Mindful Breathing – Simple but Powerful

by Julie Rowin, MD

Modern science is catching up to the ancient wisdom of mindfulness and movement-based practices such as Meditation, Yoga, Breathing, Tai Chi and Qigong. These ancient techniques have plentiful scientific evidence backing beneficial effects as far reaching as improved psychological health, immune function, hormone balance and cognitive function.

The Science

Stress elevates cortisol, our main stress related hormone. Sustained elevations in cortisol promote inflammation, weight gain, and sleep problems and have been associated with multiple diseases including diabetes, dementia and pain syndromes. Mindfulness-based practices such as breathing exercises help to regulate cortisol levels, reducing the levels when we need to rest, sleep and digest and elevating the levels when we need to wake up, exercise, and cope with stressful situations.

In our fast-paced modern society, an issue arises when our cortisol increases during stress and then stays elevated, not returning to the low restful levels we need for recovery. With sustained elevated cortisol, insomnia ensues, followed by caffeine intake (leading to further elevated cortisol) and over time, this cycle of insomnia may wear us down causing fatigue, immune dysfunction and disease.

A Daily Practice of Stress Reduction

The ancients knew that it is preferable to alternate activity with rest. This is as natural a rhythm for the body’s physiology as it is for the cycles of day and night. After all, we evolved with these cycles. My suggestion is to have a daily mindfulness-based practice of your choosing.  It can be as simple as 5 minutes of mindful breathing in the morning.  This is one of the best neuroprotective interventions, plus the side-effects of a daily practice of stress reduction…improved attention, mood, sleep, memory, relationships, job satisfaction…are worth the effort.

Our breath sustains us. It not only supplies our cells with life-giving oxygen, the mechanical act of breathing itself is intimately connected to our body’s basic physiology.  With every breath in our heart rate increases and with every breath out it slows.

The modulation of respirations, heart rate, blood pressure and digestion are interconnected through the primitive part of the brain called the brainstem and primitive nervous system called the autonomic nervous system.  Most of the autonomic nervous system functions are unconsciously controlled. The distinguishing feature of the breath, however, is that we have conscious control over the speed, depth and flow of our breathing.  And, by consciously controlling our breath, we can have far reaching positive effects on other aspects of our autonomic nervous system physiology and our response to stress.

The autonomic nervous system acts like a switch.  It is either in ‘rest and digest’ mode or ‘fight or flight’ mode.  Consciously slowing and deepening your breathing will ‘flip the switch’ and take you from ‘fight or flight’ to ‘rest and digest’ by slowing your heart rate, decreasing your blood pressure, improving your digestion and calming your mind.

The stress response and breathing are hard-wired in our nervous system.  Someone who has trouble breathing will naturally panic just as someone who has a panic attack will naturally feel short of breath.

The Quality of Breath

Did you ever catch yourself holding your breath during a stressful situation?  Most of us spend a good deal of the day with shallow chest breathing and when times get stressful we may even unconsciously hold our breath.  It follows that shallow chest breathing and breath holding are associated with increased blood pressure, heart rate and anxiety, while the opposite, deep belly breathing, is associated with decreased blood pressure and heart rate, reduced pain and a calm state of mind.

Ancient practitioners of yoga knew that the quality of breath dictates our state of mind.  As Westerners, we are just catching up to this.  Breathing techniques that slow the breath, concentrating on prolonging the exhale, change brain waves to the alpha rhythm which is a rhythm correlated with relaxation, positive mood and a reduction in the stress hormone, cortisol.  It follows that breathing exercises are useful in the management of chronic pain.  And learning to regulate the breath can even decrease performance anxiety and improve work performance.

Your breath is free, travels with you, and can be used as a tool anywhere and anytime to calm and elevate your mood and bring you to the present moment.  Practice slowing and deepening your breath into the belly (while relaxing and expanding the belly). Next, concentrate on a slow exhale, without strain, with a slight contraction of the belly.

Do this for a few minutes, elongating the breath as much as is comfortable, several times a day, whenever or wherever you are, in a meeting, in your car, in line at the grocery store, in a heated argument.  It will ‘flip your switch’, change your life, and improve your health.  It is simple, but powerful.

If you need a reminder, put up a ‘breathe’ sign at your workspace or one on your bathroom mirror.

Mindful Breathing Exercises

Breath, well-being and energy are intrinsically connected.  Mindful breathing can be performed anywhere and anytime.  It’s all about bringing yourself to the present moment and focusing on a slower deeper belly breath.  Relax and soften your belly.  A tight abdomen tends to lead to chest breathing which is excitatory to the nervous system.  Here we are looking for a calming effect.  The following are a couple of formal breathing exercises to get you started.

Equal Breathing Exercise

  1. Find a comfortable place to sit or lie down, with your feet slightly apart, one hand on your abdomen near the navel, and the other hand on your chest.
  2. Inhale slowly through your nose to the count of 4, relaxing into and expanding your abdomen
  3. Exhale slowly through your nose to the count of 4, feeling the gentle contraction in your abdomen.
  4. Repeat for a total of 5 cycles.
  5. Increase your inhale and exhale to a count of 5 for a total of 5 cycles.
  6. You may increase the length of the inhale and exhale by one count every 5 cycles so long as it causes contentment without strain. 3-5 minutes is sufficient to see a calming effect on the nervous system.

Once you feel comfortable with the above exercise, you can try the following, more advanced, exercise.

4-4-8 Breathing Exercise

  1. Find a comfortable place to sit or lie down, with your feet slightly apart, one hand on your abdomen near the navel, and the other hand on your chest.
  2. Inhale slowly through your nose to the count of 4, relaxing into and expanding your abdomen
  3. Hold the breath at the top of the inhale for a count of 4 or whatever is comfortable for you, never straining or going outside of your comfort zone
  4. Slowly exhale through your nose while counting to 8. Gently contract your abdominal muscles at the end of the exhale.
  5. Repeat until you feel deeply relaxed or for a total of 5 cycles. At first you may only feel comfortable doing 1 or 2 cycles