How to breathe better to feel better

Breathing is something we can say we have done and will do every day of our lives. Furthermore, we can be certain that we do it well enough, otherwise we would be dead (or on a ventilator). However, a quick search on the internet yields results that suggest that, like in many things we do in our lives, there is room for improvement. There are techniques and exercises. Keeping ourselves alive is just the foundation. Breathing better can bring its own rewards.

Before moving on to the techniques and the possible benefits of including breathing exercises in our routine, let’s start at the beginning: could a healthy person, with no respiratory disorders, breathe better than they do now? “In many cases it is very likely that yes, [they could],” says Miguel Soro, member of the Board of Directors of the Spanish Association of Physiotherapists (AFI). “From childhood we have been given advice on a wide variety of things related to health. As for breathing, we have always been told that the correct way to do it is to take air in through the nose and release it through the mouth. But, apart from that, it is not very common to have been taught the correct way to breathe,” he says.

The expert explains that the diaphragm — the main respiratory muscle, which contracts and relaxes to allow air to enter and exit the lungs — is underused in many cases, which “influences our ventilatory mechanics and our lung capacity, in other aspects”. Still, even with an underused diaphragm, most people will not notice that they need to work on improving their breathing. Shallow breathing is almost always sufficient, says Gerard Muñoz Castro, a researcher and respiratory physiotherapist, and a member of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR). However, when it is necessary to use the respiratory muscles to make an effort, “it is important to have an adequate respiratory pattern”, which is something that can be trained.

The first direct benefit of improved breathing, Soro says, is that it is “deeper and more efficient,” which “helps oxygenate the body better and makes the muscles stronger and helps them function correctly.” “This is especially applicable to people with chronic respiratory pathologies,” however, as Gerard Muñoz points out, “the scientific evidence of this improvement in efficiency in healthy people is not so apparent.”

Breathing better can also mean “an improvement in physical ability, and it can therefore contribute to better development of peripheral muscles,” adds Muñoz. It has been speculated, in fact, that certain respiratory techniques could improve core strength, although there is no “strong scientific evidence” in this regard either. What better oxygenation can achieve is an improvement in sports performance, says Soro. In fact, he points out, “training the respiratory muscles is already being included in many athletes’ routines as a complement to training in their own discipline, since it is another aspect that they have to take care of to improve their performance.”

Better posture, less pain

Regardless of whether or not breathing better can help us in everyday life or when doing sports when we do not have any respiratory problems, there are other benefits from doing specific breathing exercises. For example, according to a study published in 2022 in the International Journal of Environmental Research and Public Health, a breathing exercise program guided by a physical therapist can improve posture, muscular balance, and pectoral mobility, compared to programs based on yoga and pilates. The exercises performed by the participants in the study (women between 20 and 22 years old), however, did not only consist of lying on the floor and breathing in a specific way, but breathing exercises were carried out in different positions and sometimes accompanied by slow movements.

Practicing certain breathing exercises will also help us prepare for surgery. It is common in hospitals for patients undergoing certain operations to also undergo respiratory rehabilitation. In recent years, prehabilitation has also been introduced, that is, doing breathing exercises before surgery. “These respiratory rehabilitation or ‘prehabilitation’ programs have shown a reduction in post-surgical complications, a reduction in hospitalization time, or less functional loss. In more colloquial language we could say if you undergo surgery in ‘better shape’, the ability to recover in the post-operative period will also be better,” says Gerard Muñoz Castro.

Another area that has been studied a lot is pain. On the one hand, as Miguel Soro says, in many cases a decrease in respiratory efficiency is related to neck pain. By training breathing, “we can improve or prevent this type of condition at certain times.” The lung function of people with chronic neck pain, in fact, is usually sub-ptimal, so specific training focused on improving breathing can help relieve that pain as well. Likewise, it has been seen that breathing exercises help reduce pain in other cases, such as lower back pain. Furthermore, as breathing techniques reduce stress and help us to relax, they also help relieve pain.

Breathe to relieve stress and anxiety

“Learning to carry out conscious breathing is one of the first therapies that are carried out in all interventions with anxiety and stress,” says Ismael Dorado, the organizational secretary of the Spanish Society for the Study of Anxiety and Stress (SEAS). As a clear example of how breathing is related to this, the expert asks us to think about when we get scared. “We automatically shorten our breathing,” he points out. “Anxiety and stressful situations are related to the respiratory rate, so regulating breathing, making a conscious intervention, is one of the first things we can do for our well-being,” he explains.

There is also plenty of research on the effect of conscious breathing on our psychological state. A study from 2015 concluded that practicing slow breathing (less than ten breaths per minute, with exhalation longer than inhalation) can reduce stress and anxiety levels. As for why breathing in a certain way makes us relax, there are quite a few possible reasons. For example, it has been proven that this type of breathing decreases levels of cortisol (the so-called “stress hormone”) in saliva and can reduce blood pressure.

Ismael Dorado adds that this conscious and relaxed breathing “directly influences our brain activity.” This is because “breathing has direct connections with different parts of the cerebral cortex, which are areas where thinking, perception, and imagination originate, and it also has connections with processes directly related to learning, attention and, above all, memory (because breathing badly makes us sleep poorly, which harms memory).” Controling our breathing can help improve all of this.

Breathing techniques

Although scientific evidence is gradually making it clear that doing breathing exercises can have multiple health benefits, it is also important to understand that there is still a lot of research to be done. Most studies have a very small sample and focus on the short term. Moreover, as a meta-analysis published in 2023 warned about the effects of breathing exercises on mental health and stress, we must be cautious to avoid mixing hype and evidence. Even so, the experts who spoke with EL PAÍS believe that it may be a good idea to incorporate some breathing exercises into our routines.

The first step, Miguel Soro recommends, is to “see how we breathe”, that is, analyze our normal pattern and see what could be improved. From there, he proposes two exercises “that can help us breathe correctly and relax”:

Diaphragmatic breathing

“This exercise involves breathing deeply using the diaphragm. To do it, sit or lie down in a comfortable position. Place one hand on your abdomen and the other on your chest. Inhale slowly through your nose, allowing your abdomen to expand while your chest remains relatively still. Exhale slowly through your mouth, and let your abdomen contract. Repeat this process several times, focusing on deep, slow breathing.”

Breathing with apnea

“This exercise involves inhaling, holding the air, exhaling and holding the air again, all at equal intervals. To do it, inhale slowly for a count of four, hold it for a count of four, exhale slowly for a count of four, and hold it again for a count of four. Repeat this process several times while maintaining a constant rhythm.

Ismael Dorado, for his part, describes a variation of this last technique, which he recommends doing before going to sleep, when we have a difficult situation or decision ahead of us. “It’s about filling our lungs to the maximum until we can’t take it anymore, holding it for three seconds, releasing the air over five seconds and wait three seconds again before repeating. Maintaining this breathing rhythm for one minute can help a lot,” he explains.

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