3 Breathwork Exercises for Stress & Anxiety
“Deep breathing brings deep thinking and
shallow breathing brings shallow thinking.”
– Elsie Lincoln Benedict
I’ve written about the purpose and benefits of breathwork in the past. Today I will talk about why breathwork is such an important tool to humans in the modern world and I’ll share 4 more breathwork techniques to add to your arsenal.
Why You Need Breathwork Exercises
Our hunter-gatherer ancestors would laugh at the stressors we experience on a frequent basis. Sitting in a beautiful and advanced machine amongst similar machines and “inching” ahead at a running pace? A waiter taking too long to write down your made-to-order food request you didn’t have to spend days hunting down? Missing a comma in a spreadsheet? Yes, these are our first-world problems but they are still problems. They create the same stress response of high blood pressure and systemic inflammation throughout your body as that lion chasing our ancestors did.
Most of the time these modern-day stressors are subtle. Even the act of checking our email leads 80% of us to hold our breath in what has been coined email apnea. But frustration with your boss, checking email, and even not getting as many Instagram likes as you expected can lead up to a daunting cumulative effect with a huge impact on both our short- and long-term health.
The good news is that we have control over it.
One of the best ways to do this is through the use of your breath. A meta-analysis of 12 randomized control trials on breathwork showed just that. With the help of 785 participants, that concluded that breathwork had significant improvements on improving stress, depression, and anxiety.
Think of your stress or anxiety as the alarm to your home. When you walk in the door at the end of the day you need to punch in the code or else the alarm will be blaring. Using that code is breathing. When you breathe in intentional ways you can instantly reduce your stress and increase your parasympathetic (rest, digest, repair) nervous system.
The Perils Of Chronic Stress
Stress is not intuitively a bad thing. But chronic stress is. Because it begins in your brain it reaches every part of your body. Chronic stress can lead to:
Accelerated aging
Insomnia and other sleep problems
Weight gain
Hair loss
Skin issues such as acne, eczema, and rashes
Headaches
Anxiety
Depression
Reduced sexual desire and erectile dysfunction
Low energy
Osteoporosis
Worsened asthma symptoms
Infertility for both men and women
Lower sperm count, sperm motility, and an abnormal production
Decreased testosterone
Less muscle growth
Poor recovery from exercise
Muscle tension
Brain fog
Gastrointestinal dysfunction such as heartburn, constipation, bloating, and diarrhea
Difficulty with digestion and nutrient absorption
Weak immune system
Damaged blood vessels
High blood pressure
Type 2 diabetes
Heart attack
Stroke
Many people have had a level of chronic stress for so long that they think it is their baseline. It is so ingrained in who they are that not only do they not know anything else but they actually become less comfortable when they get into that more relaxed state.
We see these people every day and there are no shortage of ways this stress presents. Given society’s love of productivity there are positive ways of describing them: high achiever, hard charger, driven, quick talker, extremely organized, and “always on.” There are also the less societally-accepted ways of describing them: scattered, jittery, anxious, irritable, and impatient. These characteristics all fall under the umbrella of an elevated sympathetic nervous system or stressed.
Of course, someone can have these traits at times and have a fully engaged and balanced parasympathetic nervous system at other times but this is rare. The best way to tell if you are in a chronic state of stress is to check your heart rate variability (HRV). (The second best way might just be to ask your friends.) HRV is the most comprehensive, non-invasive biomarker and a great way to objectively measure your nervous system. I’ve written about the different ways to check your HRV, the benefits of checking it, and different ways to improve your HRV.
Fortunately, you can break this pattern and unlock the other side of your autonomic nervous system–the parasympathetic nervous system–through breathwork. Tapping into this rest and digest state can have incredible effects like the more obvious: improved sleep, lower blood pressure, and decreased anxiety and depression. It also has an impact on the less obvious: lower blood sugar, better sex drive, improved digestion, and the ability to grow muscles.
So start with one of the techniques below, try it for a few days then pick another one. Stick with what works for you and use it on a regular basis.
Tips:
I don’t provide information on what position to be in when using these techniques. It’s typically recommended you do these in a cross-legged position in a non-distractible area but don’t limit yourself to this. The more important thing is just practicing the techniques.
At the end of the instructions for each technique, it simply states “repeat.” A good rule of thumb is to shoot for 8-10 rounds of each technique unless otherwise stated. Some people feel the benefits after 5 rounds and others after 30 minutes. Use your discretion.
3 Breathwork Exercises For Stress & Anxiety
1. Extended Exhales
Your heart rate slightly increases with inspiration stimulating your sympathetic nervous system and decreases with expiration stimulating your parasympathetic nervous system and the vagus nerve. When you exhale longer than you inhale, the parasympathetic response dominates the sympathetic and increases your vagal tone resulting in a state of calmness.
Instructions
The only rule for this one is to exhale longer than your inhale. The best results are typically exhaling 2-3 times longer than your inhale. For example, if you take a 4-second inhale then you would exhale for 8-12 seconds. I like to do a 1:2 ratio with a pyramid approach where I gradually increase the inhale/exhale time by 1 second per rep then decrease by 1 second then repeat. (e.g. 4s-8s / 5s-10s / 6s-12s / 7s-14s / 8s-16s / 7s-14s / 6s-12s/5s-10s / 4s-8s…).
Inhale at a count of 4 seconds.
Exhale for 2-3x as long.
Repeat.
