Brief Structured Respiration Practices Enhance Mood and Reduce Physiological Arousal

Controlled Breathwork practices have emerged as tools for stress management and well-being. Here we report a remote, randomized, controlled study (NCT05304000) of three different daily five-minute Breathwork exercises in comparison to an equivalent period of Mindfulness Meditation (MM), over one month. The three breathing conditions are 1) Cyclic Sighing (CS), which emphasizes relatively 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. MM involves passive attention to breath. The primary endpoints are improvement in mood and anxiety as well as physiological arousal (respiratory rate (RR), heart rate, and heart rate variability). Breathwork produces greater improvement in mood and a significant effect of adherence on mood improvement was found using a mixed-effects model. Breathwork also results in greater reduction in RR. Among the Breathwork types, CS produces significantly more positive mood and reduction in RR than MM. Daily CS is superior to daily MM in improving mood and decreasing overall average RR.