It’s been taught to people who survived 9/11, veterans of the Iraq war, and refugees in Somalia. And proponents say this simple breath work can help anyone dealing with stress, depression, and perhaps even pain.
Best yet: It’s something people with rheumatoid arthritis (RA) can learn to do in seconds.
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A Calm, Even Breathing Style Can Help Relaxation
If you’ve ever been to a yoga class, you’ve likely tried one of the breathing practices many yogis incorporate. Some breaths are done at a fast pace to facilitate alertness; others use slow inhalations to relax the brain. All of these breathing methods are beneficial and have their place.
But some mental health experts have been particularly excited about a specific type of breath work. In this method, inhalations and exhalations are evenly paced, a process they say may be ideal for creating balance between the two sides of the nervous system — the sympathetic (fight-or-flight) and the parasympathetic (“rest and digest”).
They have taken to calling this breath work resonance frequency breathing, resonant breathing, or coherent breathing.
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This RA-Friendly Breathing Style Is Used in Some Types of Yoga, Meditation
Like most complementary and alternative modalities, only a few small studies have been done on resonant or coherent breath work for medical conditions. Some combine the breath work with yoga or other movements (mostly because that’s the easiest way to get funding, the researchers say). Still, the results, while preliminary, are encouraging.
In a study of 32 people published in the Journal of Psychiatric Practice in November 2019, researchers examined whether Iyengar yoga and coherent breathing might help people with major depressive disorder. After three months of two to three yoga classes weekly plus several 30-minute movement and breath work at home, depression significantly improved.
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Australian researchers tested the method’s effects on the hearts of 10 men who did resonance frequency breathing and then were monitored. Their heart rate, blood pressure, and sympathetic nervous system all lessened after the session, according to research published in November 2019 in Physiological Reports.
Other research focused on people living with irritable bowel disease (IBD) who did qigong movement (tai chi) and meditation in addition to the resonant breathing. People doing this program for six months, primarily at home, reduced depression, stress, blood levels of the inflammatory marker C-reactive protein, along with their perception of how much their illness limits their life. Meanwhile, a control group reported no significant changes.
When heart rate, blood pressure, and mood were measured in people who did 15 minutes of either resonant breathing or sitting quietly, the breath work group had lower blood pressure and reported being in a better mood, according to research published in the journal Frontiers in Public Health.
And a study published in February 2021 in Frontiers in Psychology found that a resonant breathing technique resulted in higher heart rate variability, a measure of well-being.
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Calm Breathing Tells Your Body and Mind Not to Stress
Patricia Gerbarg, MD, assistant clinical professor of psychiatry at New York Medical College in Valhalla, and a coauthor of the depression and IBD studies, among others, speculates that the practice is so effective because the vagus nerve — the way the brain tells organs when to beat, breathe, digest, and the like — is now known to send even more messages in the other direction, from the body to the brain.
“The respiratory system sends information to the brain based on how we breathe, and this influences how we think and feel,” Dr. Gerbarg says. “If you breathe in certain patterns, you tell the brain that conditions are safe. If you breathe in different patterns, you tell the brain they are unsafe.”
Gerbarg and others have been teaching this breath work around the world and in their own psychiatry practices, per Breath-Body-Mind, and have seen firsthand how powerful it can be. People dealing with depression, post-traumatic stress disorder (PTSD), and pain conditions find the technique helpful, she says.
Depression commonly occurs in people with rheumatoid arthritis, notes Mayo Clinic, and one of the effects of untreated depression can be greater pain. If breathwork can help alleviate depression, it might also ease pain.
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Breath Work Doesn’t Replace Conventional Medical Care
Of course, even a valuable breathing practice does not replace psychiatric care if you are dealing with depression. And while it may assist people experiencing pain, it does not replace conventional medical care. Rheumatologists agree that treating RA early with disease modifying drugs is the only way to slow the progression of the condition and prevent permanent damage to the joints.
Trying It: How to Do the Breathing Technique
To do this breathing, you simply take regular breaths in and out of your nose at a pace of five breaths per minute. The easiest way to do this is to count to six — one count per second — for the inhalation, and another count of six for the exhalation. You repeat this counting with each breath. Breaths should be of average force — nothing too firm or too gentle.
Although Gerbarg recommends doing this breath work for 15 or 20 minutes, or even longer, any amount of time is beneficial, she says.
Initially, it helps to keep your eyes closed, so you can better focus. Once you become experienced, you can do it with them open. That way, if you’re on a bus, in a meeting, or having dinner with friends and feel anxious or depressed, you can sit and do a few rounds without anyone being the wiser.
Some people enjoy having bells time their inhalations and exhalations. The Coherence Channel on YouTube features chimes ringing every six seconds so you can do a session without the need for counting.
You can also learn from Gerbarg’s husband Richard Brown, MD, associate clinical professor of psychiatry at Columbia University in New York City, and a fellow breath-work researcher, as he does a few rounds on a video on YouTube.
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