I have studied a lot of breathwork of late. I am still a novice though. For a guru breathwork expert check out Stuart Wilson at breathinspired.com. He is located in Bangkok, Thailand as am I. I am blessed to have him as my friend and mentor. Note: I hope this site is help and I am not a medical doctor, cannot give medical advice. Any breathwork done maybe best to check with a medical professional first or a breath work expert at least.

Coherent breathing is a rhythmic breathing practice that I find very calming when done for 5 to 10 minutes. A common pattern is:

5 seconds inhale
5 seconds exhale

That produces about 6 breaths per minute. Typically I breathing a lot more times per minute. There is evidence this better – 6 breaths per minute than say 14. I have heard we over breathe in general or at least I do. Supposedly, 5.5s inhale and exhale is optimal or so I’ve heard. Though I think 5 and 5 is fine and will be a little easier for people with little to no breathwork experience.

Possible physiological effects

Research suggests slow breathing may influence:

Parasympathetic activation

The parasympathetic (“rest-and-digest”) system may become more dominant, especially during extended exhalation phases.

Heart rate variability (HRV)

Slow breathing around 6 breaths/minute is associated with improved HRV in many studies. HRV is often used as a marker of autonomic flexibility and stress resilience.

Stress and anxiety reduction

Some studies show reductions in:

subjective stress
anxiety symptoms
physiological arousal

Blood pressure regulation

Slow breathing may modestly reduce blood pressure in some individuals, particularly those with hypertension.

Emotional regulation

People often report:

calmer mental state
reduced reactivity
improved focus
easier transition into meditation

Sleep support

Practicing before bed may help reduce sympathetic activation and aid sleep onset.

Variant: 5s inhale / 5s exhale / 2s breath hold

This variation introduces a short pause after exhalation (or sometimes after inhalation depending on the protocol). A common structure is:

5s inhale
5s exhale
2s hold

This is slightly slower overall than classic coherent breathing. Actually, for many 6s inhale and 6s exhale could work better and no breath hold.

Why add a breath hold?

Short breath holds may:

increase awareness of respiratory control
deepen relaxation for some people
create a stronger pause between cycles
reduce breathing frequency further

Some practitioners report:

enhanced calmness
increased meditative depth
greater body awareness

However, evidence specifically comparing “5-5” versus “5-5-2” protocols is limited.

I have often heard that holding ones breath is a stressor. Thus for some adjusting to 6s inhale and 6 exhale could be better.

Possible additional effects of brief holds

A short hold may:

slightly increase carbon dioxide (CO₂) tolerance
reduce overbreathing tendencies
encourage slower respiratory rhythms

CO₂ is important because overly rapid breathing can reduce CO₂ excessively, sometimes contributing to:

dizziness
tingling
anxiety sensations
lightheadedness

Gentle breath retention may help some people become more comfortable with normal CO₂ fluctuations. This is what I am personally hoping for when I add a short breath hold to my practice.

That said, breath retention is where risk starts increasing relative to standard coherent breathing.

Potential risks and side effects

Even slow breathing can cause problems in some people.

Common temporary side effects

Especially when starting:

dizziness
lightheadedness
tingling in fingers or lips
chest discomfort
air hunger
anxiety or panic sensations

These can happen if:

breathing becomes forced
breaths are too deep
CO₂ levels shift too much
the person is sensitive to bodily sensations

Risks of breath holding

Breath holds may increase risk for:

fainting
panic responses
blood pressure fluctuations
discomfort in people with cardiovascular or pulmonary disease

Longer or aggressive retention practices carry greater risks than mild 2-second pauses.

People who should use caution or seek medical guidance first

Especially important for individuals with:

cardiovascular disease
uncontrolled hypertension
asthma or COPD
panic disorder
epilepsy/seizure disorders
pregnancy
history of fainting/syncope
serious psychiatric conditions
respiratory disorders
recent surgery

Important distinction: coherent breathing vs aggressive breathwork

Coherent breathing is generally:

slow
gentle
regulated
calming

This differs substantially from more intense methods involving:

hyperventilation
prolonged breath holds
rapid cyclic breathing

Aggressive breathwork methods can produce stronger physiological stress and carry higher risk.

Practical guidelines for safer practice

Good starting approach

Try:

5 minutes daily
relaxed posture
nasal breathing
comfortable breath depth

Do not try to maximize lung volume.

The goal is:

smooth
quiet
sustainable breathing

—not dramatic sensations.

If adding the 2-second hold

Keep it:

effortless
very short
non-straining

If discomfort appears:

remove the hold
return to normal breathing
stop if symptoms persist

Situations where you should NOT practice

Avoid breathwork:

while driving
in or near water
during heavy exercise
if dizzy or ill
after alcohol or recreational drugs
in situations where fainting would be dangerous

Legal and medical disclaimer

This information is educational only and is not medical advice, diagnosis, or treatment. Breathwork practices can affect the cardiovascular, respiratory, and nervous systems. Individual responses vary significantly.

You should consult a qualified healthcare professional before starting breathwork if you have:

any medical condition,
take prescription medications,
are pregnant,
or have a history of cardiovascular, respiratory, neurological, or psychiatric illness.

Stop immediately and seek medical attention if you experience:

chest pain,
severe shortness of breath,
fainting,
persistent dizziness,
confusion,
or other concerning symptoms.

Breathwork should never replace professional medical or mental health care.