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How To Formulate Your Ideal Breathwork Routine, From A Pulmonologist

Man breathing in fresh air
Image by Julia Forsman / Stocksy
December 1, 2020
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Imagine a medicine that can quickly and continuously reduce stress, improve digestion, lower inflammation, strengthen the lungs, and release feel-good hormones. What if it was completely free and didn't come with any harsh side effects? It may sound too good to be true, but it turns out this remedy already exists and is available to everyone, at any time of day. We're not talking some miracle pill or panacea powder; we're talking breath.

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The healing potential of controlled breathing.

Physician and researcher of pulmonary medicine Michael J. Stephen, M.D., has seen the mental and physical health benefits of controlled breathing firsthand in his own life as well as with patients with lung diseases like COPD and asthma.

In his upcoming book Breath Taking: The Power, Fragility, and Future of Our Extraordinary Lungs, Stephen chronicles, as he puts it to mbg, "how we control the breath and how the breath controls us."

From a physical perspective, Stephen says that slower, deeper breaths into the belly are beneficial because they engage the diaphragm and help the body take in more oxygen.

Belly breathing, a cornerstone of many breathwork techniques, helps with something called ventilation-perfusion matching. "Once the air goes in," he explains, "we have to have the blood in the right place to pick up that oxygen. Down at the diaphragm because of gravity, blood flow is much better. If we're not using the diaphragm, we're not getting air down to where the perfusion (i.e., circulation of blood) is best."

Mentally, taking deeper breaths stimulates the vagus nerve, which has a calming effect: "It sends signals back to the brain for calming, like, 'OK, all is well with the world. This person is taking slow, deep, easy breaths,'" Stephen says.

Breathwork delivers these benefits in a relatively short amount of time. The key is consistency. Stephens recommends starting with a minute of slow, controlled breathing every day and building up from there, "If you could work up to three to five minutes a day," he says, "I think that's the sweet spot where you will notice very dramatic changes."

How to personalize your breath practice based on your health goals.

A quick internet scroll (or flip through the mbg archives) will deliver dozens of popular breathwork routines. Many of them, like the 4-7-8 breath, prescribe a certain number of seconds to spend on the inhale, hold, and exhale respectively. But Stephen says that there is room to play around here and personalize your routine based on your health goals and challenges. Here's a quick framework to follow:

  • The inhalation—that first number—is all about increasing oxygen flow to the body. If you are looking for a more energizing breathwork, you can make that number a little longer.
  • The breath hold—the middle number—engages the diaphragm and helps out with gas exchange. If you're looking to open up the lungs, either for athletic training or because you have a lung issue, consider making this number a little longer.
  • And finally, the exhalation—the last number—releases carbon dioxide, a waste product. This number is usually equal to or longer than your inhale, and making it even longer can further promote relaxation and detoxification.
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Personally, Stephen starts every morning off with a 5-2-7 breath for lung health, focus, and clarity for the day ahead. "I do my best work in the morning," he says, "so when I wake up, I'm taking five minutes immediately and doing some breathwork and doing some yoga to center myself for the day." If he's feeling extra tired or in need of a boost, he says that fast, forceful inhalations and exhalations can serve as a 'shot of espresso' of sorts. "I'll do that for 30 seconds, and then I'll come down from there and do my regular 5-2-7."

If you're looking to lean into a more relaxing breath sequence—maybe one with a longer exhale—you might opt to do yours at night before bed. The beauty of breathwork is that it's adaptable and easily personalized. So, what's your number?

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Emma Loewe
Emma Loewe
mbg Sustainability + Health Director

Emma Loewe is the Sustainability and Health Director at mindbodygreen and the author of Return to Nature: The New Science of How Natural Landscapes Restore Us. She is also the co-author of The Spirit Almanac: A Modern Guide To Ancient Self Care, which she wrote alongside Lindsay Kellner.

Emma received her B.A. in Environmental Science & Policy with a specialty in environmental communications from Duke University. In addition to penning over 1,000 mbg articles on topics from the water crisis in California to the rise of urban beekeeping, her work has appeared on Grist, Bloomberg News, Bustle, and Forbes. She's spoken about the intersection of self-care and sustainability on podcasts and live events alongside environmental thought leaders like Marci Zaroff, Gay Browne, and Summer Rayne Oakes.