Controlled breathing has been shown to reduce stress, increase alertness and boost your immune system.

While various breathing practices have been around for centuries, science is just beginning to provide evidence that the benefits of this ancient practice are real. Studies have found that breathing practices can help reduce symptoms associated with anxiety , insomnia , post-traumatic stress disorder, depression, and attention deficit disorder.

At Parsley Health, providers often recommend meditation and breathwork as part of a holistic treatment plan , whether you’re targeting stress and burnout , hormonal imbalances , sleep disorders, or digestive dysfunction , in order to restore balance to your days and encourage positive mental health habits. New to breathwork? Don’t feel intimidated if you’ve never had a formal meditation or breathwork practice: Certain breathing techniques are simple enough to practice at home, during a work break, first thing in the morning, or before bed. Here’s the scoop on breathwork and what the science has to say about this historic and healing wellness practice.

What is breathwork?

Breathwork describes a group of exercises that teach you to manipulate your breathing rate and depth with the goal of bringing awareness to your breath and ultimately providing the same benefits you might get from a meditative practice. Even if it seems like an “up-and-coming” wellness practice in the West, people in the Eastern part of the world have been practicing breathwork for thousands of years. Prana, the foundation of the Pranayama breathwork practice dating back to ancient India, means “sacred life force” in Sanskrit, and also fuels traditional yoga practices, according to Dr. Stanislov Grof , a psychiatrist and one of the premiere researchers of breathwork in the Western world. A similar concept in traditional Chinese medicine, chi, describes the “cosmic essence” of breathing, while Japanese spiritual and martial arts practices use the term ki to refer to this idea, Dr. Grof adds. (Learn more about why it’s important to understand the history of wellness practices from Asia .)

The majority of breathwork, regardless of where exactly the specific practice originated, aims to move some type of energy through the body. Most formal practices involve 20 minutes to an hour of sustained, rhythmic breathing techniques. People who practice breathwork describe feeling tingling sensations throughout their body, feelings of clarity, alertness, increased mind-body connection, and even emotional purging.

What are the different types of breathwork?

There are many types of breathwork practices, some ranging from fairly basic and easy to do at home, to others requiring a practitioner to teach you the practice. Some breathwork practices are rooted in yogic traditions such as Pranayama or the breath and movement sequences of Kundalini yoga. Some breathwork practices have a religious basis, such as in Buddhism. Other breathwork practices, including Holotropic breathwork, involving accelerated breathing and meditative music and developed by Dr. Stanislov Grof and psychotherapist Dr. Christina Grof, are entirely secular and were developed to help people heal their minds or bodies or even to withstand extreme physical conditions.

Here are some breathing exercises you might want to try to get you started with a regular breathwork practice that aims to calm your nervous system.

1. Box Breathing. This exercise, which mental health practitioners commonly recommend, involves visualizing a square shape and focusing on that, and then breathing in deeply for a count of four. Then you hold your breath for a count of four, and exhale for a slow count of four. After, hold your breath again for four counts before taking another four-count inhale.
2. Diaphragmatic Breathing. Taking a breath from your diaphragm, between your chest and abdomen, can help you achieve deeper, more expansive breathing. The easiest way to get comfortable with diaphragmatic breathing is by lying down with your knees bent and feet on the floor, with one hand on the chest and one hand on the abdomen. Inhale, feeling the abdomen and chest rise, hold the breath at the top, and then exhale, and let the abdomen and chest fall.
3. 4-7-8 Breathing. Rooted in Pranayama, 4-7-8 breathing is another way to calm and ground yourself by counting your inhales and exhales. Start by exhaling, and then take a fresh breath in through your nose to a count of four. Hold your breath at the top, for seven counts, and then exhale any negative energy out for a full count of eight. Then, repeat this breath cycle three more times for a total of four cycles.
4. Alternate Nostril Breathing. This type of breathwork, known as Nadi Shodhana in Sanskrit, also originated in Pranayama. The act of strategically breathing in one nostril at a time has been shown to reduce baseline markers of anxiety , according to a 2017 study published in the journal Biomedical Research International . It’s one of the less simple types of breathwork, but can be done at home. First, take your right hand in front of your face and with your right thumb, close your right nostril. Inhale through your left nostril, and then plug it shut with the right ring finger. Both nostrils should be plugged at the top of the breath. Now, open your right nostril and exhale through that side. Repeat the practice, now inhaling through the right nostril and plugging the left with the right ring finger, pausing at the top, and exhaling through the left nostril. This is one circuit; keep doing this circuit a few more times.

