A new study shows that “box breathing,” a simple method involving inhalation, holding the breath, exhalation and a pause before inhaling again, can help control the body’s response to stress and prevent sharp increases in heart rate and some other stress markers in high-pressure situations.
According to BBC News, box breathing consists of four stages: a person inhales for four seconds, holds their breath for four seconds, exhales for four seconds and then pauses for another four seconds before the next inhale. This cycle is repeated. The duration of each stage does not necessarily have to be four seconds, but the length of all four stages should be the same, and the name of this technique comes from this four-part pattern.
Stuart Sandman, a breathing coach, says box breathing can be done before stressful or anxiety-provoking situations, such as an exam or a presentation. The exercise has no fixed duration; some people feel its effects after a few minutes and others continue for up to 15 minutes.
Breathing exercises have roots in traditional practices such as yoga and have been used for centuries in areas like martial arts. According to Sandman, box breathing has become popular because it helps focus the mind and balance the nervous system. The U.S. Navy SEALs also use this method before entering dangerous situations.
Research conducted by scientists at Texas State University and the University of Toronto Mississauga found that box breathing can prevent sharp increases in heart rate and some other stress markers in people placed in high-pressure situations.
Helen Garr, a general practitioner who treats doctors and nurses with mental health problems, describes box breathing as one of the evidence-based methods for controlling the body’s stress response and regulating the nervous system, and says she recommends it to many of her patients.
According to Garr, the most important physical stage of this exercise is the final pause after exhalation. In this stage, carbon dioxide remains in the body and when the brain detects its increased level it becomes alarmed and the person feels an urgent need to breathe. Practicing this stage helps a person build greater tolerance to rising carbon dioxide levels and reduces feelings of stress.
Garr explains that people breathe differently when stressed, and this changes the body’s carbon dioxide level. Box breathing trains the body to adapt to changes in carbon dioxide levels in the blood and brain and can help counter feelings of stress and panic.
The method can be performed at different times of day. Some do it before sleep or after waking during the night and others at the start of the day. Box breathing is used in counseling sessions, especially before discussing difficult emotional topics, to help create a sense of calm.