In our day to day lives, we rarely think about how we breathe. In fact, it is often thought of as such an automatic bodily function, that we do not consider how our state of mind might affect it and vice versa.

There are endless blogs, Youtube videos and ‘tip lists’ about how breathing can help to ground us in moments of anxiety or panic. However, these methods frequently sit in the abstract realm of ‘practical interventions’ that simply do not feel accessible when your anxiety is triggered, or you are feeling particularly stressed.

Understanding the science and psychological evidence behind some simple techniques, and ‘grounding’ it in the very real physiological effects can help to bring it out of that abstract realm. In this blog, we will discuss in detail the evidence and practice behind: alternate nostril breathing, 4-7-8 breathing and finally resonance breathing that is informed by heart rate variability (HRV).

Alternate nostril breathing

Originating from yoga practices and known originally as nadi shodhana pranayama, or ‘subtle energy clearing breathing technique’, this method encourages us to slow down, listen to our body and mind, lowers the heart rate and promotes the ‘rest’ state or parasympathetic nervous system.

The practice

We’re going to take you through this step by step. First, ensure you are sat in a position or on a seat/the floor in a way that allows you to sit up, fully straight and back extended, you can cross your legs if you wish but if not ensure they are relaxed.

  1. Roll your shoulders back, sit up and place your left hand on your left leg, or knee if you are sat cross legged.
  2. Place the middle and index fingers of your right hand on your forehead, try to aim for as centrally as possible, right in between your eyebrows.
  3. Do one uninterrupted long exhale.
  4. Then, using your thumb, close your right nostril and inhale through your left.
  5. Use your ‘ring’ finger to close your left nostril, then open and exhale through your right.
  6. Staying put, inhale through the right nostril.
  7. To finish the cycle, close your right nostril again, open your left nostril and exhale.
  8. Continue this cycle for up to five minutes and make sure you end the cycle by exhaling on the left side.

Why does it work?

Alternate nostril breathing was found to be one of the few breathing techniques that had a positive lowering effect on heart rate, respiratory rate and blood pressure, in a 2013 study on a group of young healthcare students, who statistically have higher ‘perceived stress’ than other students.

Overall, because this technique is so focused on the breath itself, and controlling how and when it enters and exits the body, it can promote a general increase in wellbeing. Breath and how we breathe is more linked to how stressed or happy we are than we might realise and becoming more aware of this can allow us to intervene and soothe where necessary.

4-7-8 breathing

Similarly to the alternate nostril breathing, this technique also has its origins in the pranayama yogic practice of breath work. The benefits of this technique include learning how to breathe deeper, regulating our fight-flight and freeze response, aiding sleep, replenishing the body of it’s oxygen.

The practice

Again, find a comfortable place to sit in a relaxed but upright posture, alternatively you can practice this technique in order to fall asleep so you might want to try it lying down.

  1. Open your mouth and relax your jaw, try positioning your tongue so that it rests on the roof of your mouth behind your teeth.
  2. Exhale one deep breath (try to not move your tongue).
  3. Close your mouth and inhale for a count of four through your nose.
  4. For seven seconds, hold your breath.
  5. Open your mouth again, with your tongue still in position resting against the roof of your mouth and exhale slowly for eight seconds – this is one full cycle.

Why does it work?

The 4-7-8 breathing technique is a relaxation and grounding practice. You may have heard of grounding in relation to anxiety or panic attacks, it is a practice that allows you to come back to the present reality. Through the deep, controlled breathing of this technique we can bring our body out of the hypervigilant states of stress that we find ourselves in during fight, flight, freeze, flop or fawn (all stress and trauma responses).

Forcing the mind and body to focus on the counts of inhale, hold, exhale we can turn away from rumination or the ‘what ifs’ that plague us when we are feeling anxious. Dr Andrew Weil who developed this technique called it:

“a natural tranquilizer for the nervous system.”

Resonance breathing

Resonance breathing has a less spiritual origin but is no less of a therapeutic technique for it. Resonance breathing or sometimes known as coherent breathing is related to our heart rate variability (HRV). HRV is the interval of time between heartbeats. Interestingly, inconsistency of HRV is healthier as it points to a body and cardiovascular system that is responsive to minute changes in environment and internal changes such as temperature.

In contrast, a acutely stressed person or a person who has experienced trauma and is hypervigilant will have a consistent HRV that demonstrates a faster resting heartrate.

The practice

A way to interact and communicate with our HRV in order to calm us, decrease anxiety and stress is to do what is called HRV biofeedback (HRVB). This means training our breath cycle to decrease and slow down. A resting respiratory rate can be anything between 12 to 20 breaths per minute, so resonance does not come naturally.

Why is it called resonance?

We have a mechanism in our body that keeps our blood pressure at stable level or homeostasis, it is called the baroreflex. When we inhale, our blood pressure decreases, and our baroreflex increases our heartrate, the opposite happens when we exhale, which increases our blood pressure again and our heart rate slows down.

The baroreflex clicks into gear in around five seconds during the start of a breath cycle and the end (the inhale and then exhale). So, a baroreflex ‘cycle’ is about ten seconds, meaning in a minute it completes six cycles.

So, this is where the word resonance comes in. If we can sync our breathing with our baroreflex cycle, we optimize our HRV. This means six cycles of an inhale for five seconds, and an exhale for five seconds during a minute. This kind of accuracy isn’t necessary possible for everyone, and people’s resonance frequency might differ slightly.

It’s a good idea to trial this technique a few times with a timer before implementing it seriously. Start out first by seeing how many slowed down cycles of breath you need during a minute, then slow down a bit more, maybe holding a breath in between an inhale and exhale. You can also find ‘breath spacing’ apps for free online, such as Awesome Breathing: Pacer Timer.

Practicing this just two to three times a week can lead to a noticeable decrease in stress.

Why does it work?

Reaching resonance between our breath, baroreflex and HRV allows our system to regulate itself at its peak ability. This can result in a reduction of the physiological symptoms that come with things such as anxiety, depression, post-traumatic stress disorder (PTSD) and chronic stress. These physiological symptoms, often in turn aggravate the psychological symptoms of panic, hypervigilance, rumination and so addressing them frequently reduces symptoms overall.

A 2021 study found that an improvement in ‘resonance efficiency’ related to a reduction in ‘depression and anxiety symptoms.’ Likewise, a 2017 study found that when combined with a yoga practice, resonant breathing reduced symptoms of depression.

As we mentioned at the start, breath and breathing is often taken for granted. Although breathing practices and techniques can seem a little arbitrary at first we hope this breakdown of some simple but highly effective techniques is helpful.