Breathing happens around 20,000 times a day (mostly) without a single conscious thought. And for most people, that’s exactly the problem. Because when something runs on autopilot, it’s easy for bad habits to go unnoticed. Research suggests the majority of adults have developed dysfunctional breathing patterns, including ‘over-breathing’ – that quietly drive symptoms like anxiety, dizziness, and fatigue; symptoms most people would never think to connect to the way they breathe.
The fix isn’t as simple as “just breathe deeper.” Real, structured breath retraining means identifying exactly how your respiratory habits have gone off course and then systematically rebuilding them from the ground up. It’s less about effort and more about pattern. Less about volume and more about rhythm.
That process is what breathing retraining addresses. And while the practice itself is simple, the science behind why it works is anything but.
Breathing retraining is the practice of identifying and correcting dysfunctional breathing patterns, whether that means breathing too fast, too shallow, too irregularly, or mainly through the mouth.
At its core, dysfunctional breathing is exactly what it sounds like: a breathing pattern that isn’t working the way it should. It can develop independently of any underlying condition, or it can emerge alongside other health issues like heart and lung disease. What makes it tricky sometimes is that certain symptoms like dizziness, chronic tension and heart palpitations,
Breathing retraining, also sometimes called breath retraining, encompasses a range of techniques designed to address these patterns, including diaphragmatic breathing, nasal breathing training, slow-paced breathing, and CO2 tolerance work. The specific approach depends on the individual, but the underlying goal is consistent: restore breathing to a rhythm and pattern that supports rather than disrupts the nervous system.
Most people with dysfunctional breathing don’t know they have it. The symptoms can look like something else altogether – anxiety, poor sleep, low energy, persistent tension, or an inexplicable sense of not being able to get a satisfying breath.
Some common signs that you may have developed incorrect breathing patterns include:
The Nijmegen Questionnaire is a widely used clinical tool for identifying these patterns. It consists of 16 questions ranked on a five-point scale, and a score above 19 is considered suggestive of dysfunctional breathing. If you score in that range, breath retraining is often one of the most effective first-line interventions available.
To understand why breathing retraining works, you need to understand what goes wrong in the first place.
When we breathe too fast, too shallowly, or habitually through the mouth, carbon dioxide levels in the blood drop. This might sound like a good thing – less CO2 means more oxygen, right? In reality CO2 plays a critical role in helping oxygen transfer from the blood into the cells. Strip it away too fast and you get a cascade of physiological effects: blood vessels constrict, blood pH rises, and the nervous system begins to interpret these shifts as a threat signal.
Effective breathing interventions support greater parasympathetic tone, which can counterbalance the high sympathetic activity intrinsic to stress and anxiety – and breathing practices’ effects on the autonomic nervous system and brain may underlie their broader stress-reducing benefits.
In other words, when you retrain your breathing, you’re recalibrating your entire autonomic nervous system.
One of the clearest ways to measure this shift is through heart rate variability (HRV) – essentially, how much the time between your heartbeats naturally changes. A higher HRV is a reliable marker of a well-regulated nervous system, and study after study has shown that heart rate variability and breathing is connected, and that slow, nasal, and diaphragmatic breathing consistently moves it in the right direction.
Beyond HRV, structured breathing programs have been shown to slow respiratory rate and meaningfully reduce perceived stress. There’s also growing evidence that improvements in how long you can comfortably hold your breath – something most people never think to measure – are a reliable sign that your respiratory control and CO2 tolerance are improving.
These aren’t just abstract numbers. Higher HRV means better emotional regulation, greater stress resilience, improved sleep, and more adaptive responses to challenges.
One of the most important – and most overlooked elements of effective breathing retraining is the shift from mouth to nasal breathing.
Breathing through your nose does more than just filter air entering your lungs. It triggers the release of nitric oxide – a molecule that widens blood vessels (vasodilation), improves oxygen uptake, reduces inflammation, and helps regulate the nervous system. Mouth breathing bypasses all of that, and in turn exacerbates the stress response.
For many people, simply learning to breathe through their nose, including during sleep, significantly improves how they feel day to day. It’s one of the most foundational breathing retraining exercises there is.
The scientific evidence for breathing retraining is growing; and while the field still has gaps, the picture emerging is promising.
A five-year follow-up study found that patients with dysfunctional breathing who did breathing retraining – consisting of education, advice, and diaphragmatic breathing – reported lasting improvements across quality of life, anxiety, depression, and the frequency of emergency room visits.
In the anxiety space specifically, a research paper co-authored by Breathless founder Johannes Egberts, looked at 16 clinical studies which examined breathwork interventions for adults clinically diagnosed with anxiety disorders. What was found was that across the 16 studies reviewed, a range of breathwork techniques produced significant improvements in anxiety symptoms in clinically diagnosed patients.