Top health benefits of breathwork

You’ve probably read about the benefits of deep breathing — even a few deep breaths can lower blood pressure and cortisol levels and increase parasympathetic tone, but breathwork is a little different. Formal breathwork practices exert some even more impressive positive effects on the body and work in a different and almost opposite way. Here’s the science behind the magic.

Alkalizes your blood PH.

The physiologic changes we see during sustained, rhythmic breathing are caused by a shift of the blood pH that follows hyperventilation – a state called “respiratory alkalosis.” Thanks to the field of anesthesiology, we know a lot about what the body does during respiratory alkalosis.

You probably remember that we take in oxygen during the inhale breath and get rid of CO2 with every exhale. When we take faster breaths we get rid of more CO2. CO2 is an acidic molecule, so you can think of hyperventilating as getting rid of acid in the blood and shifting to a higher, or more alkaline pH (thus the term respiratory alkalosis).

Increases muscle tone.

When the blood becomes more alkaline a few things happen. First, calcium ions floating around in the blood go into hiding, binding onto large proteins in the blood called albumin. The body now experiences a short-term low-calcium state which causes increased firing in sensory and motor neurons. The artificially low blood calcium now manifests in the neurological system as tingling sensations, smooth muscle contractions, and increased muscle tone (If you’ve ever not been able to move your mouth after a breathwork class, you know this feeling too well.) In addition, the diaphragm is a muscle that’s responsible for 80 percent of your breathing, according to Penn Medicine , so consistent breathwork is a way to exercise that muscle and support your breathing, especially for other forms of exercise like long-distance running.

Has an anti-inflammatory effect.

Neurons in the autonomic nervous system also fire more during hyperventilation, releasing epinephrine (what many people call “adrenaline”). A 2014 study found that the epinephrine surge causes the innate immune system to increase its anti-inflammatory activity and dampen its proinflammatory activity. Subjects who were taught a breathwork routine had less severe inflammatory responses after exposure to IV bacterial toxins than those who didn’t. The paper was the first in scientific literature to describe voluntary activation of the innate immune system .

Improves blood pressure and circulation.

Deep breathing exercises can be beneficial to people with high blood pressure, and in improving blood circulation in general, according to a small 2017 study published in the International Journal of Pharma and Bio Sciences . This may be helpful for people who struggle with stress, a risk-factor for hypertension . In the experimental group of the study, participants had lower blood pressure after practicing breathwork than before.

Elevates your mood and reduces stress.

The “high” feeling some people experience during breathwork can also be explained by hyperventilation and respiratory alkalosis. Increased blood pH decreases oxygen delivery to tissues (a phenomenon called the Bohr Effect). Within one minute of hyperventilation, the vessels in the brain constrict, reducing blood flow and oxygen delivery to the brain by 40 percent. The effect is probably responsible for the feelings of wellbeing that breathwork practitioners experience. That’s right—you are actually getting a little high in your Kundalini yoga class.

Not only that, but breathwork can also have marked benefits to your mental health. In a new study conducted by Yale University, students who participated in a yoga and breathwork program self-reported improvements in stress, depression, positive affect, mindfulness, and social connectedness. The study compared the breathwork program to an emotional intelligence program, for which students reported only mindfulness as a benefit, and a mindfulness-based stress reduction program, which didn’t show any changes. The breathwork program is what seemed to have the most positive effect on participants’ overall mental health.

What you should know before starting breathwork.

Breathwork is generally safe, well-tolerated, enjoyable and definitely worth a try for most people. It might be particularly good for people with an autoimmune disease as there’s evidence that it can change the inflammatory response from our innate immune system. However, there are a few cases when it would not be advised to do breathwork; namely for anyone with a known cardiac arrhythmia (including very slow heart rate), a history of heart block, or people taking certain antipsychotic medications.

Additionally, some types of breathwork can induce hyperventilation, which can bring on dizziness, chest pain, and pounding heartbeat.

Final thoughts on breathwork.

• Breathwork involves manipulating your breathing rate to change how you’re feeling.
• There are several types of breathwork practices, some ranging from fairly basic and easy to do at home, to others requiring a practitioner to guide you.
• The benefits of breathwork include reducing stress and inflammation to alkalizing your blood PH levels.
• Check with your doctor before you start a breathwork practice if you have a history of cardiovascular issues, including high blood pressure, or are currently taking antipsychotic medications.