Breathwork types range from slow nasal patterns to faster pranayama and breath holds, and they work by changing rate, depth and timing to shift the autonomic nervous system, blood gases and heart rhythm. Slow breathing near six breaths per minute raises heart rate variability and supports a calmer state, exhale-weighted patterns can lift mood, and specialized methods such as alternate-nostril breathing or humming influence airflow and nasal nitric oxide. Intensive formats use fast breathing or long holds and need added care. Controlled trials and reviews report small to moderate benefits for stress and mood, with mechanisms that include vagal engagement and cardiorespiratory coupling.
Slow breathing methods and why they calm the body
Slowing the breath increases the natural rise and fall of heart rate with each cycle, a pattern called respiratory sinus arrhythmia. Studies show that breathing close to six breaths per minute strengthens these oscillations, improves baroreflex function and often raises short-term heart rate variability. This is one reason many entry-level methods target an even 5-second inhale and 5-second exhale through the nose.
A recent review pooled lab and training studies and found that voluntary slow breathing increases vagally mediated heart rate variability during practice and in short windows after practice, consistent with a shift toward parasympathetic activity. The same review noted wide variation in protocols, which matters when comparing methods.
Resonance breathing at about six breaths per minute
Resonance breathing asks you to breathe slowly so that oscillations in heart rate and blood pressure line up near 0.1 Hz. This pacing is used in heart rate variability biofeedback and has been shown to maximize cardiorespiratory coupling for many people. A practical way to try it is 5 seconds in and 5 seconds out for five to ten minutes.
Clinical and laboratory research links this practice with improved baroreflex sensitivity and higher heart rate variability during and after sessions. These changes likely underpin the calming effect that many users report.
Exhale-weighted cyclic sighing
Cyclic sighing uses a small nasal inhale, a second short top-off inhale, then a slow sighing exhale. In a randomized trial, five minutes per day produced greater gains in positive affect and larger drops in resting breathing rate than a mindfulness control and than other tested breathing patterns. The short daily dose and clear instructions make it easy to add during a busy day.
Box breathing and other paced-hold methods
Box breathing uses equal counts for inhale, hold, exhale and hold. Evidence for this exact pattern is limited, yet its benefits likely overlap with other slow paced methods because the total breathing rate drops toward the six-per-minute range. Reviews of slow breathing point to autonomic shifts as a shared pathway across techniques.
The 4-7-8 method
The 4-7-8 count is another common pattern with a long exhale and a mid-breath hold. An experimental study found that a brief 4-7-8 session improved heart rate variability and lowered blood pressure, with stronger effects in rested participants than in those who were sleep deprived. People often use this method at night to wind down.
Alternate-nostril and unilateral-nostril breathing
Alternate-nostril breathing, known as nadi shodhana, shifts airflow between sides of the nose in a set rhythm. Trials report improvements in heart rate variability, blood pressure and simple lung function measures after weeks of practice. Mechanistic work using electroencephalography suggests that unilateral and alternate patterns change brain network oscillations during practice.
Some research reports that left-nostril practice may tilt the body toward a quieter state and right-nostril practice toward alertness, although findings differ across studies and standardization is still a challenge. Results should be read as preliminary and method specific.
Humming and Bhramari breathing
Humming during exhalation is central to Bhramari. Humming increases air exchange between the nasal cavity and the paranasal sinuses, which hold high concentrations of nitric oxide. Reviews describe nasal nitric oxide as a local messenger that influences airway function and may reach the lungs during nasal breathing. Small studies of Bhramari report favorable shifts in heart rate variability during or after practice, but larger trials are needed.
Fast pranayama such as Kapalabhati and Bhastrika
Fast breathing methods increase ventilation and often produce tingling or lightheadedness in novices. A 2023 overview of high-ventilation practices noted marked shifts in carbon dioxide and called for clear contraindications for some groups. Early work on slow-paced Bhastrika reports short-term reductions in blood pressure, yet protocols vary. These methods sit in the advanced category for most people.
Breath holds and hypoventilation during training
Some athletes pair breath holds with intervals to increase the hypoxic stimulus. Research on voluntary hypoventilation at low lung volume reports gains in repeated sprint ability in certain settings and sports, although results differ across protocols. A meta-analysis in 2025 found improved fatigue resistance during repeated sprints when training used voluntary hypoventilation at low lung volume compared with similar training while breathing normally. Other work shows mixed findings for broader aerobic adaptations, so planning needs to be sport specific.
Breath holds also have a long history in diving sports. Reviews describe acute increases in catecholamines, changes in blood distribution and shifts in ventilatory response with repeated practice. These training choices should be supervised and matched to the demands of the sport.
