Sleep, stress & energy
Slow breathing for stress
Can slow breathing help me feel calmer?
Slow, deep breathing helps bring on the body's relaxation response. Evidence suggests it may ease stress and modestly lower blood pressure, but the studies are small, and it does not replace treatment.
In 30 seconds
The short answer
Yes, modestly. Slow, deep breathing, also called diaphragmatic breathing, is a recognized relaxation technique.5 It aims at the relaxation response: slower breathing, lower blood pressure and a reduced heart rate.3 It may help reduce stress and modestly lower blood pressure,7 but it is not a treatment for anxiety disorders or high blood pressure.1023
- It counters the stress response. Stress raises heart rate, breathing and blood pressure; relaxation is the opposite.23
- The evidence is real but small. Reviews suggest benefits for stress and blood pressure, with short studies and a high risk of bias.89
- It is safe for most people. Rarely it worsens symptoms in epilepsy, some psychiatric conditions or after trauma.1314
- It works alongside care. Persistent anxiety needs a professional; therapy and medication are the main treatments.23
What happens in the body
Stress response and relaxation response
An illustration of direction only, based on NCCIH and MedlinePlus descriptions. Not measured values.
Everyday calm
Breathing and heart rate at your usual resting pace.
Stress response
Heart rate, breathing rate and blood pressure go up; muscles tense.12
Relaxation response
Slower breathing, lower blood pressure, reduced heart rate.3
How to do it
The NHS calming breath
Takes a few minutes and can be done anywhere.18
Get comfortable
Stand, sit with your back supported, or lie down. Loosen tight clothes.19
Breathe into your belly
As deep as is comfortable, without forcing. In through the nose, out through the mouth.20
Count gently
In for a count of 1 to 5, out for 1 to 5, if counting helps.21
Keep going
At least 5 minutes, ideally as part of your daily routine.1821
What the research shows
The evidence points the same way for stress and blood pressure, but the studies are few, small and short.
How many people the main reviews included
Who was studied, and what they did
- Blood pressure: 1,165 participants practicing slow breathing exercises; short follow-up and high risk of bias.9
- Stress: 880 participants doing diaphragmatic breathing exercises; evidence called preliminary.8
- Anxiety disorders: 856 people with generalized anxiety, social anxiety or panic disorder receiving relaxation therapy.11
- Countries and study lengths are not given on the NCCIH page.
Results from research reviews in these participants, not a description of a ProperHealth or Clarkson service.
- Diaphragmatic breathing may help reduce stress; the evidence is preliminary.8
- Slow breathing gave a modest drop in blood pressure, in short studies with a high risk of bias.9
- Relaxation therapy reduced anxiety and worry in people with anxiety disorders.11
- It was less effective than CBT for PTSD and OCD.12
Where it fits
There is no drug to cure stress,4 and slow breathing is one of several ways people release tension.31
Slow breathing is a tool alongside care. It is not a treatment for any disease.
- For blood pressure, NHLBI lists managing stress and relaxation techniques as part of a healthy lifestyle.29 Keep up your treatment plan.10
- For sleep, relaxation is often one part of CBT-I, but on its own it doesn't seem especially promising.1617
- For long-term stress, which can show up as poor sleep, headaches or irritability, notice the signs; it is easy to get used to them.2526
- For anxiety that won't go away, talk to a professional. Talk therapy and medication are the main treatments.23
From the Dr. Majid Ali archive
A historical perspective
“Normal breath-in, slow breathe-out”— Dr. Majid Ali, 2015-09-23Dr. Ali taught what he called limbic breathing for decades: abdominal breathing, a normal breath in and a slow breath out, practiced when calm so it is available when you are not. He paired it with gentle, non-competitive movement.
The practical core matches current descriptions of slow, deep diaphragmatic breathing as a relaxation technique.5 The NHS version counts the same length in and out;21 his longer out-breath is shown here as his teaching, not as a requirement.
Where ProperHealth stops. Dr. Ali linked breathing to his oxygen and "dysox" models and, in places, to disease outcomes. Only the technique is presented here; the sources used here do not support the disease claims. Nothing here presents breathing as a treatment for any condition.
What to do next
Try it once today, while calm
It takes a few minutes and can be done anywhere.18 Practicing on an ordinary day makes it easier to use later.
