Belly breathing

How to do it

1. Lie on your back with your knees bent and your head supported, or sit tall with your shoulders loose.
2. Put one hand on your upper chest and the other on your belly, just below your ribs.
3. Breathe in through your nose for 4 seconds. The lower hand rises; the upper one barely moves.
4. Breathe out through your nose for 6 seconds. Your belly falls by itself, like a balloon slowly letting air out.
5. Rest for 2 seconds on empty, with your belly soft, before you breathe in again.
6. Repeat for 5 minutes. That's 25 breaths, five a minute.
7. To finish, take your hands away, breathe without counting and, if you're on the floor or in bed, roll to one side before getting up.

What belly breathing is

The diaphragm is a large, dome-shaped muscle at the base of your lungs. When it contracts, it moves down and makes room for air; on its way down it pushes the contents of your abdomen forward, which is why your belly moves. You aren't breathing with your belly: your belly is showing you that the diaphragm is working.

It's less a count than a way of moving. Here it comes with a rhythm of 4 seconds in, 6 out and 2 of rest, but what defines it is where the movement starts. That's the difference from its neighbors: 4-6 breathing gives you a rhythm, and this one teaches you where to put it.

Where it comes from

No one invented it, and it has no date. It's how the body breathes at rest, and several traditions teach it as a starting point: in yoga it's practiced before pranayama, qigong places attention below the navel, and voice teachers work on it as the basis of singing.

In medicine it has a documented history. In 1954, The American Journal of Medicine published a physiologic evaluation of diaphragmatic breathing training in patients with emphysema, by W. F. Miller. Today it's one of the exercises that pulmonary rehabilitation specialists teach to people with chronic lung diseases, according to the American Lung Association.

What people use it for

To learn. Many people breathe high, with the chest and shoulders, especially in front of a screen or under tension. A few minutes with a hand on the belly shows them another option.

It's also used at bedtime, because the movement is easier to feel lying on your back, and as a warm-up before singing, speaking or meditating. Once you have it, you carry it inside every other breathing on this site.

What studies say

The evidence exists, and it's modest. In 2017, a trial published in Frontiers in Psychology randomly assigned 40 healthy adults: one group did 20 sessions of slow diaphragmatic breathing over eight weeks, with a device that showed them their breathing, and the other received no intervention. The group that practiced reported less negative mood, did better on a sustained attention test and had lower cortisol in their saliva.

A 2019 systematic review looked for studies in adults on stress, and only three met its criteria: one randomized trial and two studies without random assignment. All three found some benefit, but they were so different from one another that they couldn't be pooled, and the authors point to sample size as a limitation.

In people with COPD, the 2012 Cochrane review of breathing exercises included a diaphragmatic breathing group of 30 participants, with an improvement of about 35 meters on the six-minute walk test and inconsistent results for breathlessness. One thing to keep in mind when reading all of this: studies almost always combine breathing with the diaphragm and breathing slowly, so nobody knows how much each one contributes.

What it feels like and what to notice

At first it can feel odd, even backward. Cleveland Clinic notes that it may be tiring the first few times and that it becomes more automatic with practice. Watch for three things: the lower hand moves more than the upper one, your shoulders don't rise, and your nose makes no noise.

There's nothing to clench during the 2-second rest: it's a moment of stillness, not a hold. If you feel dizzy, tingly or short of breath, you're taking in too much air. Stop and breathe normally.

Variations

• Easier, no count: on your back, hands in place, just watch your belly rise and fall for a couple of minutes.
• With a book: Cleveland Clinic suggests resting a book on your abdomen once it feels easy, to add a little challenge.
• With pursed lips: the American Lung Association and Cleveland Clinic teach it with the exhale going out through nearly closed lips, two to three times as long as the inhale.
• Slower and even, 6 and 6: that's Qigong abdominal breathing on this site, with no rest between cycles.
• In three parts: filling the belly, the ribs and the chest in turn. That's the dirga breath.

Common mistakes

• Pushing your belly out with your muscles. It rises because air comes in, not because you shove it.
• Taking in a huge amount of air. A low breath isn't an enormous breath.
• Lifting your shoulders or arching your back to get more in.
• Pulling your belly in hard on the exhale. In this guide it falls by itself.
• Turning the rest on empty into an endurance test. If you want air before the 2 seconds are up, breathe in.
• Giving up because your chest moves too. A little movement up top is normal.

How often and how long

Five minutes a day, lying down, for a week or two is usually enough to recognize the movement. Then take it to a chair and, later, to loose moments of the day: in a line, at your desk, before sleep.

Medical institutions give longer guidance to people learning it for a breathing condition: Cleveland Clinic talks about 5 to 10 minutes, three or four times a day, and the American Lung Association about 5 to 10 minutes daily. That guidance is followed with your care provider.

Before you start

• If you feel dizzy, tingly or short of breath, stop and breathe normally.
• Don't force your belly or the rest on empty: nothing in this breathing gets squeezed.
• If you have COPD, asthma or another lung or heart condition, or you're pregnant, check with your care provider first.
• If you've had recent abdominal or chest surgery, ask before practicing.