Clinical techniques such as pursed-lip breathing
Pursed-lip breathing is used in pulmonary rehabilitation. By narrowing the lips on exhale, airway pressure stays higher and small airways are less likely to collapse. Randomized cross-over studies in chronic obstructive pulmonary disease show reduced dynamic hyperinflation and better exercise tolerance during tests when patients use pursed-lip breathing. This technique is a clinical tool rather than a general stress practice. (PubMed)
Intensive session formats and branded methods
Holotropic breathwork and related long sessions use rapid breathing with music and extended timeframes. Evidence includes small observational and pilot studies that report changes in mood and self-ratings weeks after a session, along with recent work linking lower end-tidal carbon dioxide during deliberate hyperventilation to the onset of altered states. These formats can provoke strong physical and emotional reactions and are usually done with trained facilitators.
Another well known protocol pairs fast breathing with cold exposure and breath holds. A controlled experiment showed that trained participants could voluntarily raise adrenaline and dampen inflammatory responses during endotoxin challenge. Later syntheses report trends toward reduced inflammatory markers, with open questions on clinical use and performance effects. This approach is not entry level and should be practiced with strict safety rules.
We note that breathwork is also practiced in plant medicine retreats hosted by ONE Retreats, and we meet visitors to Jamaica who ask about how it fits within a broader program. This mention is for information only.
How the main types compare
Goal calm and steady focus
Resonance breathing and exhale-weighted cyclic sighing target parasympathetic activity and show benefits for mood, stress and resting breathing rate in short daily sessions. These are practical first choices for most people building a habit.
Goal breath awareness and pacing skills
Box breathing and 4-7-8 give clear counts that simplify practice. The counts slow the rate which is likely the key driver of effect. Experimental work shows that a brief 4-7-8 session can move heart rate variability and blood pressure in the desired direction.
Goal nasal function and gentle autonomic reset
Alternate-nostril breathing and Bhramari humming adjust airflow through the nose and sinuses. Trials report improvements in simple cardiovascular and respiratory measures, while reviews highlight the biology of nasal nitric oxide as a possible link to airway and vascular effects. Results vary and protocols differ, so start short and track response.
Goal advanced experiences or sport-specific stressors
Fast breathing, long breath holds and intensive sessions add stronger physiological loads. Research documents large shifts in carbon dioxide and catecholamines. These methods are optional for most users and call for supervision and screening.
What the evidence says about mental health and stress
A 2023 meta-analysis of randomized trials found small to moderate improvements in self-reported stress, anxiety and depressive symptoms when breathwork was compared with controls. An RCT of five minutes per day of breathing practice reported that cyclic sighing produced the largest gains in positive affect relative to a mindfulness control and other breathing patterns. These results support short, structured daily use, while larger trials with low risk of bias are still needed.
Special cases such as asthma
For adults with mild to moderate asthma, a Cochrane review concluded that breathing exercises may improve quality of life and hyperventilation symptoms with mixed findings for lung function. Trials of the Buteyko method report improved quality of life and lower use of reliever medication in some settings. These approaches are add-ons to medical care rather than replacements.
Safety notes that apply across types
Gentle slow breathing is generally safe for healthy adults when seated. High-ventilation practices, long breath holds and methods that trigger strong emotional release require added caution. A 2023 review of high-ventilation practices called out specific contraindications for pregnant people and for some clinical populations such as those with epilepsy and panic disorder. People with heart or lung disease, severe anxiety or a history of fainting should speak with a clinician before trying fast breathing or prolonged holds. Avoid any intensive breathing practice in water or while driving.
A practical way to pick and use a method
Step one choose a base pattern
Start with resonance breathing or cyclic sighing for five to ten minutes daily for two weeks. Both have controlled evidence for stress and mood and are simple to pace without equipment.
Step two add one targeted method
If you like nostril practices add two to five minutes of alternate-nostril breathing in the afternoon. If you want a simple count for evenings use 4-7-8 for two minutes then switch back to gentle resonance breathing until you feel settled.
Step three keep notes
Record time of day, minutes practiced and basic outcomes such as stress level or sleep onset. If a method produces tingling, dizziness or strong emotion, stop and return to easy nasal breathing while seated.
Step four progress only if needed
Advanced choices like fast breathing, long holds or intensive sessions are optional. If you pursue them, seek qualified instruction and confirm that no contraindications apply to you. Reviews and trials show powerful physiological effects which is why guidance matters.
Conclusion
Slow nasal breathing near six per minute, exhale-weighted patterns and simple counts have the strongest practical case for beginners because they are easy to repeat and supported by controlled trials and physiological models. Alternate-nostril breathing and humming add nasal and sinus mechanics that may matter for some users. Intensive protocols and breath-hold training produce large physiological shifts and fit specific goals, not general daily stress relief. Across methods the most consistent gains come from short daily practice over weeks, with safety rules in place for anything fast or breath-hold heavy.
