PausesA 4-minute read
Breathing is the one stress tool you always carry. It needs no equipment, no app and no special place, and the National Institutes of Health have looked at the research on it. This guide explains what slow breathing is meant to do, how to practice it, and what the National Center for Complementary and Integrative Health, part of the NIH, says the evidence shows.
Stress response, relaxation response
Under stress, NCCIH explains, the body releases hormones that produce the fight-or-flight response: heart rate, breathing and blood pressure rise, muscles tense, and you sweat more. Relaxation techniques aim at the opposite, which NCCIH calls the relaxation response, characterized by slower breathing, lower blood pressure and a reduced heart rate. NCCIH describes it as a built-in stress reset button.
How to practice slow, deep breathing
NCCIH describes breathing exercises simply: you focus on taking slow, deep breaths, a practice also called diaphragmatic breathing. A basic way to try it:
- Sit or lie down comfortably. Place one hand on your chest and one on your belly.
- Breathe in slowly through your nose, letting your belly rise more than your chest.
- Breathe out slowly.
- Keep your attention on the breath. When your mind wanders, bring it back.
- Continue for a few minutes, then sit quietly for a moment before getting up.
Tip: Pair breathing with something that already happens every day: the kettle boiling, the computer starting up, waiting at a red light with the car stopped. That way the practice does not need its own appointment.
What the research shows
NCCIH is careful about the evidence, and it is worth reading its findings as written rather than as headlines.
| Finding cited by NCCIH | Studies | What it means |
|---|---|---|
| Diaphragmatic breathing may help reduce stress (2019 review) | 3 studies, 880 participants | Preliminary evidence, with changes in self-rated mental health, cortisol and blood pressure |
| Slow breathing led to a modest drop in blood pressure (2019 review) | 17 studies, 1,165 participants | Studies differed, had short follow-up and high risk of bias |
| Heart rate variability biofeedback, which uses breathing, reduced self-reported stress and anxiety (2017 review) | 24 studies, 484 participants | A promising approach, the researchers said |
| Paced breathing improved hot flashes (2019 review) | 4 studies, 398 participants | Specific to hot flashes |
NCCIH also notes that deep breathing has been found to reduce blood sugar in people with type 2 diabetes, which may make it a useful addition to standard care. If you have high blood pressure or diabetes, though, breathing exercises are an addition to your treatment plan, not a replacement. NCCIH advises discussing any complementary approach with your health care provider.
Other techniques in the same family
- Progressive muscle relaxation: tense a muscle group, then release it, working through the body. NCCIH says studies show it may produce stress-alleviating effects.
- Guided imagery: picture a calm scene and try to produce the same feeling in your body.
- Autogenic training: mental exercises that focus attention on the body’s sensations of relaxation.
- Mindfulness meditation: often uses the breath as its focus; NCCIH says current evidence suggests it may help reduce symptoms of stress.
Use of these practices is growing. According to the National Health Interview Survey, cited by NCCIH, 6.4 percent of U.S. adults used guided imagery or progressive muscle relaxation in 2022, up from 3.8 percent in 2002.
For people with diagnosed anxiety, NCCIH describes mixed but notable results. A 2018 review of 16 studies with 856 people with anxiety disorders found that relaxation therapy reduced symptoms of anxiety, depression, phobia and worry. Another 2018 review of 50 studies found relaxation therapy less effective than cognitive behavioral therapy for post-traumatic stress disorder and obsessive-compulsive disorder. In other words, these techniques can help, but they are not a substitute for treatment when it is needed.
Is it safe?
Relaxation techniques are generally considered safe for healthy people, NCCIH says, and most studies report no negative side effects. Occasionally people report increased anxiety, intrusive thoughts or fear of losing control, and there have been rare reports that certain techniques might cause or worsen symptoms in people with epilepsy, certain psychiatric conditions, or a history of abuse or trauma. If a technique makes you feel worse, stop and try another, or talk to a professional.
When breathing is not enough
If stress or anxiety will not go away, or interferes with daily life, the National Institute of Mental Health advises talking to a health care provider; psychotherapy and medication are the two main treatments for anxiety. If you are in immediate distress or thinking about hurting yourself, call or text 988. For everyday use, breathing fits well into Short Breaks During the Workday: Move, Breathe and Reset Between Tasks, Slow Mornings: How to Start the Day Without Rushing and A Simpler Evening Routine: Winding Down the Way Sleep Experts Suggest.