Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials.
Guy William Fincham, Clara Strauss, Jesus Montero-Marin, Kate Cavanagh
Scientific Reports January 9, 2023 DOI: 10.1038/s41598-022-27247-y (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 785 |
| Population | Adult participants from randomized controlled trials |
| Intervention | breathwork |
| Topics | Breathwork |
| Key findings | Breathwork interventions were associated with lower levels of self-reported stress, anxiety, and depressive symptoms compared to non-breathwork controls. |
Abstract
Deliberate control of the breath (breathwork) has recently received an unprecedented surge in public interest and breathing techniques have therapeutic potential to improve mental health. Our meta-analysis primarily aimed to evaluate the efficacy of breathwork through examining whether, and to what extent, breathwork interventions were associated with lower levels of self-reported/subjective stress compared to non-breathwork controls. We searched PsycInfo, PubMed, ProQuest, Scopus, Web of Science, ClinicalTrials.gov and ISRCTN up to February 2022, initially identifying 1325 results. The primary outcome self-reported/subjective stress included 12 randomised-controlled trials (k = 12) with a total of 785 adult participants. Most studies were deemed as being at moderate risk of bias. The random-effects analysis yielded a significant small-to-medium mean effect size, g = - 0.35 [95% CI - 0.55, - 0.14], z = 3.32, p = 0.0009, showing breathwork was associated with lower levels of stress than control conditions. Heterogeneity was intermediate and approaching significance, χ211 = 19, p = 0.06, I2 = 42%. Meta-analyses for secondary outcomes of self-reported/subjective anxiety (k = 20) and depressive symptoms (k = 18) showed similar significant effect sizes: g = - 0.32, p < 0.0001, and g = - 0.40, p < 0.0001, respectively. Heterogeneity was moderate and significant for both. Overall, results showed that breathwork may be effective for improving stress and mental health. However, we urge caution and advocate for nuanced research approaches with low risk-of-bias study designs to avoid a miscalibration between hype and evidence.
Comparable studies
Other systematic reviews and meta-analyses on breathwork, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Pranayamas and their neurophysiological effects | 2020 | Systematic review | |
| Implication of asana, pranayama and meditation on telomere stability | 2018 | Systematic review | |
| Effect of a single session of yoga and meditation on stress reactivity: A systematic review. Healthy adults | 2024 | Systematic review | n = 2,574 |
| The role of non-ordinary states of consciousness occasioned by mind-body practices in mental health illness. | 2023 | Systematic review | |
| Effect of Meditation, Mindfulness-Based Stress Reduction, and Relaxation Techniques as Mind-Body Medicine Practices to Reduce Blood Pressure in Cardiac Patients: A Systematic Review and Meta-Analysis. Patients with cardiovascular disease | 2024 | Systematic review and meta-analysis | n = 927 |
Citations in the library
Cited by 55
- High ventilation breathwork practices: An overview of their effects, mechanisms, and considerations for clinical applications. Neuroscience & Biobehavioral Reviews December 1, 2023
- Breathwork-induced psychedelic experiences modulate neural dynamics. Cerebral Cortex August 1, 2024
- Effects of conscious connected breathing on cortical brain activity, mood and state of consciousness in healthy adults Current Psychology September 8, 2023
- Decreased CO2 saturation during circular breathwork supports emergence of altered states of consciousness. Communications Psychology April 13, 2025
- Health Workers' Mindfulness-Based Stress Reduction and Resilience During COVID-19 Pandemic. Journal of Multidisciplinary Healthcare 2024
and 50 more in the library
Cites 13
- Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation Perspectives on Psychological Science October 10, 2017
- Long-term meditators self-induce high-amplitude gamma synchrony during mental practice Proceedings of the National Academy of Sciences November 8, 2004
- Breathing‐Based Meditation Decreases Posttraumatic Stress Disorder Symptoms in U.S. Military Veterans: A Randomized Controlled Longitudinal Study Journal of Traumatic Stress August 1, 2014
- Long-term mindfulness training is associated with reliable differences in resting respiration rate Scientific Reports June 7, 2016
- Effects of Yoga Respiratory Practice (Bhastrika pranayama) on Anxiety, Affect, and Brain Functional Connectivity and Activity: A Randomized Controlled Trial Frontiers in Psychiatry May 21, 2020
and 8 more in the library