Man sitting in a butterfly position with his hands on his chest and eyes closed with blue lines around him to show that he's taking a deep breath

This 5-Minute Breathing ‘Physiological Sigh’ Exercise Kills Anxiety Quicker Than Mindful Meditation

There’s really no downside to the physiological sigh.
By Paul Schrodt
April 30, 2024

If you didn’t have anxiety before the COVID-19 pandemic, chances are you probably have it now. While there’s nothing wrong with looking to medication for relief, we all have a powerful anxiety queller within all of us: breathing. Yes, simply breathing could unlock relief from a mental stress overload.

A new study from Stanford Medicine suggests the powerful ways the physiological (or cyclic) sigh can combat anxiety. The research from David Spiegel, neurobiologist Andrew Huberman, and Melis Yilmaz Balban demonstrates that this style of controlled breathing (performed by taking one deep inhale, immediately followed by another sharp inhale, and a long, slow, sighing exhale) for five minutes can lower your anxiety, improve mood, and even result in decreased rates of breathing at rest, which is a sign of overall body calmness, Stanford reports.

“Two inhales, followed by an extended exhale”

The physiological sigh or cyclic sighing is simple, can be done anywhere, and (bonus) costs nothing. If you’re feeling rattled, take two sharp inhales of breath, typically through the nose, followed by an extended exhale through the mouth, as Huberman demonstrates above. After just one or two of these sighing exercises, you may feel more relaxed, but to get the full effect, Spiegel recommends repeating the cyclic sighing for about five minutes. The second inhale in the double inhale is “really important,” Huberman says, allowing for not just the intake of more oxygen, “but also the offload of carbon dioxide.”

And the exhalation is critical, too, activating the parasympathetic nervous system, according to Spiegel, which then slows down your heart rate and has an overall soothing effect on the body.

You’ve likely at least heard of some kind of breathwork, whether it’s box breathing employed by the U.S. Navy SEALs or breathing in traditional practices like yoga, tai chi, and meditation. But the science behind breathing exercises and their benefits is just starting to come to light.

How Does the Physiological Sigh Work?

While most of the time our breathing is automatic, like digestion and other bodily functions, “you can very easily take over and control your breath, which then affects your overall physiology and stress response,” Spiegel says.

Stressful moments can trigger physical changes like a faster heartbeat, tightened muscles, and sweaty armpits, all of which can lead to spiraling negative thoughts. “As soon as you notice what’s going on in your body, your brain thinks, ‘Oh no, this must be really bad,’ and you get more anxious,” Spiegel explains. “It’s like a snowball rolling downhill.” And for those with anxiety disorders, the feeling can be crushing, making everyday life considerably more difficult.

As Huberman notes in the above YouTube video breaking down the breathing exercise, it allows you to “feel more calm in real-time, meaning without having to disengage from the stress-inducing activity.”

The Study

Huberman and Spiegel led a randomized, controlled trial involving 111 volunteers, comparing cyclic sighing to two other types of breathing exercises, one focusing on inhalation and another in which participants were asked to breathe in and out for equal amounts of time. The researchers also had a control group of participants who passively observed their breath during five minutes of mindful meditation.

“In mindfulness meditation, we instruct people to be aware of their breath but not try to control it,” Spiegel says.

Other studies have pointed to the benefits of mindful meditation, but it turns out that directly controlling your breath may unlock a more powerful response. In the Stanford study, published in Cell Reports Medicine, the controlled breathing groups reported even more improvements to their moods, with significant increases in positive affect (feelings like energy, joy, and peacefulness).


The Results

On average, the controlled breathing participants experienced a daily increase in positive affect of 1.91 points on the Positive and Negative Affect Schedule scale, while the mindfulness meditation group saw an increase of 1.22 points, meaning the improvement from controlled breathing was greater by about one-third. And cyclic sighing in particular resulted in the greatest daily improvement in positive feelings. The researchers think that the sighing, emphasizing slow exhalation, may prove to be the most effective type of controlled breathing to combat stress.

Spiegel and Huberman still want to investigate controlled breathing more, with MRI tests to measure brain activity. But in the meantime, there’s really no downside to trying the straightforward physiological sigh next time you need a minute.

“There’s a growing interest in non-pharmacological ways of helping people regulate their mood,” Spiegel says. “We may be able to identify certain kinds of anxiety that respond substantially to this simple treatment.”