Research reveals ‘box breathing’ can help stop stress and anxiety

By Lauren Wilkin

New research has revealed box breathing — a form of meditative breathing — effectively prevents spikes in anxiety and stress.

Box breathing refers to breathing in, holding the breath, breathing out and pausing all in equal measures — usually for a count of four seconds each.

It's a common technique used to calm the nervous system, but its effectiveness has previously been questioned.

But now, a new study — published in in the journal Comprehensive Psychoneuroendocrinology — has proven how useful it can be.

Researchers at Texas State University wanted to test how effective breathing methods — including box breathing and slow exhalations — could be in real-life situations for reducing or even preventing stress and anxiety.

To do so, they put 66 students in a situation that was likely to cause a spike in stress levels.

Each student had five minutes to prepare for a speech they had to make, convincing multiple judges that they were the right candidate for a job.

Then, five minutes before the speech, 22 students practiced box breathing, 22 students practiced slow exhalation and 22 students breathed as they normally would.

They then all individually joined a video call where a pre-recorded video played of professionally dressed judges listening and taking notes.

Immediately afterward, the participants spent one more minute practicing their breathing technique.

Finally, the participants completed two rapid cognitive tests on a computer, including a color-word matching game and a series of mental math problems.

Afterward, the students had saliva tests to check their levels of alpha-amylase enzyme — which is produced in response to spikes in anxiety and stress.

Alongside this, their heart rates were measured and they filled out a self-reported anxiety questionnaire.

Researchers found that the public speaking task successfully induced a physiological stress and anxiety response in the control group.

In participants who breathed normally, researchers observed an increase in their heart rates, self-reported anxiety and salivary alpha-amylase levels.

In contrast, the participants who practiced either of the two controlled breathing techniques did not show these spikes.

Box breathing and prolonged exhalation both prevented the typical surge in anxiety and physiological stress markers.

The researchers noted that preventing this physiological spike could have a huge benefit in real-world scenarios where rapid recovery is required.

Especially considering that the study found no differences between the three groups regarding cognitive performance.

Participants in all groups scored similarly on the mental math and color-word matching tests, suggesting the breathing exercises didn't impact their immediate cognitive speed.

It is thought that slow and deep breathing can activate the vagus nerve — which can stimulate the nervous system responsible for the "rest and digest" state, rather than the "fight or flight" response.