Brief structured respiration practices enhance mood and reduce physiological arousal

Melis Yilmaz Balban; Eric Neri; Manuela M Kogon; Lara Weed; Bita Nouriani; Booil Jo; Gary Holl; Jamie M Zeitzer; David Spiegel; Andrew D Huberman

doi:10.1016/j.xcrm.2022.100895

Brief structured respiration practices enhance mood and reduce physiological arousal

Cell Rep Med. 2023 Jan 17;4(1):100895. doi: 10.1016/j.xcrm.2022.100895. Epub 2023 Jan 10.

Authors

Affiliations

¹ Department of Neurobiology, School of Medicine, Stanford University, Stanford, CA 94305, USA.
² Department of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA.
³ Department of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA; Stanford Center for Integrative Medicine, Stanford Health Care, Palo Alto, CA 94304, USA.
⁴ Department of Bioengineering, School of Engineering and School of Medicine, Stanford University, Stanford, CA 94305, USA.
⁵ Department of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA; Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care Service, Palo Alto, CA 94304, USA.
⁶ Department of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA; Center for Stress and Health, School of Medicine, Stanford University, Stanford, CA 94305, USA. Electronic address: dspiegel@stanford.edu.
⁷ Department of Neurobiology, School of Medicine, Stanford University, Stanford, CA 94305, USA; Department of Ophthalmology, School of Medicine, Stanford University, Stanford, CA 94305, USA; BioX, School of Medicine, Stanford University, Stanford, CA 94305, USA. Electronic address: adh1@stanford.edu.

Abstract

Controlled breathwork practices have emerged as potential tools for stress management and well-being. Here, we report a remote, randomized, controlled study (NCT05304000) of three different daily 5-min breathwork exercises compared with an equivalent period of mindfulness meditation over 1 month. The breathing conditions are (1) cyclic sighing, which emphasizes prolonged exhalations; (2) box breathing, which is equal duration of inhalations, breath retentions, and exhalations; and (3) cyclic hyperventilation with retention, with longer inhalations and shorter exhalations. The primary endpoints are improvement in mood and anxiety as well as reduced physiological arousal (respiratory rate, heart rate, and heart rate variability). Using a mixed-effects model, we show that breathwork, especially the exhale-focused cyclic sighing, produces greater improvement in mood (p < 0.05) and reduction in respiratory rate (p < 0.05) compared with mindfulness meditation. Daily 5-min cyclic sighing has promise as an effective stress management exercise.

Keywords: anxiety; autonomic; breathwork; heart rate variability; limbic; mindfulness meditation; mood; physiology; sleep; stress; wearable.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Affect
Anxiety / therapy
Arousal
Humans
Meditation*
Respiration

Grants and funding

P30 EY026877/EY/NEI NIH HHS/United States