From chapter 5, The Long Exhale

A longer exhale is a brake

This note is from Running with Llamas. It is general education, not care. The chapter rates the practice moderate. The book is plain about the limit: this does not treat anxiety, panic, asthma, trauma, or depression.

Breathwork, in the chapter, means a decision to breathe more slowly than your worry, for a short planned time, with a longer exhale. A 2023 meta-analysis of randomized trials linked breathwork with lower self-reported stress than controls that were not themselves breathwork. The effect was small to moderate. Most of the studies carried a moderate risk of bias. The authors ask readers not to oversell it. You might feel a shift. You might not.

One smaller trial asked people to practice for five minutes a day for about a month. Of 140 people who consented, 108 enrolled. Positive mood rose more across the month with breathwork than with mindfulness, and a double inhale followed by a long exhale accounted for the clear difference. The kind of anxiety you feel right now fell after the five minutes in every group. Breathwork did not beat mindfulness on anxiety or on negative mood. A longer-term anxiety score did not meaningfully change. Heart-rate variability and resting heart rate did not change either. A gadget that promises five minutes of sighing will "raise your HRV" is ahead of this trial. On an optional debrief, most people who answered described the exercises positively, and a minority described negative experiences.

The trial screened out heart disease, glaucoma, a history of seizures, pregnancy, psychosis, suicidal thinking, bipolar disorder, and substance use disorders. If breathing feels frightening, if you are pregnant, or if you live with a heart, lung, seizure, or fainting condition, talk with a clinician before you try a breathing exercise. The book does not teach breath-holds, fast deep breathing, or cold water.