Of all the techniques examined, slow diaphragmatic breathing produced the most consistent results. Every single study that incorporated it reported improvements, from reduced panic attacks and lower anxiety levels, to better day-to-day functioning.
Research also suggests that fast-only breathing is less likely to be effective, while breathing interventions that pair fast and slow techniques, or that build CO2 tolerance through breath holds, tend to result in better outcomes.
But the science is still catching up. A systematic review of 68 trials and over 2,100 participants confirmed that breathing retraining is the most researched intervention for dysfunctional breathing, but also flagged that the quality of evidence currently available is low, with too much variation in how studies are designed and measured to result in firm conclusions. More rigorous, standardised research is needed.
The honest takeaway is that breathing retraining shows real clinical promise, but it works best when it’s tailored, structured, and guided by a professional.
Retraining your breathing doesn’t require complicated equipment or hours of daily practice. A handful of well-researched techniques form the backbone of most breathing retraining programs, and between them, they address the most common dysfunctional patterns.
Why it works: Most people with dysfunctional breathing breath into their upper chest, rather than the diaphragm. Retraining the diaphragm as the primary breathing muscle helps correct your breathing. How to do it: Lie or sit comfortably. Place one hand on your chest, one on your belly. Breathe in slowly through your nose, directing the breath downward so your belly rises first – your chest should stay relatively still. Exhale slowly and passively. Practise for five to ten minutes daily.
Why it works: Slowing your respiratory rate to around 5-6 breaths per minute activates the parasympathetic nervous system and directly improves HRV. This is sometimes called resonance, or coherence breathing, and has shown to improve cognition and reduce stress.
How to do it: Inhale through the nose for 5-6 seconds. Exhale through the nose for 5-6 seconds. Keep the breath smooth and unforced. Practise for five to twenty minutes daily.
Why it works: Building tolerance to CO2 is a longer-term goal of breath retraining, particularly for people who experience anxiety, breathlessness, or panic. Gentle breath-hold exercises help recalibrate the chemoreceptors – the sensors in the brainstem that respond to CO2 levels – so that normal levels no longer trigger an alarm response.
How to do it: After a relaxed exhale, hold your breath until you feel the first distinct urge to breathe. Note this time – known as the Control Pause. With regular practice, this number tends to increase as dysfunctional patterns resolve. Start small and stay comfortable. This is not about pushing to the limit.
There’s no single timeline. Some people notice a meaningful shift in how they feel within a few weeks of consistent practice. For others, particularly those with longer-standing dysfunctional breathing patterns or health issues, it’s a more gradual process.
The main thing is consistency. Breathing retraining exercises are most effective when practised daily, not just during a weekly session or when symptoms flare. The goal is to establish new defaults – patterns that your nervous system starts to adopt automatically, even when you’re not thinking about it.
Breathing retraining isn’t just for people with diagnosed conditions. It’s relevant to anyone who:
That said, if you suspect your breathing difficulties may be linked to a medical condition, it’s worth working with a healthcare professional alongside your breathwork practice.
The research is clear that guided breathing retraining tends to outperform self-directed practice, particularly in the early stages. Evidence-based programs typically combine education on breathing physiology with practical weekly exercises, helping people understand what to do, why to do it, and how to adjust based on their own responses.
A trained breathwork facilitator can assess your specific patterns, provide real-time feedback, and help you work at a pace that’s appropriate for your nervous system. This matters more than most people realise, moving too fast, or using the wrong technique for your baseline, can occasionally make things worse before they get better.Want to experience structured breath retraining for yourself? This is just one breathwork technique we cover in our Breathwork Facilitator Training.
Breathing is the one function of the autonomic nervous system you can consciously control, making it extremely powerful. Breathing retraining isn’t about learning to breathe “harder” or with more effort, it’s the opposite – to breathe-less. It’s about unlearning incorrect breathing patterns, and returning to something more fundamental.
Science is still catching up to this practice in some areas. But the evidence that already exists – across anxiety, dysfunctional breathing, stress resilience, and autonomic regulation – suggests that how you breathe matters far more than you may realise.
The good news is that it’s trainable. Your nervous system has already shown it can adapt to unhelpful patterns. It can adapt to healthier ones too.
Medical Disclaimer
The information in this article is intended for educational purposes only and does not constitute medical advice. Breathing retraining exercises are generally safe for healthy adults, but individual responses can vary. If you have a pre-existing medical condition, including cardiovascular disease, epilepsy, respiratory conditions, severe anxiety or panic disorder, please consult a qualified healthcare professional before beginning any new breathing practice. If you experience dizziness, chest pain, or feel unwell during any breathing exercise, stop immediately and seek medical advice. Breathless does not diagnose, treat, or cure any medical condition.
Written by
Johannes Egberts