Breathe into your belly
Gently, without forcing; in through the nose, out through the mouth.20
Count 1 to 5 in, 1 to 5 out
Only if counting helps. Keep going for at least 5 minutes.21
Stop if you feel dizzy or uncomfortable
Return to normal breathing. Tell your clinician if relaxation ever makes you feel worse.13
Keep your treatment plan
If you have high blood pressure or anxiety, breathing practice is an addition, not a substitute.1023
Medicines and safety
A pharmacist can review what you take for stress or sleep, check interactions, and help you prepare questions for your prescriber. A pharmacist does not treat anxiety and does not adjust psychiatric or blood pressure medicines.
- Blood pressure. Slow breathing may modestly lower readings,7 but follow the treatment plan your provider prescribed10 and keep up lifestyle changes while taking your medicines.30
- Epilepsy, psychiatric conditions or a history of trauma. Rarely, relaxation techniques have worsened symptoms; talk with your clinician first.14
- If it makes you feel worse. Occasionally people report more anxiety or intrusive thoughts.13 Stop, and mention it to your clinician.
- Anxiety that persists needs a qualified professional.15 Breathing practice is not a reason to stop or change an anxiety, heart or blood pressure medicine.
Compared
Conventional and integrative care, compared
What medicine can and cannot do for stress, where breathing exercises can go wrong, what long-term stress does, and how strong the slow-breathing evidence really is.
What conventional treatment does
- There is no drug to cure stress.4 Talk therapy and medication are the two main treatments for anxiety; if you are struggling or symptoms will not go away, talk to a professional.23 If you have high blood pressure, follow the treatment plan your provider prescribed,10 and keep up healthy lifestyle changes while taking blood pressure medicines.30
Limits and adverse effects
- Relaxation techniques are generally considered safe for healthy people, but occasionally people report more anxiety, intrusive thoughts or fear of losing control,13 and rarely they have been reported to cause or worsen symptoms in people with epilepsy, certain psychiatric conditions, or a history of abuse or trauma.14 Severe or long-lasting symptoms of any kind need a health care provider.15
What stress does
- Stress is how your brain and body respond to a challenge; stress hormones can raise blood pressure, heart rate and blood sugar — the "fight or flight" response.1 Long-term stress lasts weeks, months or longer and can harm your health,24 showing up as trouble sleeping, headaches, or feeling sad, angry or easily upset;25 you can get used to the symptoms and not realize there is a problem.26
Integrative and naturopathic approaches, by evidence
Evidence levels: EstablishedEmergingHypothesisNot supported
- Established
A 2018 review of 16 studies (856 people with generalized anxiety, social anxiety or panic disorder) found relaxation therapy reduced symptoms of anxiety and worry;11 another 2018 review found it less effective than cognitive behavioral therapy for PTSD and OCD.12 NHLBI lists managing stress, including relaxation techniques, counseling and support groups, as part of a healthy lifestyle for high blood pressure.29
- Emerging
A 2019 review of 17 studies (1,165 participants) found slow breathing led to a modest drop in blood pressure — with short follow-up, a high risk of bias, and no stroke or heart-attack outcomes.9 A 2019 review of 3 studies (880 participants) found preliminary evidence that diaphragmatic breathing may help reduce stress.8 Studies show slow, deep breathing may modestly lower blood pressure and cortisol.7
- Hypothesis
Relaxation can be one part of CBT-I, the insomnia therapy, but on its own it does not seem especially promising for sleep.16 Claims that a breathing pattern alone replaces treatment for anxiety or blood pressure are not made by any source used here.
Breathlessness that is new or getting worse is a symptom, not something to breathe through: see your provider, and call 911 if it comes on suddenly or makes it hard to talk.33
When to get help now
Each warning sign cites the official guidance behind it. The wording still needs pharmacist sign-off.
- Thoughts of suicide or of harming yourself — call or text 988 (Suicide & Crisis Lifeline, US) now. In immediate danger, call 911.28
- Chest pain, pressure or tightness, especially with sweating, nausea or pain spreading to the arm or jaw — call 911.32
- Breathlessness at rest, or breathlessness that is new or getting worse — see your provider; call 911 if it comes on suddenly or makes it hard to talk. Do not try to breathe through it.3334
- Fainting, or dizziness that keeps happening during or after breathing exercises — stop and get checked.3536
- Panic attacks that are frequent, or that you are reorganizing your life around — see a provider; this is treatable.27
- Waking up gasping or choking at night — ask for a sleep assessment.37