# Motivation and emotion/Book/2024/Breathing exercises and relaxation

* Multimedia presentation (3 min)

## Overview

* Figure 1. People use breathing techniques as a form of well-being maintenance and also in immediately distressing situations to help diffuse the immediate physical and psychological impacts.
* Scenario
* Caroline sat at her desk, feeling overwhelmed as the pressure of an upcoming work deadline weighed heavily on her. Her heart began to race, and her chest tightened—a familiar sensation signalling the onset of a panic attack. Remembering a breathing technique she had learned in a wellbeing workshop, she quickly started to regulate her breathing. She inhaled deeply for 4 seconds, held her breath for 4 seconds, and then slowly exhaled for 8 seconds.
* As she continued this breathing pattern, her parasympathetic nervous system was activated, countering the “fight or flight” response driven by her sympathetic nervous system. The extended exhalation helped lower her heart rate and reduce the excess release of cortisol, the stress hormone. Gradually, the balance of oxygen and carbon dioxide in her bloodstream stabilised, preventing hyperventilation and easing the tightness in her chest. Psychologically, the rhythmic breathing calmed her mind, bringing a sense of emotional control and mental clarity. As her heart rate slowed and her anxiety diminished, Caroline felt a growing sense of calm and focus. With her panic subsiding, she found herself more grounded, ready to approach the task that had initially seemed so overwhelming.
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* Focus questions:
* How do different breathing exercises physiologically affect the body to promote relaxation?
* What psychological mechanisms underlie the effectiveness of breathing exercises in reducing stress and anxiety?
* In what ways can the regular practice of breathing exercises improve emotional regulation and overall mental health?

## Breathing Exercises

Breathing exercises, a subset of mind-body practices, have garnered considerable attention for their ability to induce relaxation and mitigate stress. These exercises involve the intentional regulation of breathing patterns to affect both physiological and psychological states. Breathing exercises help activate the parasympathetic nervous system, which encourages a state of calm and counteracts the “fight or flight” response that is activated by the sympathetic nervous system.[factual?]
Physiologically, these exercises assist in maintaining an adequate balance of oxygen and carbon dioxide in the body, which is crucial to preventing anxiety-related hyperventilation[factual?]. They also foster emotional stability by encouraging a state of psychophysiological coherence, where the heart rate and brain waves become synchronised[factual?]. Psychologically, breathing exercises are effective in alleviating symptoms of anxiety and stress by reducing the body’s primary stress hormone, cortisol. They enhance mindfulness and support increased emotional regulation and cognitive clarity, making them useful in both clinical and everyday settings[factual?]. Because breathing techniques are easy to incorporate into daily routines, they provide a practical and accessible means of improving overall well-being[factual?].
There are several types of breathing exercises, each with specific benefits[factual?]:

### Diaphragmatic Breathing (Belly Breathing)

How to Practice:
* Sit or lie down in a comfortable position with your shoulders relaxed.
* Place one hand on your chest and the other on your abdomen, just below your ribcage.
* Inhale slowly and deeply through your nose, allowing your abdomen (not your chest) to rise as your diaphragm engages.
* Exhale slowly through your mouth or nose, feeling your abdomen fall.
* Repeat for 5 to 10 minutes.
When to Practice:
Diaphragmatic breathing can be practiced daily, particularly during moments of stress or anxiety, or as a relaxation routine before bed. It’s effective in situations where you feel overwhelmed, such as before a meeting, during a break, or when trying to calm your mind before sleep.
Specific Benefits:
* Reduces Stress and Anxiety: By activating the parasympathetic nervous system, diaphragmatic breathing reduces cortisol levels and lowers heart rate, leading to a more relaxed state (Jerath, Edry, Barnes, & Jerath, 2006).
* Improves Lung Function: Diaphragmatic breathing encourages fuller oxygen exchange, allowing for better oxygen-carbon dioxide balance and improving lung capacity, which can be particularly beneficial for individuals with respiratory conditions (Ritz & Roth, 2003).
* Lowers Blood Pressure: Regular practice of diaphragmatic breathing has been shown to lower blood pressure by reducing the body’s overall stress response (Nakao, et al., 2001).