The Science
Every time we inhale we trigger the sympathetic nervous system. Every time we exhale we inhibit it. A longer exhale, therefore means that we are in a stressed state for less time. A group of researchers performed 2 studies and published them in the International Journal of Psychophysiology. The first study looked at slow breathing on HRV metrics. The second study looked at the relationship between decision-making and perceived stress on breathwork practices. They concluded that breathwork with longer exhales can significantly improve HRV metrics, decrease perceived stress, and improve decision-making skills.
When To Do It
Use this technique when you need to activate your parasympathetic system such as when you are in a stressed or jittery state, having trouble focusing during meditation, or having trouble falling asleep (substitute sheep for seconds). You can also use this at work to help make better decisions.
2. Alternate Nostril Breathing
The name says it all. Alternate nostril breathing is a breathing practice commonly used in yoga. It involves breathing through one nostril by blocking the other and then switching back and forth.
Instructions
Inhale and exhale slowly
Use your thumb to close off your right nostril.
Inhale and exhale through the left nostril
Close the left nostril with your middle finger of the same hand
Inhale and exhale through the right nostril
Repeat
The Science
One study had 25 male participants perform alternate nostril breathing for 15 minutes a day for 6 weeks and found significant improvement in parasympathetic tone.
In a 2017 pilot study, researchers broke up medical students into two groups prior to a simulated public speaking test. One group sat in a quiet room for 15 minutes without instruction and the other performed alternate nostril breathing. The breathwork group showed a trend toward lower anxiety, however, it was not statistically significant.
Another study broke up 13 participants into three groups: quiet sitting, breath awareness, and alternate nostril breathing. Using an EEG, they found that performing alternate nostril breathing increased calmness, whereas sitting without instructions actually increased arousal.
When To Do It
Use alternate nostril breathing to activate your parasympathetic nervous system for relaxation and stress reduction.
Bonus: Use this to clear out your airways and nasal cavity. If you are a mouth breather, this is a great exercise to overcome the “fear” your brain associates with nasal breathing due to an increase in pressure with nasal breathing vs. mouth breathing.
3. Resonance Breathing
Resonance breathing (aka coherent breathing) is a technique that synchronizes your breath to your heart rate. This breath rate varies by individual and it can range from 4-7 breaths per minute. In James Nestor’s book, Breath, he writes that all traditions practice some sort of prayer, chanting, or meditation at a rate of about 5.5 to 6 breaths per minute with common examples including yogic breathing and the Hail Mary. He writes, “The perfect breath is this: Breathe in for about 5.5 seconds, then exhale for 5.5 seconds. That’s 5.5 breaths a minute for a total of about 5.5 liters of air.”
Instructions
Inhale to a count of 5.5 seconds slowly without force
Exhale to a count of 5.5 seconds slowly without force
Repeat
The Science
This study showed that taking 5.5 breaths per minute correlated with the best HRV measurements compared to both 6 breaths per minute and compared to an inhale-to-exhale ratio of 4:6.
In this study, researchers divided 95 participants into three groups: no instructions, pre-determined resonance breathing + 1 breath per minute, and a pre-determined standard resonance breathing. Interestingly, the researchers used Rosenthal’s HRV determination protocol to determine each participant's individual breathing rate which ranged from 5-7 breaths per minute. There was an improvement in systolic blood pressure, HRV, and overall mood in the resonance breathing group as compared to both the group that took 1 extra breath a minute and the group that just sat there.
Researchers in a 2019 study took a similar approach by studying resonance breathing and resonance breathing + 1 breath per minute on 10 participants. They reported that both breathing patterns “induced the same acute changes on the sympathetic nervous system and BP, with both breathing paradigms inducing similar changes in the pattern of sympathetic firing.”
When To Do It
Use resonance breathing to activate your parasympathetic state and put you in a calm mindset. The above studies show that you can use it to lower your blood pressure and improve your mood as well. Sometimes I’ll use the Cardiac Coherence app (similar one for iOS) which uses audio (waves on the ocean) and visual (a moving cursor) cues as a pacer so that I can focus on the breath instead of the count.
What I do
When I become stressed about something (that I don’t want to be stressed about) the first thing I try to do is recognize the trigger. What exactly put this stress into motion? Then I mentally sit with the symptoms of this–even if it is for a few seconds. I tend to have more energy, less saliva in my mouth, and more blood flow to my head and face. Then I start to breathe to recenter myself. I weave all three of these breathwork techniques into my routine whether it’s a way to decrease stress or simply as “practice” when I’m not stressed.
My favorite go-to breathwork strategy is extended exhales. I use this frequently and, really, whenever I think about my breath (sometimes helped with a notification on my phone). I often use resonance breathing as a way to help center me in meditation when I’m losing focus.
In a short time, the saliva returns to my mouth, my heart rate trends downward, and I return to my baseline.
Takeaway
Stress is our body’s natural way of protecting us. Acutely, it helps to save our lives. Chronically, it can kill us. There are many ways chronic stress has an impact on our lives. One difficulty with this is recognizing stress. Many people are chronically stressed and totally unaware. Once you use tools to identify your stress, the next step is to manage it.
Enter breathwork. Breathing is our body’s natural stress reliever but few of us realize it and fewer use it in that way. Recognize your breath and then use one of the three breathwork techniques—extended exhales, alternate nostril breathing, and resonance breathing—above to become healthier. Studies have shown that these exercises lower your blood pressure, improve calmness, HRV metrics, and mood, and they even help with decision making
Take one out for a spin, commit to it every day for a week, and then try the next one. You’re breathing anyway so you mine as well get some benefit out of it.
What’s your favorite breathwork exercise to manage stress and anxiety?