What is ‘breathwork’? And do I need to do it?

From “breathwork recipes” to breathing techniques, many social media^[1] and health websites^[2] are recommending breathwork to reduce stress.

But breathwork is not new. Rather it is the latest in a long history of breathing techniques such as Pranayama^[3] from India and qigong^[4] from China. Such practices have been used for thousands of years to promote a healthy mind and body.

The benefits can be immediate and obvious. Try taking a deep breath in through your nose and exhaling slowly. Do you feel a little calmer?

So, what’s the difference between the breathing we do to keep us alive and breathwork?

Breathwork is about control

Breathwork is not the same^[5] as other mindfulness practices^[6]. While the latter focus on observing the breath, breathwork is about controlling inhalation and exhalation^[7].

Normally, breathing happens automatically via messages from the brain, outside our conscious control. But we can control our breath, by directing the movement of our diaphragm and mouth.

The diaphragm^[8] is a large muscle that separates our thoracic (chest) and abdominal (belly) cavities. When the diaphragm contracts, it expands the thoracic cavity and pulls air into the lungs.

Controlling how deep, how often, how fast and through what (nose or mouth) we inhale is the crux of breathwork, from fire breathing^[9] to the humming bee breath^[10].

Breathwork can calm or excite

Even small bits of breathwork can have physical and mental health benefits and complete the stress cycle^[11] to avoid burnout.

Calming breathwork includes diaphragmatic (belly) breathing, slow breathing, pausing between breaths, and specifically slowing down the exhale.

In diaphragmatic breathing, you consciously contract your diaphragm down into your abdomen to inhale. This pushes your belly outwards and makes your breathing deeper and slower.

You can also slow the breath^[12] by doing:

• box breathing^[13] (count to four for each of four steps: breathe in, hold, breathe out, hold), or

• coherent breathing^[14] (controlled slow breathing of five or six breaths per minute), or

• alternate nostril breathing^[15] (close the left nostril and breathe in slowly through the right nostril, then close the right nostril and breathe out slowly through the left nostril, then repeat the opposite way).

You can slow down the exhalation specifically by counting, humming or pursing your lips as you breathe out.

In contrast to these calming breathing practices, energising fast-paced breathwork increases arousal. For example, fire breathing^[16] (breathe in and out quickly, but not deeply, through your nose in a consistent rhythm) and Lion’s breath^[17] (breathe out through your mouth, stick your tongue out and make a strong “haa” sound).

What is happening in the body?

Deep and slow breathing, especially with a long exhale, is the best way to stimulate the vagus nerves^[18]. The vagus nerves pass through the diaphragm and are the main nerves of the parasympathetic nervous system.

Simulating the vagus nerves calms our sympathetic nervous system (fight or flight) stress response. This improves mood, lowers the stress hormone cortisol^[19] and helps to regulate emotions and responses. It also promotes more coordinated brain activity^[20], improves immune function and reduces inflammation^[21].

Taking deep, diaphragmatic breaths also has physical benefits^[22]. This improves blood flow, lung function and exercise performance, increases oxygen in the body, and strengthens the diaphragm.

Slow breathing^[23] reduces heart rate and blood pressure and increases heart rate variability (normal variation in time between heart beats^[24]). These are linked to better heart health.

Taking shallow, quick, rhythmic breaths in and out through your nose stimulates the sympathetic nervous system. Short-term, controlled activation of the stress response is healthy and develops resilience to stress^[25].

Breathing in through the nose

We are designed to inhale through our nose^[26], not our mouth. Inside our nose are lots of blood vessels, mucous glands and tiny hairs called cilia^[27]. These warm and humidify the air we breathe and filter out germs and toxins.

We want the air that reaches our airways and lungs to be clean and moist. Cold and dry air is irritating to our nose and throat, and we don’t want germs to get into the body.

Nasal breathing^[28] increases parasympathetic activity and releases nitric oxide, which improves airway dilation and lowers blood pressure.

Consistently breathing through our mouth is not healthy^[29]. It can lead to pollutants^[30] and infections^[31] reaching the lungs, snoring, sleep apnoea, and dental issues^[32] including cavities and jaw joint problems.

References

1. ^{^} social media (www.instagram.com)
2. ^{^} health websites (www.healthline.com)
3. ^{^} Pranayama (www.ncbi.nlm.nih.gov)
4. ^{^} qigong (www.ncbi.nlm.nih.gov)
5. ^{^} not the same (www.ncbi.nlm.nih.gov)
6. ^{^} other mindfulness practices (www.ncbi.nlm.nih.gov)
7. ^{^} controlling inhalation and exhalation (www.nature.com)
8. ^{^} The diaphragm (www.medicalnewstoday.com)
9. ^{^} fire breathing (www.healthline.com)
10. ^{^} humming bee breath (www.headspace.com)
11. ^{^} complete the stress cycle (theconversation.com)
12. ^{^} slow the breath (www.ncbi.nlm.nih.gov)
13. ^{^} box breathing (www.medicalnewstoday.com)
14. ^{^} coherent breathing (pubmed.ncbi.nlm.nih.gov)
15. ^{^} alternate nostril breathing (www.healthline.com)
16. ^{^} fire breathing (www.webmd.com)
17. ^{^} Lion’s breath (www.healthline.com)
18. ^{^} stimulate the vagus nerves (theconversation.com)
19. ^{^} cortisol (www.ncbi.nlm.nih.gov)
20. ^{^} coordinated brain activity (www.ncbi.nlm.nih.gov)
21. ^{^} improves immune function and reduces inflammation (www.ncbi.nlm.nih.gov)
22. ^{^} physical benefits (my.clevelandclinic.org)
23. ^{^} Slow breathing (link.springer.com)
24. ^{^} time between heart beats (www.health.harvard.edu)
25. ^{^} develops resilience to stress (pubmed.ncbi.nlm.nih.gov)
26. ^{^} inhale through our nose (www.ncbi.nlm.nih.gov)
27. ^{^} blood vessels, mucous glands and tiny hairs called cilia (www.ncbi.nlm.nih.gov)
28. ^{^} Nasal breathing (journals.physiology.org)
29. ^{^} is not healthy (www.sciencefocus.com)
30. ^{^} pollutants (www.ncbi.nlm.nih.gov)
31. ^{^} infections (www.ncbi.nlm.nih.gov)
32. ^{^} dental issues (www.ncbi.nlm.nih.gov)
33. ^{^} mi_viri/Shutterstock (www.shutterstock.com)
34. ^{^} Slow breathing (www.ncbi.nlm.nih.gov)
35. ^{^} helping post-traumatic stress disorder (www.ncbi.nlm.nih.gov)
36. ^{^} chronic heart failure (www.ncbi.nlm.nih.gov)
37. ^{^} chronic obstructive pulmonary disease (pubmed.ncbi.nlm.nih.gov)
38. ^{^} asthma (www.medicalnewstoday.com)
39. ^{^} improve exercise performance (www.ncbi.nlm.nih.gov)
40. ^{^} reduce oxidative stress (pubmed.ncbi.nlm.nih.gov)
41. ^{^} doublelee/Shutterstock (www.shutterstock.com)
42. ^{^} take shallow, quick breaths (www.betterhealth.vic.gov.au)
43. ^{^} a few minutes a day (www.nature.com)
44. ^{^} in the workplace (www.frontiersin.org)
45. ^{^} burnout rates are high (theconversation.com)