### 4-7-8 Breathing

How to Practice:
* Sit or lie down in a comfortable position.
* Close your eyes and inhale quietly through your nose for a count of 4 seconds.
* Hold your breath for 7 seconds.
* Exhale slowly and completely through your mouth for 8 seconds, making a “whooshing” sound.
* Repeat the cycle 4 to 8 times.
When to Practice:
4-7-8 breathing is ideal for moments when you need to quickly calm your nervous system, such as before sleep or during times of acute stress or anxiety. It’s effective when practiced twice daily, in the morning and before bed, or when you feel overwhelmed and need to ground yourself.
Specific Benefits:
* Reduces Anxiety: The technique activates the parasympathetic nervous system, which reduces the body’s stress response, calming the mind and alleviating anxiety symptoms (Brown & Gerbarg, 2005).
* Improves Sleep: 4-7-8 breathing has been found to promote relaxation and improve sleep quality by reducing overactive thoughts and promoting a calm state (Khng, 2018).
* Decreases Blood Pressure: Studies show that extending the exhalation period, as in 4-7-8 breathing, helps lower blood pressure by encouraging a more controlled, slower heart rate (Pal et al., 2004).

### Box Breathing (Square Breathing)

How to Practice:
* Sit in a comfortable position with your back straight.
* Inhale deeply through your nose for a count of 4 seconds.
* Hold your breath for 4 seconds.
* Exhale slowly through your mouth for 4 seconds.
* Hold your breath again for 4 seconds.
* Repeat for 5 to 10 minutes.
When to Practice:
Box breathing can be used before stressful events, such as meetings or public speaking, or during moments of high anxiety to regain focus. It’s also a useful tool during breaks in the day when you need to relax and refocus, or as a method to regulate breathing under pressure.
Specific Benefits:
* Improves Focus and Mental Clarity: Box breathing helps calm the nervous system and bring clarity to the mind, often used by individuals in high-stress environments, such as military personnel, to stay focused (Navy SEALs breathing training, Grossman & Christensen, 2007).
* Reduces Stress: This breathing technique has been shown to lower cortisol levels and decrease the “fight or flight” response, reducing overall stress and emotional reactivity (Kabat-Zinn, 1992).
* Promotes Emotional Stability: By regulating breathing patterns and promoting mindfulness, box breathing enhances emotional regulation, helping individuals stay composed in high-pressure situations (Kabat-Zinn, 1992).
By understanding the specific benefits of each type of breathing exercise, individuals can tailor these techniques to their specific needs, whether they are looking to reduce stress, improve emotional regulation, or address physical conditions. The accessibility of breathing techniques ensures that they can be seamlessly integrated into daily routines, promoting long-term mental and physical well-being.

## Mechanisms of breathing exercises

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### Autonomic nervous system regulation

Breathing exercises help regulate the autonomic nervous system by influencing its two major branches: the sympathetic nervous system and the parasympathetic nervous system[factual?]. Slow, deep breathing activates the parasympathetic nervous system, which promotes the “rest and digest” state, as opposed to the “fight or flight” state activated by the sympathetic nervous system[factual?]. Studies have shown that this shift lowers heart rate, decreases blood pressure, and reduces the production of stress hormones like cortisol (Jerath, Edry, Barned, & Jerath, 2006). For instance, participants who practiced deep breathing techniques regularly showed significant reductions in cortisol levels and improved heart rate variability, indicating a more balanced autonomic response (Kabat-Zinn, Massion, Kristeller, & Peterson, 1992). By enhancing parasympathetic activity, breathing exercises help restore balance within the autonomic nervous system, leading to improved relaxation and overall stress management[factual?].

### Oxygen-Carbon dioxide balance

Engaging in breathing techniques optimises the exchange of gases in the lungs, improving the oxygen-carbon dioxide balance[factual?]. Controlled, deep breathing enhances oxygen intake while facilitating the expulsion of carbon dioxide, which helps maintain a stable blood pH level. Research has shown that this balance prevents hyperventilation and mitigates feelings of anxiety associated with low carbon dioxide levels (Martarelli, Cocchioni, Scuri, & Pompei, 2011). A study investigating the effects of deep breathing exercises found that participants were able to avoid hyperventilation by controlling their breathing, which reduced their anxiety and prevented symptoms commonly associated with panic attacks. By regulating the ratio of oxygen to carbon dioxide, breathing exercises ensure the body’s metabolic processes function smoothly, promoting both physical calmness and emotional well-being.[factual?]

