurs comorbidly with cardiovascular disease, and both can make you short of breath when walking or exercising.⁷
Improved diaphragmatic functioning can help in managing these symptoms.

Diaphragmatic breathing improves cardiovascular functioning by:

• Lowering blood pressure: Diaphragmatic breathing can lower blood pressure by engaging the parasympathetic nervous system. Effects can be felt immediately, but when practiced consistently, diaphragmatic breathing can produce long-term results.
• Improving respiratory capacity: Diaphragmatic breathing fills the lungs to their capacity, which allows for better lung and muscle strength.
• Increasing oxygen in the blood: An imbalance of oxygen in the blood can be a risk factor for many diseases, including cardiovascular disease.
• Preventing complications from cardiovascular surgery: Controlled breathing after cardiovascular surgery may help prevent lung collapse.⁸
• Increasing venous return to the heart: When the diaphragm is engaged, this increases blood flow. Arteries are then stretched, engaging the parasympathetic (aka “rest and digest”) nervous system to promote relaxation.⁹.¹²

Asthma

Diaphragmatic breathing can help improve quality of life for people with asthma by decreasing the amount of flare-ups and boosting the effectiveness of other treatment methods.¹⁰ Those with asthma may also experience anxiety about their symptoms, such as worrying about when they may experience another asthma attack. Diaphragmatic breathing can help them manage their anxiety.

Diaphragmatic breathing can provide respiratory benefits, such as:

• Increased oxygen to the lungs: Diaphragmatic breathing helps fill the lungs to capacity and decreases the oxygen needs of other parts of your body.
• Decreased shortness of breath: Diaphragmatic breathing helps slow down the breath and reduce the energy needed to breathe.
• Increased muscle relaxation: When stressed, chest muscles can tense up. Diaphragmatic breathing can relax these muscles.

Panic Disorder

Panic disorder is characterized by repeated panic attacks and is often described as an “intense form of anxiety.” Panic attacks occur with little to no warning and have intense physical symptoms. People who have had a panic attack may describe it as being “frozen” with fear or feeling like they can’t breathe. Diaphragmatic breathing can help a person relax during these attacks and feel more at ease.

Diaphragmatic breathing can help manage symptoms of panic disorder by:

• Helping muscles relax: When a person experiences panic or stress, the muscles in the body tense up. Diaphragmatic breathing helps relax those muscles.
• Managing shortness of breath: When practiced during a panic attack, diaphragmatic breathing helps slow down the breath and reduce the energy necessary to breathe.
• Encouraging mindfulness: Diaphragmatic breathing encourages a person to engage in mindfulness, helping to manage anxiety and panic symptoms.

Personality Disorders

Personality disorders are mental health disorders that affect a person’s patterns of thinking and behavior, which impairs their everyday and occupational functioning as well as their ability to maintain relationships. Those with personality disorders can improve their symptoms with effective treatment, including psychotherapy, medication, and mindfulness tools, like diaphragmatic breathing.

Diaphragmatic breathing can help manage symptoms of personality disorders by:

• Improving emotional regulation: Individuals who have a personality disorder may struggle with emotional regulation. Diaphragmatic breathing is one way to regulate emotions by focusing on the present and remaining grounded.
• Improving focus: An inability to maintain focus is a symptom of some personality disorders, and diaphragmatic breathing can help improve one’s concentration.

GI Problems

Diaphragmatic breathing can also be used to manage stress caused by GI problems. When a person is stressed, the sympathetic nervous system is activated and releases stress hormones that can affect digestion. Controlled breathing not only helps us relax, but enhances the digestion process.

Diaphragmatic breathing can help improve GI functioning by:

• Activating the diaphragm: When the diaphragm is engaged, this can act as an internal “massage” for the intestines and stomach, which can help reduce uncomfortable symptoms like bloating and pain.¹¹
• Easing panic: During stressful moments, diaphragmatic breathing can help calm the digestive tract
• Reducing GERD: Diaphragmatic breathing helps manage symptoms of GERD, like belching, and could reduce the need for medications.¹²

Potential Risks of Diaphragmatic Breathing

Diaphragmatic breathing may not always work as a standalone treatment, especially for those with COPD and asthma. It’s important to discuss including this practice as a part of treatment with a care team. A doctor can help train individuals slowly in this type of breathwork if it is suitable for them and their condition.

Diaphragmatic breathing could potentially worsen anxiety symptoms if a person is not used to the feeling of being present in their body. Experiencing and accepting their symptoms as they occur can be overwhelming, or they may feel even more worried if the practice is not working for them.

Helpful Tips for Starting Diaphragmatic Breathing

When you add diaphragmatic breathing into your routine, it can be helpful to let go of any judgments you may have and allow yourself to be open to the experience. It can be beneficial to start by lying down so that you’re able to fully focus on your breath. Try listening to a script or a youtube video if you’re worried about doing it correctly or not.

If you have a breathing condition, talk to your doctor first before trying diaphragmatic breathing. They may want to observe you and train you on the practice before you do it on your own. Practicing just a few minutes each day can make diaphragmatic breathing easier, and the best part is that no equipment is needed! Take note of any bodily sensations or emotions you feel throughout the process.

