Alternate nostril breathing with holds

How to do it

1. Sit tall with your head centered. Bring your right hand to your face: thumb beside the right nostril, ring finger beside the left. Breathe out through both nostrils.
2. Close the right nostril and breathe in through the left for 4 seconds, without filling all the way to the top.
3. Close the left nostril too, with a light touch, and hold for 4 seconds. Keep your throat and face soft.
4. Release the right nostril and breathe out through the right for 8 seconds, in one even stream from start to finish.
5. Breathe in through the right for 4 seconds.
6. Close both nostrils and hold for 4 seconds.
7. Release the left nostril and breathe out through the left for 8 seconds. That's one full cycle: 32 seconds.
8. Repeat for 6 minutes, which is about 11 cycles. Finish on an exhale through the left, lower your hand, and breathe at your own pace for half a minute before you get up.

What it is and how it differs from the simple version

The route is the same as in alternate nostril breathing: the air goes in one side, out the other, and then back. What changes is the timing on each side: 4 seconds in, 4 seconds holding with the air in, 8 seconds out. That's a 1-1-2 ratio.

The count makes it much slower. Simple alternate nostril breathing completes a cycle every 16 seconds. Here a cycle takes 32, so you're breathing fewer than four times a minute. That's why it's rated intensity 2: it isn't hard, but it asks for a control the simple version doesn't need.

Where it comes from

The version with holds is actually the older of the two. The Hatha Yoga Pradipika, the manual Svatmarama composed in the 15th century, doesn't describe alternate nostril breathing without a pause. It says to breathe in through the left nostril, keep the air confined, and let it out slowly through the right, then do the same from the other side. The text calls that retention kumbhaka.

What the text doesn't give is seconds or ratios. It asks you to hold according to your ability and to breathe out slowly, without force. The 4-4-8 count is a convention of modern teaching. One current yoga guide presents it as the third step in a progression: first 4 and 4, then the 8-count exhale, and only then the 4-count hold with both nostrils closed, after a few months of practice with no difficulties.

Nobody seems to have recorded who first set this count, or when. It's a teaching ratio, not a quotation from an old text.

Who it's for and what people use it for

It's for people who already know the simple version: your hand moves by itself, you don't lose track of the sides, and 5 minutes feels easy. If 4-4-8 breathing through both nostrils is comfortable too, you're ready to try it. If you've never done alternate nostril breathing, start with the simple one.

People who practice it tend to use it as a concentration session: before meditating, first thing in the morning, or when they want ten minutes away from a screen. The longer count and the finger changes take up your whole attention.

What the studies say

No trial in sight compares alternate nostril breathing with holds against the version without them. What exists is research on alternate nostril breathing in general, where the versions get mixed together. A 2017 systematic review of 44 randomized trials makes exactly that point: each study uses a different variation, and there's no standard method.

A 2024 meta-analysis of six trials with 525 participants found systolic blood pressure about 7 mmHg lower in people who practiced alternate nostril breathing than in control groups. The authors caution that results differed widely from trial to trial and that study quality is limited.

The short version: nobody knows whether the hold adds anything measurable. The reason to choose this version is that you like how it feels, not a demonstrated effect.

What it feels like and what to notice

The pause with the air in rarely bothers anyone: it's 4 seconds. What you notice most is the exhale. Eight seconds through a single nostril means letting the air out very slowly, and at first it's common to run out early or to reach the end wanting to grab the next breath.

Both problems have the same fix: breathe in less. With a medium-sized inhale, the hold feels lighter and the exhale lasts. Around the third or fourth cycle the rhythm tends to settle and your body goes still.

If you feel dizzy, feel pressure in your head or chest, or need to gulp air through your mouth, lower your hand and breathe normally. Come back to the simple version another day.

Variations

• Easier (4-8 variation, no hold): breathe in for 4 on one side and out for 8 on the other. It's the previous step in the usual progression.
• Shorter (3-3-6 variation): the same ratio with 3 seconds in, 3 holding and 6 out, counted by yourself.
• No switching: 4-4-8 breathing uses the same count through both nostrils, hands-free.
• Long holds: the 1-4-2 ratio holds the air for four times the length of the inhale. It's an intensity 3 practice, with its own page and its own cautions.

Common mistakes

• Overfilling. With your lungs topped off, the hold feels tight and the exhale comes out in spurts.
• Clamping your nose or throat during the hold. Your fingers barely close the nostrils. Holding means not breathing for a moment, not straining.
• Letting most of the air out up front. The exhale lasts its full 8 seconds: start with very little air so it stretches.
• Lengthening the hold to make progress. Progress here is that it feels easy, not that you hold longer.
• Pushing on with a stuffy nose. Eight seconds through a congested nostril doesn't work. Pick a different breath that day.

How often and how long

One 6-minute session a day is enough, and three or four times a week already counts as a real practice. You don't need more to get a feel for it, and no studies point to a dose.

A kind way in is to do two minutes of simple alternate nostril breathing first and then move to this one. If the count is a struggle one day, stay with the simple version.

Before you start

• Practice sitting down, unhurried. Never while driving or in water.
• If you feel dizzy, feel pressure in your chest or get short of breath, lower your hand and breathe normally.
• The holds should take no effort. If you have to fight to reach 4 seconds, go back to simple alternate nostril breathing.
• If you're pregnant or have a heart, lung or blood pressure condition, or a history of fainting or panic attacks, check with your care provider first.
• With a nose blocked by a cold or allergies, save it for another day.