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Deep breathing, diaphragmatic breathing, slow breathing, or controlled breathing exercises are popular in the
wellness movement as a mind-body technique. It is not a form of physical exercise, in and of itself. It is a mind-body
technique that can be added to various routines for an added relaxing effect.
Highlights of Deep Breathing:
- Deep breathing is a mind-body technique.
- The long term practicing of deep breathing exercises improves wellness..
- Slow breathing is the healthiest form of deep breathing.
Controlled breathing exercises can be used to promote wellness.
- Breathing, especially the exhalation phase, has a natural automatic relaxing effect.
- One physical mechanism of action for this relaxing effect is the accumulation of carbon dioxide in the blood.[9]
- Self-perceived reductions in levels of tension and anxiety.[7]
- Slow breathing (6 breaths/minute) increases resting oxygen saturation and improves exercise tolerance.[3]
- "Several studies ... showed that 15 minutes of daily breathing exercise lowered BP [Blood Pressure]
within 8 weeks by 12.1/6.1 mmHg as compared to 7.6q3.4 mmHg in the control group."[6]
- "Slow breathing at 6 breaths/minute increases baroreflex sensitivity and reduces sympathetic activity
... suggesting a potentially beneficial effect in hypertension. ... Slow breathing decreased systolic and diastolic
pressures in hypertensive subjects ... Slow breathing reduces blood pressure and enhances baroreflex sensitivity
in hypertensive patients."[5]
- Baroreflex is the system in the body that regulates blood pressure by controlling heart rate, strength of heart
contractions, and diameter of blood vessels.
- EXPLANATION OF THE MOST LIKELY PHYSICAL MECHANISM OF ACTION FOR DEEP BREATHING: "The linkage between
vagal baroreflex impairment and mortality may partially reflect patients' autonomic responses to cardiac rhythm
changes. ... the body's modulatory processes (e.g., the well-known modulation of BP [blood pressure] changes by
baroreflex activity), through which vagal as well as sympathetic reflexes may be controlled. ... Thus, vagal cardiac
and pulmonary mechanisms are linked, and there are reasons to expect that improvements in one vagal limb might
spill over into the other. ... We suggest that chronic biofeedback-induced increases in baroreflex gain, which,
to our knowledge, has not previously been reported, reflects neuroplasticity [i.e., nerves that are capable of
growing or developing]."[10]
- "Baroreflex sensitivity can be enhanced significantly by slow breathing, both in health and in the
presence of CHF [chronic heart failure]. This seems to occur through a relative increase in vagal activity and
a reduction in sympathetic activity, as could be argued by the small reduction in heart rate observed during slow
breathing and by the reduction in both systolic and diastolic blood pressures."[2]
- Deep breathing can be used to elicits the relaxation response.[8]
- Deep breathing can be used as a mind-body sleeping aid.[8],[9]
Controlled breathing exercises have the following variables.
- Breaths per minute, respiration rate, or rate of breathing:
- Slow breathing
- 6 or 5 breaths/minute[2]
- "Slow, rhythmic, and deep breathing"[4]
- "There was a significant decrease in basal heart rate in slow breathing group after three months of
practice of slow breathing exercise."[1]
- "produced a significant increase in respiratory pressures and respiratory endurance."[4]
- "Heart rate, rate-pressure product and double product decreased."[4]
- Slow breathing is the healthiest method of deep breathing.
- Spontaneous, or normal uncontrolled, breathing
- Fast breathing
- 20 breaths or more/minute, such as the Lamaze childbirth rapid panting method.
- "Bellows-type rapid and deep breathing"[4]
- "Heart rate, rate-pressure product ... increased significantly."[4]
- All Fast/Rapid breathing techniques should be avoided. Yogic rapid breathing rates can get extremely high and
might result in hyperventilation. Also, the research indicates that rapid breathing negatively affects your heart.
- Relative duration of the inhalation, holding, versus the exhalation phases of breathing.