Below are tips for starting diaphragmatic breathing:

• Locate a video or script: Find a video you can listen to that will walk you through the process, or familiarize yourself with a script before you get comfortable.
• Find a comfortable environment: This could include lying down, sitting, or standing in a place free from distractions.
• Dedicate a certain amount of time: You can start by dedicating five to ten minutes per day. It may be helpful to practice at the same time to create a routine.
• Keep practicing: The more you practice, the more you will feel the effects of diaphragmatic.

Diaphragmatic Breathing Exercises to Try

The great thing about diaphragmatic breathing is that all you need is you! No equipment is needed and it can be used at any time. This type of breathing can be done sitting, standing, or lying down. Eventually, you’ll feel comfortable practicing it in public (like if you’re stressed out in line at the grocery store!), in a yoga class, while meditating, or with a breathwork instructor.

Below are four diaphragmatic breathing exercises to try:

Sitting Down

Engaging in diaphragmatic breathing while sitting is an option after you gain more experience with this type of breathing, as it can be more difficult to relax in this position. You can use diaphragmatic breathing while sitting anywhere, even on a plane or stuck in traffic and feeling stressed.

To practice diaphragmatic breathing while sitting, follow these steps:

• Sit comfortable in a chair with your knees bent.
• Keep your head, neck, and shoulders relaxed. You may close your eyes or fix your gaze if it helps you relax.
• Place one hand in the middle of your chest and the other on your stomach, below your rib cage.
• Inhale through your nose and imagine the air going into your stomach. Your stomach should move outward and your chest should not move.
• Tighten your stomach muscles to draw them inward and exhale through your mouth. Again, your chest should move as little as possible.

Standing Up

Many of us don’t have the best posture, which impacts our breathing as our diaphragm does not have the space to fully expand. Standing up allows the spine to extend and the diaphragm to be fully engaged in the breath.

To practice diaphragmatic breathing standing up, follow these steps:

• Find a comfortable standing position without locking your knees.
• Keep your head, neck, and shoulders relaxed.
• Place one hand in the middle of your chest and the other on your stomach, below your rib cage.
• Inhale through your nose and imagine the air going into your stomach. Your belly should rise and your chest should not move.
• Tighten your stomach muscles to draw them inward and exhale through your mouth. Again, your chest should move as little as possible.

Lying down

Lying down is a good way to start practicing diaphragmatic breathing, as it’s usually easier for people to relax in position. You’ll want to make sure you are in a quiet, comfortable place where you have time and space to practice.

To practice diaphragmatic breathing lying down, follow these steps:

• Lay down with a pillow under your knees and head for support.
• Keep your head, neck, and shoulders relaxed.
• Place one hand in the middle of your chest and the other on your stomach, below your rib cage.
• Inhale through your nose and focus on the air going into your stomach. Your belly should rise and your chest should not move.
• Tighten your stomach muscles to draw them inward and exhale through your mouth. Again, your chest should move as little as possible.

While meditating

You can add diaphragmatic breathwork very easily into a meditation practice. You can practice just by focusing on the breath or integrating this with a guided meditation.

To practice diaphragmatic while meditating, follow these steps:

• Find a comfortable position, you may want to sit or lay down.
• Keep your head, neck, and shoulders relaxed.
• You can set an intention for what you want to achieve with this meditation.
• Place one hand in the middle of your chest and the other on your stomach, below your rib cage.
• Notice what it feels like to be connected with your body as you feel supported by whatever you’re sitting/laying on.
• Bring your attention to your breath–notice what happens when you breathe in and out. Does your chest move? What feelings or emotions come up?
• Inhale through your nose and imagine the air going into your stomach. Your belly should rise and your chest should not move.
• Tighten your stomach muscles to draw them inward and exhale through your mouth. Again, your chest should move as little as possible. What do you notice?
• Repeat for the next few minutes or more.

Where to Find a Professional

It can be helpful to meet with a professional before trying diaphragmatic breathing, especially if you’re unsure about where to start. Those with a breathing condition should discuss this practice with their healthcare team before starting. There are a number of professionals who can help you with this type of breathwork.

Professionals who can help you practice diaphragmatic breathing include:

• Yoga teachers: Diaphragmatic breathwork is a fundamental part of yoga and has been around for thousands of years. Yoga teachers can help you learn more about how to perform diaphragmatic breathing correctly.
• Mindfulness-based cognitive behavioral therapy (MBCT): MBCT is a blend of cognitive behavioral therapy (CBT) and mindfulness that teaches people about their thoughts in order to address unwanted emotions. This type of therapy may include diaphragmatic breathing as a way to stay in the present moment.
• Respiratory therapists: These professionals are trained to work with people who have cardiopulmonary issues and can provide necessary interventions. They can teach you proper breathing techniques if you have a respiratory condition.
• A physician: Your primary care doctor or other specialist may be able to guide you on practicing diaphragmatic breathing correctly.
• Physical therapists: PTs are often trained in breathwork and can teach you how to add this into your routine.

Final Thoughts

Diaphragmatic breathing is a type of breathing that involves engaging the diaphragm to fill the lungs more efficiently. It can be used as a relaxation technique to help manage symptoms of anxiety, stress, and physical health conditions. Diaphragmatic breathing can be a great addition to your treatment plan and provide long-term benefits.