### Psychophysiological coherence

Breathing exercises positively impact psychophysiological coherence by synchronising physiological processes such as heart rate, respiration, and brain activity[factual?]. Controlled breathing has been shown to increase heart rate variability (HRV), a marker of parasympathetic activity and autonomic flexibility (McCraty & Childre, 2010). Studies[factual?] indicate that this coherence between physiological functions fosters a more stable emotional state and enhances cognitive clarity. For example, research on heart rate variability biofeedback suggests that individuals who practice breathing techniques experience improved HRV and greater emotional regulation, which helps them manage stress more effectively and maintain emotional equilibrium. By fostering psychophysiological coherence, breathing exercises contribute to a heightened sense of relaxation and improved overall well-being.
To strengthen these claims, research studies[factual?] further support the physiological and psychological benefits of various breathing techniques, such as diaphragmatic breathing and resonance breathing, which show consistent results in reducing stress and improving autonomic nervous system balance.

## How are breathing exercises and relaxation related?

Breathing exercises are intimately connected to relaxation through their influence on both the body and mind. Controlled breathing techniques directly activate the parasympathetic nervous system, which induces a “rest and digest” state, lowering heart rate, reducing blood pressure, and alleviating the production of stress hormones like cortisol. This physiological shift promotes relaxation by calming the body’s natural stress responses. In addition, breathing exercises improve oxygen-carbon dioxide balance, which helps prevent hyperventilation and its associated feelings of anxiety, thereby fostering both mental and physical relaxation (Jerath et al., 2006).

### Prefrontal Cortex

Breathing exercises also have a direct impact on brain regions associated with emotional regulation and executive function, particularly the prefrontal cortex[factual?]. The prefrontal cortex is responsible for decision-making, impulse control, and maintaining emotional balance. Slow, controlled breathing has been shown to increase activity in the prefrontal cortex, enhancing cognitive clarity and reducing emotional reactivity. This leads to improved emotional regulation, as the prefrontal cortex is better able to suppress overactivity in the amygdala, the brain’s fear centre, thereby reducing feelings of anxiety and stress (Tang et al., 2009).
An important link between breathing exercises and brain function is the activation of the vagus nerve, the main component of the parasympathetic nervous system[factual?]. The vagus nerve connects the brain to various organs, including the heart, lungs, and digestive system, playing a critical role in regulating internal body functions. When slow, deep breathing is practiced, the vagus nerve is stimulated, which activates parasympathetic responses, helping to calm the body and mind[factual?]. This vagal activation results in the reduction of heart rate, blood pressure, and cortisol levels, all of which are key indicators of reduced stress and anxiety (Thayer et al., 2012).
In addition to its physiological effects, the vagus nerve also influences emotional regulation[factual?]. By stimulating the vagus nerve through breathing exercises, individuals can enhance communication between the body and brain, improving emotional resilience. Vagal stimulation has been shown to increase heart rate variability (HRV), which is a marker of the body’s ability to adapt to stress. Higher HRV is associated with better emotional regulation and executive functioning, as the prefrontal cortex and vagus nerve work together to maintain balance between emotional responses and cognitive clarity (McCraty & Childre, 2010).
Thus, the connection between the prefrontal cortex and the vagus nerve provides a powerful physiological foundation for using breathing exercises to reduce anxiety, improve emotional control, and enhance overall cognitive functioning.

### Parasympathetic Nervous System

The parasympathetic nervous system is crucial in the relaxation response, and breathing exercises play a key role in its activation. Slow, deep breathing stimulates the vagus nerve, which activates parasympathetic functions, leading to reduced heart rate, lower blood pressure, and a decrease in the production of stress hormones such as cortisol. This shift helps counterbalance the “fight or flight” response initiated by the sympathetic nervous system, promoting a state of calm and relaxation. Regular practice of breathing techniques helps to maintain this parasympathetic dominance, improving overall stress resilience and emotional well-being (Brown & Gerbarg, 2005).

### Improvement in Mood and Emotional Regulation

Breathing exercises can lead to significant improvements in mood and emotional regulation by influencing both physiological and psychological processes[factual?]. Physiologically, controlled breathing activates the parasympathetic nervous system, reducing cortisol levels and heart rate, creating a calmer, more balanced state in the body[factual?]. This physiological calmness supports better emotional regulation by reducing the intensity of stress responses[factual?]. Psychologically, breathing exercises enhance the function of the prefrontal cortex, which plays a key role in managing emotions and improving focus. Studies show that increased activity in this brain region helps reduce impulsive reactions and stabilises mood, leading to decreased anxiety and depression symptoms (Tang et al., 2009; Brown & Gerbarg, 2005). Regular practice of breathing techniques helps improve emotional resilience, leading to greater overall well-being.

