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In this article, I discuss recent research on breathing techniques that promote relaxation, calm, and pain relief. Specifically, I review two recent investigations.

Breathing and relaxation

Slow and deep breathing appears to have a number of mental health benefits (e.g., relaxation) perhaps because it counteracts the “sympathetic dominance” of the nervous system, which contributes to rapid heart rate, high blood pressure, stress, anxiety, and depression.

So let me review a recent investigation by Gholamrezaei et al., (published in the February issue of Psychophysiology), which explores physiological and psychological responses to four types of deep breathing exercises.

Note, deep breathing is sometimes also called diaphragmatic breathing or abdominal breathing. Deep breathing practices are often performed slowly, about six breaths per minute, or one breath every ten seconds (0.1 Hz breathing frequency). The normal breathing rate is much faster—around 10-20 breaths every minute (about 0.16-0.33 Hz).

The breathing practices investigated in this study, all of which may be considered types of deep breathing, included pursed-lip breathing, left and right unilateral nostril breathing, and loaded deep breathing exercises. Before continuing, I briefly describe these breathing techniques below.

Unilateral nostril breathing involves breathing in through one nostril and breathing out through the same or another nostril.

Pursed-lip breathing involves inhaling through the nose and exhaling through pursed lips.

Loaded breathing is a little different, in that it uses inspiratory threshold loading, a rehabilitative technique often used in patients with chronic obstructive pulmonary disease. Basically, this technique creates resistance and thus exercises muscles involved in inhalation.

Now, on to the study: The sample included 35 volunteers (20 females); average age of 21 years (range of 18 to 32 years). Participants were asked to alter their breathing for three minutes. Measures included, among others, ones related to blood pressure, heart rate, baroreflex function, arousal, and dyspnea (breathing difficulties).

The data were analyzed to determine which deep breathing technique is more effective in promoting calm and relaxation. The results showed that of the four breathing exercises, “loaded breathing was associated with enhanced cardiovascular effects and pursed-lips breathing with better emotional responses, while also enhancing cardiovascular effects (albeit less than loaded breathing).” In addition, participants reported finding pursed-lip breathing more calming, pleasant, and associated with a greater sense of control.

Breathing and pain relief

Let us move to the second study, conducted by Jafari and colleagues, and published in the Journal of Pain.

The sample comprised 48 volunteers (73% female, average age of 23 years), who were asked to perform the following:

  1. Unpaced breathing (i.e. spontaneous breathing).
  2. Paced breathing (breathing at one’s normal breathing frequency).
  3. Slow deep breathing; six breaths a minute; high inspiration/expiration ratio.
  4. Slow deep breathing; six breaths a minute; low inspiration/expiration ratio.

Specifically, the high inspiration/expiration ratio involved breathing in for six seconds, holding it for half a second, breathing out for two seconds, and pausing for a second and a half. The low inspiration/expiration ratio, in contrast, involved breathing in for two seconds, holding it for half a second, breathing out for six seconds, and pausing for a second and a half.

While engaged in these breathing exercises, participants received painful stimuli (heat at three different temperatures) and rated the intensity of the pain.

The study used a variety of measures and instruments (e.g., heart rate and blood pressure, ECG).

The results showed that compared to spontaneous breathing, participants experienced less intense pain while practicing the breathing patterns that involved instructions (i.e. Techniques 2-4). In addition, the fourth technique reduced pain more than the rest.

In summary, one of the most effective breathing exercises for pain relief may be slow, deep breathing, particularly breathing characterized by expiration lasting longer than inspiration.

Note, the findings of the two studies reviewed today do not stand on their own: They agree with the findings of previous research that has shown the importance of deep breathing exercises for pain relief and relaxation.


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Takeaway: Breathing techniques to manage stress and pain

If you are feeling stressed and need a quick way to relax, or if you are experiencing pain and need pain relief, consider using slow, deep breathing practices, such as pursed-lip breathing. Regular practice of deep breathing is an effective stress-management technique and promotes well-being.

Breathing practices are emphasized in a variety of non-pharmacological and alternative therapies—like exercise, meditation, hypnosis, yoga, qi gong, and tai chi. These therapies are used for the non-pharmacological management of acute and chronic physical health and mental health problems like asthma, hypertension, pain conditions, physiological arousal, anxiety, anger, and depression.

However, it is important to know when to use breathing exercises and how to perform them correctly. For instance, severely anxious people who force themselves to practice a specific breathing technique might only experience greater anxiety. In such cases, it may be more beneficial to initially focus on the breath without trying to change it at all. Once the anxiety is more manageable, one can use a paced breathing technique that feels most comfortable.

Practice the breathing technique regularly, including when calm and relaxed, because using it only when distressed might create a mental association between the breathing technique and distress.

Let me end this article with instructions on how to practice one of the most effective breathing practices (and one of my favorites): pursed-lip breathing.

First, inhale slowly through your nose. Then exhale through puckered lips—imagine you are about to whistle, give someone a kiss, or slowly blow out a candle.

During exhalation, do not force the air out. The pressure will naturally push the air out. As you exhale, just keep it slow and steady.

If you have a minute, try pursed-lip breathing now. Then breathe normally for a few cycles, before trying it again. Can you feel the difference? Do you have less pain? Are you more relaxed?


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