The Breathwork Challenge

The Challenge: Perform a specific breathing exercise called “Cyclic Sighing” for 5 minutes each day for 28 days, and record details of the effects on breathing rate, stress levels and sleep.

Why?

The spark for The Breathwork Challenge was a scientific paper by Melissa Yilmaz Balban and colleagues (including the Youtube guru, Dr Andrew Huberman) describing their study in which they compared 3 breathwork techniques with Mindfulness to assess which was more effective in reducing anxiety. Their results pointed to ‘Cyclical Sighing’ as the most effective. Their comments suggested that there was no particular benefit to sleep from the intervention, but another report (by whom?) suggested that there were indeed sleep improvements.

As it seems that the Cyclic Sighing breathing pattern reduces anxiety it seems strange that it apparently did not improve the sleep of the study subjects as stress and anxiety are known causes of insomnia.

Who Took Part?

17 People started the program; 3 men, 14 women, age 62 +/- 11.5 (range 38 – 78). Eleven participants were regular Qigong practitioners. 33% of the participants completed 90% of the Challenge with 4 people completing all 28 days.

What Happened? (Results)

1. Respiration Rate

The average Respiration Rate before the breathing exercise on Day 1 of the Challenge was 13.8 breaths-per-minute (bpm), where one “breath” means one cycle of in-breath and out-breath. According to the UK National Health Service (NHS) the ‘Normal’ breathing rate is 12 – 20 bpm.
 After the exercise the average Respiration Rate dropped to 10.6 on Day 1 but by the final 2 weeks of the Challenge the average had fallen to 6.6 bpm – close to 6 bpm that is regarded as ‘Synchronous Breathing’ – the breathing rate where lung and heart functions are optimised.

2. Sleep

– Average Hours of Sleep increased from 6.2 to 7.2 hours.

-The percentage of the group reporting that they got to sleep quickly rose from around 50% to over 80%

-The percentage of the group reporting unbroken sleep actually decreased from around 27% to 18%

-Anecdotally, a few group members reported noticing a distinct improvement in sleep while a similar number reported no change.

3. Stress & Anxiety

The study used two methods to assess stress levels and mood, known as STAI and PANAS respectively. Both methods use carefully constructed questionnaires that are widely used in psychological studies and have been shown to be robust and repeatable. Both provide a score to indicate the level of stress/anxiety and positive versus negative mood. In this study the absolute scores obtained from the questionnaires were not as important as the difference between the scores measured before, and after, the breathing exercise.

The average reduction in the STAI score was 6.4 (compared with 3.8 in the Balban study)

The average change in Positive mood was 3.5 (compared with 1.9 in the Balban study) and the average change in Negative mood was 0.1 (compared with 1.5 in the Balban study). However, the average PANAS Negative score for the group was 12 before the breathing exercise measured on a scale from 10 to 50 so there was very little scope for reduction in Negative mood. Unfortunately the original study paper did not give details of the absolute PANAS scores for comparison.

Conclusions

The Breathwork Challenge set out to repeat part of the study by Balban and colleagues and see if there were improvements in sleep using the Cyclic Sighing breathing pattern. In strict scientific study terms our group was small so caution should be taken when assessing the results. However, there was a substantial reduction in the respiration rate of the participants when they performed the exercise and over the course of the program which suggests that the effects were cumulative – the benefits of the exercise were carried forward from one day to the next.

Breathing rate is know to have a direct link to levels of stress and anxiety so the reductions in STAI scores were roughly as expected as were the changes in Positive and Negative mood, although on a smaller scale. The reductions in stress levels from performing the breathing exercise were particularly notable for younger members of the group – those still in employment found the exercise very helpful in managing their stress after difficult days at work.

The results for sleep were very interesting. Some participants kept records of the number of hours slept, how long it took to get to sleep and whether their sleep was broken or not, others simply gave a general impression over the 28-day program. Those that recorded the data showed a pattern of improved length of sleep and reported getting to sleep more quickly as the program progressed. Those who did not record the data tended to report ‘no change’ in sleep pattern. There are questionnaires specifically designed to test sleep (such as the PSQI – Pennsylvania Sleep Quality Index) and it would have been interesting to have used this to get a more accurate picture of the results. However, completing too many questionnaires becomes tedious and more participants tend to drop out of studies when the administrative burden becomes onerous.

Further Study

Tai Chi and Qigong are characterised by three controlled factors (‘Regulations’): movement, breathing and mind and both disciplines have been shown to improve sleep in many scientific studies. Looking closer at just one factor, breathing, was a chance to examine its contribution to improving sleep. This is part of a wider ActiveQi research program to understand how Tai Chi achieves its many recorded health benefits.

You can read the original research paper here:

“Brief structured respiration practices enhance mood and reduce physiological arousal, Melis Yilmaz Balban et al, 2023”
https://doi.org/10.1016/j.xcrm.2022.100895

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