Meditation and breath

What Is Breathwork, and What Does It Do?

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Breathwork is the deliberate control of breathing to change how you feel. Practices range from slow, gentle breathing to fast, intense breathing meant to produce altered states. A 2023 meta-analysis found breathwork associated with small-to-medium reductions in self-reported stress, anxiety and depression, while warning against hype. The intense forms carry real risks for some people.

What counts as breathwork?

A wide range of practices. The Wikipedia article on New Age breathwork) describes breathwork as various breathing practices in which conscious control of the breath is said to influence a person’s mental, emotional or physical state. One practical divide is pace:

  • Slow, gentle breathing, such as lengthening the out-breath or breathing at a steady, relaxed rhythm.
  • Fast or forceful breathing, as in holotropic breathwork, which the same article says Stanislav Grof developed as a successor to his LSD-based therapy, and which uses hyperventilation.

What does the research show?

A 2023 meta-analysis in Scientific Reports by Fincham and colleagues pooled randomized controlled trials of breathwork in adults:

  • Stress: 12 trials with 785 participants showed a small-to-medium reduction in self-reported stress compared with control conditions.
  • Anxiety and depression: similar significant effects in secondary analyses.
  • Quality: most studies were at moderate risk of bias, and the authors urge caution to avoid a miscalibration between hype and evidence.

On safety, the authors found no reported adverse events directly attributed to breathwork in the studies that tracked them, but one study of fast-paced breathwork in depression reported hot flushes, shortness of breath and sweating. They call for more research on the safety of fast-paced breathwork in particular, so that it is not given blindly to vulnerable people.

Who should be careful with intense breathwork?

Medicine has its own rules for deliberate overbreathing, which is used as a test during EEG recordings. The ANS/BSCN guidelines for hyperventilation during EEG recordings consider it reasonably safe but with a small risk of adverse events, including seizures, and list absolute contraindications: a stroke or heart attack within the last 12 months, poorly controlled or unstable angina, lung disease that leaves someone breathless at rest, sickle cell disease or trait, and moyamoya disease. That guidance is for a medical test, not a breathwork class, but it shows which conditions doctors treat as reasons not to overbreathe.

For breathwork itself, a 2024 randomized placebo-controlled trial of fast breathing with breath holds in Scientific Reports, by Fincham and colleagues, states that contraindications range from cerebrovascular and cardiovascular conditions to epilepsy and panic disorder, and advises practicing only in a safe setting, away from water and hard ground. Its participants screened themselves out for, among other things, high or low blood pressure, respiratory or cardiovascular problems, fainting, epilepsy or seizures, panic attacks, a cerebral aneurysm and pregnancy. A broader list comes from an encyclopedia entry rather than a clinical source, so treat it as cautions to raise with your doctor: the Wikipedia article on New Age breathwork lists contraindications including cardiovascular disease, glaucoma, high blood pressure, mental illness, severe asthma and seizure disorders, among others. It also notes side effects such as sleepiness, tingling in the hands, feet or face, and an altered state that some people find distressing; that hyperventilation in holotropic breathwork can cause cramping in the hands and around the mouth; and that a 1993 report raised concerns that the technique could cause seizures or lead to psychosis in vulnerable people.

If you have any of those conditions, are pregnant, or take regular medication, talk with your doctor before trying fast or forceful breathing.

How do you start safely?

With slow breathing, which you can stop at any moment. Sit comfortably, breathe in through the nose, and let each out-breath be a little longer than the in-breath. Keep it gentle for five minutes and notice how you feel. If you later want to try an intense practice, do it with an experienced facilitator, not alone, and stop at once if you feel faint, numb or distressed.

This article is general information, not medical or psychological advice; talk with a licensed clinician about your own situation.

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