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The Best Way to Breathe for Reducing Stress?


Whether you’re feeling your anxiety spiral backstage before a performance, or you’re dealing with crazy holiday traffic and airport delays, or stressing about whether the turkey is going to be fully cooked and ready before the guests arrive while balancing multiple dishes with different temperature requirements and limited oven space, you know how people like to remind you to breathe when you’re stressed out?

The research suggests that this is indeed good advice, and we’ve looked at studies before which illustrate some of the benefits (like here).

But there are so many different ways to breathe!

There’s diaphragmatic breathing, box breathing (aka tactical breathing), alternate nostril breathing, 4-7-8 breathing, mindfulness breathing, resonance breathing, and any number of other techniques that probably pop up on every day on your Instagram or TikTok feed.

Does it really matter which breathing technique you use? Or are there some ways of breathing that are more effective than others?

Is there a best one?

I’m not aware of any studies that do a head-to-head comparison of the full range of different breathwork interventions out there (though there’s this 2023 meta-analysis that kind of goes in this direction).

But there is a recent study (Balban et al., 2022) which compared three contrasting breathing exercises along with mindfulness meditation to see which might have the greatest effect on mood and anxiety.

And what did they find?

A breathing study!

The researchers recruited 108 participants, who were asked to wear a popular heart rate-monitoring device on their wrist, do some daily breathing or mindfulness exercises, and complete a series of mood and anxiety assessments every day for 28 days.

The participants were semi-randomly assigned to one of four groups.

  • 24 participants were in a mindfulness meditation group, where they basically monitored their breathing and were asked to refocus their attention on their breath and forehead whenever they found their mind wandering.
  • 30 participants were assigned to a cyclic sighing group, which is a breathing exercise that emphasizes long slow exhales, relative to shorter inhales.
  • 21 participants were assigned to a box breathing group, which involved inhales, holds, and exhales of the same exact length of time.
  • And 33 participants were assigned to a cyclic hyperventilation group, which emphasized longer inhales, relative to shorter exhales.

As you can imagine, they didn’t stick with the program every single day, but overall the groups did pretty well. Specifically, the mindfulness meditation group averaged about 6 minutes of meditation on around 18 of the 28 days. And the breathwork groups averaged 6-ish minutes of breathing exercises on about 20 of the 28 days. (BTW, this difference in adherence was not statistically significant, in case you were wondering. 😁)

So were there any differences in mood or anxiety ratings between these four groups?

What did the researchers find?

Anxiety

Well, when it came to anxiety, both the mindfulness and breathing groups experienced a similar reduction in anxiety after engaging in their meditation or breathing exercises. As in, there wasn’t any particular method that seemed to reduce anxiety more than the others.

That said, I do wonder if there might have been a difference if participants were more stressed out. Participants completed the exercises during the normal course of a day, so it wasn’t like they were especially stressed out at the time. So maybe there would have been some different findings if they assessed their anxiety and tried the breathing exercises right before a stressful test or performance for instance? Anyhow, at least in this study, all four exercises seemed to produce a similar reduction in anxiety.

Negative affect

Like with anxiety, the different meditation and breathing techniques all had some effect, with all four groups reported feeling less negative after completing their exercises. And here too, there wasn’t much of a difference between the groups.

Positive affect

However, when it came to positive affect or mood, there were some notable differences.

On one hand, the meditation group did experience somewhat of a boost in positive mood – but the breathing exercises led to a bigger improvement in positive mood than the mindfulness meditation.

And out of the three breathwork methods, cyclic sighing was the one that stood out, with these participants having the biggest increase in positive mood over the course of the study.

Interestingly, the cyclic sighing participants’ normal everyday breathing rate also slowed down more than those in the mindfulness group. And there was also a significant negative correlation between change in breathing rate and change in positive affect. Meaning, the folks who experienced a greater slowing in their breathing rate and a larger decrease in the number of breaths they took each day, were the ones who tended to report the greatest increase in positive mood and affect.

And, unlike the meditation or other breathing groups, there seemed to be a cumulative effect for the cyclic sighing group too. As in, the more consistently participants did the cyclic sighing exercise from day to day, the more they tended to benefit.

And why does breathing, and cyclic sighing in particular seem to have a greater positive effect?

Why does this work?

Well, there are a number of potential explanations. And the authors describe several neurological, physiological, and psychological mechanisms in the paper. If you’d like to dig into it a bit further, two of the co-authors of the study share some more details here (with David Spiegel) and here (with Andrew Huberman).

So what are we to take away from all of this? And most importantly, how exactly do we do this cyclic sighing thing anyway?

Take action

If you’re already really comfortable with, or have had great results with a particular breathing method, I’m guessing it’s fine to continue with this – at least when it comes to regulating anxiety.

After all, in this study, there wasn’t much of a difference in anxiety reduction between cyclic sighing and box breathing.

However, when it comes to reducing anxiety and getting into a better headspace and emotional state, it does seem like cyclic sighing is worth a try.

You can watch one of the co-authors demonstrate the technique here , but the gist is:

  1. Take a nice easy breath in through your nose, and near the end of your breath, take in another short inhale to top things off…
  2. And then take a nice slow extended exhale, breathing out your mouth

So with the Thanksgiving holidays coming up this week, maybe try setting aside a minute or two every day to practice a little cyclic sighing. And then, when an unexpected bit of stress presents itself, try a single repetition or two and see if that helps you to lower your stress a bit and even boost your mood a touch.

It may not sound like much, but you might be surprised at how much a difference a few seconds of breathing can make!


Reference

Balban, M. Y., Neri, E., Kogon, M., Weed, L., Nouriani, B., Jo, B., Holl, G., Zeitzer, J. M., Spiegel, D., & Huberman, A. D. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine4(1), 100895. https://doi.org/10.1016/j.xcrm.2022.100895

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