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7 Benefits According to Research
Diaphragmatic breathing is fundamental to ancient practices of yoga, tai chi and mind–body practices.
Although the state of scientific research on breathwork and diaphragmatic breathing is in its infancy, evidence for the effectiveness of diaphragmatic breathing to improve physical and mental health is strengthening. Several studies show the enormous potential of diaphragmatic breathing exercises to improve a wide range of symptoms in clinical and nonclinical populations.
Continued improvement in research methodology and identification of mechanisms will provide evidence-based directions to its therapeutic potential.
1. Slow breathing shows a system-wide benefit
A review of the physiological effects of slow breathing (about six breaths per minute) in healthy adults shows improvement across respiratory, cardiovascular, cardiorespiratory, and autonomic nervous system functions (Russo et al., 2017).
This system-wide effect of slow breathing demonstrates its potential to improve cardiovascular, respiratory, and digestive system health, as well as nervous system regulation separately and as an integrated system. Of interest to mental health is the impact of slow breathing on the autonomic nervous system through improved vagal activity and a shift to parasympathetic dominance (Russo et al., 2017).
2. Diaphragmatic breathing improves blood pressure
A meta-analysis of 13 studies of 665 participants with high blood pressure found that regular diaphragmatic breathing practice at six to 10 breaths per minute improved blood pressure in prehypertensive and hypertensive individuals (Yau & Loke, 2021).
Benefits to heart rate variability, quality of life, and anxiety were also found. Based on these findings, the authors concluded that four weeks of twice daily diaphragmatic breathing at a rate of less than 10 breaths (or six breaths) per minute for 10 minutes was effective (Yau & Loke, 2021).
3. Slow breathwork improves perceived stress
A meta-analysis of 12 randomized controlled trials with a total of 758 participants showed that deliberate, slow breathwork practices (but not fast breathwork) improved perceived stress in nonclinical samples (Fincham et al., 2023). The effect was not significant in clinical mental or physical health samples.
Slow breathwork significantly reduced stress when taught in a group setting or individual setting and when delivery was in-person, remote, or a combination of the two (Fincham et al., 2023).
4. Diaphragmatic breathing reduces stress hormones, improves negative affect, and increases attention
A randomized control group study showed that diaphragmatic breathing reduced cortisol levels after 20 sessions of controlled breathwork. The 30-minute intervention occurred over an eight-week period and included 15 minutes of rested breathing followed by 15 minutes of diaphragmatic breathing (Ma et al., 2017).
The intervention group showed significant improvement in sustained attention and a decrease in negative affect compared to baseline (Ma et al., 2017).
5. Diaphragmatic breathing reduces anxiety levels
An experimental study of healthy adults showed that diaphragmatic breathing intervention reduced self-reported anxiety levels and physiological indicators of anxiety, including average heart rate and breathing rate (Chen et al., 2017).
The intervention group completed an eight-week diaphragmatic breathing relaxation program and practiced twice a day at home (Chen et al., 2017).
6. Diaphragmatic breathing app improves emotion regulation in veterans with PTSD
In this experimental study (Wallace et al., 2022), veterans experiencing post-traumatic stress disorder (PTSD) and traumatic brain injury used a smartwatch app intervention for four weeks. The app included diaphragmatic breathing techniques and other stress management tools.
Veterans in the experimental group experienced a significant increase in meeting emotion regulation goals they set for themselves compared to the control group (Wallace et al., 2022).
7. Diaphragmatic breathing improves fetal attachment in pregnant women with gestational diabetes
In this randomized controlled study (Fışkın & Şahin, 2018), women with gestational diabetes practiced diaphragmatic breathing for five minutes each day for 30 days. Self-reported fetal attachment significantly increased after 30 days in women in the experimental group.
Women also experienced a decrease in self-reported stress, anxiety, and depression. The hypothesized mechanism of improved attachment is that increases in fetal movement during diaphragmatic breathing improves mother–child bonding.
How to Do Diaphragmatic Breathing: 4 Steps
A strong diaphragmatic breathing practice can prepare us with the fundamentals of healthy breathing.
From here, a personalized toolkit of breathwork practices can be built that meets the specific challenges your clients face each day.
Guide your clients with the following steps:
Step 1. Body position
Lie on your back in a comfortable position free from distraction. Place one hand on your chest. Place the other hand on your abdomen.
Step 2. Notice your breath and body
Without trying to control your breath consciously, take notice of the rise and fall of your hands, the duration of your exhalations and inhalations, and how you are using your nose and mouth to breathe.
Step 3. Inhalation
Inhale deeply through your nose into your abdomen and laterally into the lower rib cage and back toward the spine. Imagine expanding the entire surface area and perimeter of the dome shape of the diaphragm to make room for your expanding lungs. Notice how the hand on your abdomen raises higher than the hand on your chest.
Step 4. Exhalation
Take time to exhale passively through the nose and relax the diaphragm. Repeat steps three and four for a duration of five minutes.
Variations and helpful tips
- If you find it difficult to notice the rise and fall of your abdomen, try a few breaths lying on your stomach. You may more easily feel the sensation of pressure of your rising abdomen against the surface you are lying on.
- Imagine your breath as a balloon that gently inflates and deflates with each inhalation and exhalation.
- Add a brief pause at the top of each inhalation and the end of each exhalation.
- Increase the duration of your inhales compared to exhales (e.g., four-second inhale followed by six-second exhale).
- At the end of each exhalation, actively press your abdomen against your spine to empty your lungs completely.
6 Best Exercises, Handouts, and Worksheets
Think of breathwork as consciously controlling our breath using different rhythmic patterns designed to change our physiological, emotional, and cognitive states in a specific way.
Patterns are created by deliberately adjusting the ratio of inhales to exhales, adding breath holds, and adding resistance to the breath with various configurations of our lips, tongue, and nasal cavity.
1. Square breathing
In this square-breathing exercise, equalize the ratio of inhales, pauses, and exhales with this beginner’s exercise for overall relaxation.
2. Anchor breathing
Use visualization and metaphor in this grounding exercise.
3. Yogic breathing
Incorporate yoga practice in this deep-breathing exercise.
4. Physiological sigh
Quickly break the cycle of anxiety with the physiological sigh exercise led by Andrew Huberman. Just one physiological sigh can decrease anxiety in the moment. A daily five-minute practice of cyclic sighs is shown to decrease stress for 24 hours (Balban et al., 2023).