- 1:0:1
- 1:1:1
- 40:0:60
- 1:0:2
- The force by which air is blown out of the lungs during the exhalation phase.
- Do not ever try to use forceful breathing or exhalation techniques.
- It is not safe to force air out of your mouth, nose, or nostrils under a lot of pressure.
- The duration of the exercise session.
- 10 to 20 minutes, twice a day, is the usual duration.
- Practicing longer is not recommended. Deep breathing for several hours at a time and other excessive durations
might cause hallucinatiions[9] and, thus, should never be done.
A typical Controlled Breathing Exercise might proceed as follows.
You will need an analog clock with a second hand, and the numerals 1 through 12 clearly visible
on it, along with a silent electronic kitchen timer. Set the timer to 20 minutes or to the desired length of your
deep breathing exercise session.
- Sit quietly and comfortably in a quiet room.
- Focus your attention on your breathing, as well as on the sweeping second hand of the clock.
- Breath slowly at 6 repetitions per minute. Each complete breath should last 10 seconds. Breath in through your
nose for 4 seconds. And, then breath out through your mouth for 6 seconds. As the sweeping second hand passes each
number silently repeat the number to yourself: 1, 2. ... 12.
During this exercise you will be concentrating on your breathing, as well as on the sweeping second hand of
the clock. If your mind drifts passively bringing it back to silently repeating the correct number on the clock.
Your timer will keep you from worrying about the time. All you have to do is keep up the correct inhaling/exhaling
breathing rhythm while you silently repeat the correct number. If your mind drifts, bring it back to concentrating
on the clock.
It is very easy to determine how this slow breathing mind-body technique is affecting your heart. All you have
to do is measure, or monitor, your pulse rate and blood pressure before, during, and immediately after your deep
breathing sessions. However, the research indicates that long term benefits come from the long term practice of
slow breathing exercises.
References
- Pal GK, Velkumary S, Madanmohan. Effect of short-term practice of breathing exercises on autonomic functions
in normal human volunteers. Indian J Med Res. 2004 Aug;120(2):115-21. PMID: 15347862 [Online]
- Bernardi L, Porta C, Spicuzza L. Slow breathing increases arterial baroreflex sensitivity in patients with
chronic heart failure. Circulation. 2002 Jan 15;105(2):143-5. PMID: 11790690 [Online]
- Bernardi L, Spadacini G, Bellwon J. Effect of breathing rate on oxygen saturation and exercise performance
in chronic heart failure. Lancet. 1998 May 2;351(9112):1308-11. PMID: 9643792 [Abstract]
- Madanmohan, Udupa K, Bhavanani AB.Effect of slow and fast pranayams on reaction time and cardiorespiratory
variables. Indian J Physiol Pharmacol. 2005 Jul-Sep;49(3):313-8. PMID: 16440849 [Abstract]
- Joseph CN, Porta C, Casucci G. Slow breathing improves arterial baroreflex sensitivity and decreases blood
pressure in essential hypertension. Hypertension. 2005 Oct;46(4):714-8. Epub 2005 Aug 29. PMID: 16129818 [Abstract]
- Grossman A, Grossman E. [Treatment of hypertension with device-guided breathing exercise] Harefuah. 2003 Oct;142(10):677-9,
718. Review. Hebrew. PMID: 14565066 [Abstract]
- Clark ME, Hirschman R. Effects of paced respiration on anxiety reduction in a clinical population. Biofeedback
Self Regul. 1990 Sep;15(3):273-84. PMID: 2223892 [Abstract]
- Herbert Benson, The Relaxation Response (New York: Morrow, 1975). pages 114, 117, 121.
- Isadore Rosenfeld, M.D, Modern Prevention: The New Medicine, Linden Press, New York, 1986, page 68.
- Lehrer PM, Vaschillo E, Vaschillo B. Heart rate variability biofeedback increases baroreflex gain and peak
expiratory flow. Psychosom Med. 2003 Sep-Oct;65(5):796-805. PMID: 14508023 [Online]
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