### Enhanced Physical Relaxation

Breathing exercises promote enhanced physical relaxation through the regulation of physiological systems. Deep breathing optimises oxygen-carbon dioxide exchange in the lungs, helping maintain proper blood pH levels and reducing the likelihood of hyperventilation[factual?]. This physiological balance promotes relaxation by slowing the heart rate, lowering blood pressure, and relaxing tense muscles[factual?]. Psychologically, the calming effects of breathing exercises help reduce the sensation of physical tension and discomfort often associated with stress and anxiety[factual?]. By shifting the body out of a heightened “fight or flight” response and into a parasympathetic state, individuals experience greater physical relaxation, which can also aid in reducing symptoms of chronic pain and fatigue (Jerath et al., 2006; Brown & Gerbarg, 2005).

## How breathing exercises can be used in everyday routines

Breathing exercises can be seamlessly integrated into daily routines to enhance relaxation and overall well-being. By setting aside just a few minutes each day for focused breathing, individuals can create a calming ritual that counters daily stressors. For example, starting the day with five minutes of diaphragmatic breathing can help set a calm tone, reducing morning anxiety and preparing the mind for the day ahead. Similarly, incorporating brief sessions of box breathing during work breaks can improve mental clarity and reduce stress, especially in high-pressure environments. Research shows that even short, consistent practices can significantly decrease stress levels and improve cognitive function (Brown & Gerbarg, 2005).
Incorporating breathing exercises into nighttime routines can also improve sleep quality[factual?]. Practicing the 4-7-8 breathing technique before bed helps calm the mind and reduce overactive thinking, making it easier to fall asleep (Khng, 2018). For those with busy or stressful schedules, these techniques can be practiced discreetly during commute times, while waiting in line, or even during short breaks at work, offering flexibility and adaptability to various lifestyles. Regular use of these exercises supports a balanced autonomic nervous system, fosters emotional stability, and enhances physical relaxation, as studies have demonstrated the long-term benefits of daily breathing practices for overall well-being (Jerath et al., 2006).

## Conclusion

Breathing exercises are a practical, evidence-based[factual?] tool for promoting relaxation and well-being, grounded in both psychological theory and physiological research[factual?]. These techniques work by influencing the autonomic nervous system, specifically stimulating the parasympathetic branch, which governs the body’s “rest and digest” functions. This activation leads to reduced heart rate, lower blood pressure, and decreased levels of the stress hormone cortisol, all of which contribute to a relaxed state. Psychological theories, such as polyvagal theory, further explain how breathing stimulates the vagus nerve, promoting emotional regulation and cognitive clarity (Thayer et al., 2012). Research also shows that by engaging the prefrontal cortex, breathing exercises enhance executive function, impulse control, and reduce overactivity in the amygdala, which is linked to anxiety and stress (Tang et al., 2009).
Breathing exercises, such as diaphragmatic breathing, 4-7-8 breathing, and box breathing, stimulate the parasympathetic nervous system through vagal nerve activation, reducing the heart rate, lowering cortisol levels, and balancing oxygen-carbon dioxide exchange, which promotes a physiological state of relaxation (Jerath et al., 2006).
Psychologically, breathing exercises engage brain regions like the prefrontal cortex, improving emotional regulation and cognitive control. The vagus nerve’s stimulation enhances communication between the body and the brain, supporting emotional resilience and reducing anxiety by calming overactivity in the amygdala (McCraty & Childre, 2010).
Regular practice of breathing exercises improves emotional regulation by increasing heart rate variability, an indicator of autonomic flexibility and resilience to stress. This, in turn, supports better mental health outcomes, including reductions in anxiety, depression, and stress (Brown & Gerbarg, 2005).
Breathing exercises offer an accessible, cost-effective way to manage stress and improve overall well-being. Simple techniques such as diaphragmatic breathing or box breathing can be easily integrated into daily routines, whether to reduce anxiety in stressful situations or to foster relaxation before bed. Research[factual?] supports the regular use of these techniques for enhancing emotional stability and cognitive clarity. By practicing focused breathing, individuals can take proactive control of their mental and physical health, fostering long-term resilience to stress.