The Healing Breath

We take around 20,000 breaths a day, almost all of them without a thought. Yet the breath is one of the most powerful healing tools we have. It is free, it goes everywhere with us, and it works within minutes. Learning to breathe well, and knowing which breath to use when, can change how we feel, sleep, think and heal.

The remote control for your nervous system

Most of the body's automatic systems, such as the heartbeat, digestion and hormone release, run without our say. The breath is different. It runs by itself, but we can also take control of it at any moment. That makes it a doorway into the autonomic nervous system, the part of us that switches between "fight or flight" and "rest and digest".¹

The key is simple:

• Breathing in gently speeds up the heart and nudges us toward alertness.
• Breathing out slows the heart and calms us, through the vagus nerve.

So slow breathing with long out-breaths calms us down, while fast, forceful breathing wakes us up. Almost every breathwork method is a variation on this theme. A review of controlled trials found that breathwork practices lowered stress, anxiety and low mood compared with control groups.² (See Where Body Care Meets Mind.)

The foundations of good breathing

Before trying any method, it helps to get the basics right. Many of us, especially under stress, breathe too fast, too high in the chest and through the mouth. Healthy everyday breathing is:

• Through the nose. The nose filters, warms and moistens the air, and makes nitric oxide, a gas that helps open the airways and blood vessels. Nose breathing even seems to influence the brain: in one study, people's memory and their ability to recognise fear were sharper as they breathed in through the nose.³
• Low and slow. Breathing with the diaphragm, the dome-shaped muscle beneath the lungs, so that the belly rises and falls rather than the shoulders. Diaphragmatic breathing has been shown to improve attention and lower the stress hormone cortisol.⁴
• Quiet and gentle. Good breathing is almost invisible. If you can hear your breathing at rest, or you often sigh and yawn, you may be breathing more than you need.

A guide to breathwork methods

There are many ways to work with the breath. Here are some of the most useful, from the gentlest to the most energising.

Resonance breathing

How: Breathe in through the nose for about 5 seconds and out for about 5 seconds, so that you take around six breaths a minute. Keep it smooth and comfortable. Practise for 5 to 20 minutes.

When: Daily, to build resilience, calm anxiety and support the heart.

Evidence: Good. At this pace, the heart rhythm, breath and blood pressure fall into step, and heart rate variability (HRV), a measure of a healthy, flexible nervous system, rises.^5,6 Interestingly, reciting the rosary or chanting mantras naturally slows breathing to the same rhythm.⁷ (Read more in Heart-Brain Coherence.)

The physiological sigh

How: Take a deep breath in through the nose, then a second, shorter sip of air on top, to fill the lungs fully. Then let it all go in a long, slow breath out through the mouth. One to three sighs can be enough, or repeat for five minutes.

When: The fastest way to settle in a stressful moment.

Evidence: Good. This is the natural sigh the body makes by itself to reset the lungs, for example after crying. In a Stanford study, five minutes a day of "cyclic sighing" for a month improved mood and calmed breathing more than mindfulness meditation did.⁸

Box breathing

How: Breathe in for 4 seconds, hold for 4, breathe out for 4, hold for 4. Picture tracing the sides of a square.

When: To stay calm and focused under pressure, before a presentation, exam or difficult conversation. It is used by the military, firefighters and athletes.

Evidence: Moderate. It slows the breath and gives the mind something to focus on, though it has been studied less than the methods above.

4-7-8 breathing

How: Breathe in quietly through the nose for 4 seconds, hold for 7, then breathe out slowly through the mouth for 8. Repeat four times.

When: At bedtime, or when lying awake in the night. (See The Art of Sleep.)

Evidence: Limited so far, though the long out-breath is calming and many people find it helps them drift off. If the counts feel too long, keep the same pattern but count faster.

Alternate nostril breathing

How: From yoga, this is known as nadi shodhana. Close your right nostril with your thumb and breathe in through the left. Close the left with your ring finger, release the right, and breathe out through it. Breathe in through the right, close it, and breathe out through the left. That is one round. Continue for 5 minutes.

When: To feel balanced, calm and clear, and before meditation.

Evidence: Moderate. In one study, practising for 18 minutes lowered blood pressure.⁹

Humming breath

How: Known in yoga as bhramari, or "bee breath". Breathe in through the nose, then hum gently on a long breath out, feeling the vibration in your face and chest. Repeat for a few minutes.

When: To calm a busy mind, and to support the sinuses.

Evidence: Promising. Humming lengthens the out-breath and may stimulate the vagus nerve, which runs close to the vocal cords. It also increases nitric oxide in the nose around fifteen-fold.¹⁰ (For more on the healing power of sound, read The Sound of Stillness.)

Buteyko breathing

How: Developed by the Ukrainian doctor Konstantin Buteyko, this method teaches you to breathe less: gently, through the nose, with short, relaxed pauses after breathing out. It is best learned from a trained teacher.

When: For asthma, a blocked nose, snoring, and the habit of over-breathing that often comes with anxiety.

Evidence: Good for asthma. Studies show people using it need their reliever inhalers less often and enjoy a better quality of life.¹¹ Breathing exercises are now recommended alongside medicines in UK asthma guidelines. Never stop or change asthma medicines without your doctor's advice.

Energising breathwork

How: These methods use fast, deep or forceful breathing. In the Wim Hof method, you take around 30 deep, rapid breaths, then breathe out and hold for as long as is comfortable, over several rounds. Kapalabhati, or "breath of fire", from yoga, uses quick, sharp breaths out from the belly.

When: In the morning, for energy and focus. Not before bed.

Evidence: Promising, but early. In a well-known Dutch study, people trained in the Wim Hof method had fewer flu-like symptoms and lower inflammation when given a bacterial toxin.¹² But these methods are powerful and are not suitable for everyone (see the safety notes below).

Long out-breaths calm us down; fast, forceful breathing wakes us up.

Building a daily breath practice

You don't need to learn everything at once. A simple daily rhythm might look like this:

• Morning: five minutes of resonance breathing, or a few rounds of energising breathing if it suits you, ideally outdoors in daylight.
• During the day: a physiological sigh whenever you notice tension. Check in now and then: is your breathing through your nose, low and slow?
• Evening: humming or alternate nostril breathing to unwind, and 4-7-8 breathing in bed.

Like any skill, breathwork grows stronger with practice. A few minutes every day does more than an hour once a week. Pairing your breath with a feeling of warmth or appreciation deepens the effect, and if you'd like to see your progress, the heart rate variability monitors listed in Heart-Brain Coherence show your heart rhythm settling as you breathe.

The breath also works hand in hand with the rest of your health. A calm nervous system supports a healthy cortisol rhythm, better digestion and deeper sleep, and good food, movement and time in nature all make it easier to breathe well.

At Rootwise, the breath is often where healing begins. Before any herb or supplement, learning to breathe well gives the body the calm, safe signal it needs to rest, repair and come back into balance.