Breathwork in embodied psychotherapies: a systematic review and meta-analysis
Christopher Lomas
Body Movement and Dance in Psychotherapy January 5, 2026 DOI: 10.1080/17432979.2025.2609283 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Peer reviewed |
|---|---|
| Sample size | 1,278 |
| Population | Participants in controlled studies of breathwork interventions |
| Interventions | paced breathing box breathing |
| Topics | Breathwork |
| Key findings | Breathwork produced moderate to large reductions in anxiety, depression, and perceived stress, and moderate to large increases in heart-rate variability and activation of emotion-regulation neural regions. |
Abstract
Abstract Breathwork techniques such as diaphragmatic, paced, and box breathing are increasingly used in psychotherapy and embodied clinical practice yet their efficacy and mechanisms remain unevenly documented. This systematic review and meta-analysis synthesised controlled studies examining breathwork as a stand-alone or adjunctive intervention for psychological (anxiety, depression, stress) and neurobiological (heart-rate variability, brain activation) outcomes. Twenty-five eligible studies (N = 1278) were pooled using random-effects models. Breathwork produced moderate to large reductions in anxiety, depression and perceived stress, with moderate to large increases in heart-rate variability and activation of neural regions implicated in emotion regulation. Subgroup analyses suggested that slow diaphragmatic and paced breathing protocols, delivered regularly and embedded within psychotherapy, were associated with the most robust effects. These findings support breathwork as a low-cost, scalable component of embodied psychotherapies and highlight the need for further trials that integrate somatic, dance/movement, and body-oriented approaches with mechanistically informed psychophysiology.
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 |