Back to Learn
Breathwork Explained
Written by the Salūs Rooms team · Last reviewed February 2026 · 2 min read

Why Different Patterns Trigger Different Responses

Box breathing calms. Extended exhales slow the heart. Rapid breathing energises. The nervous system responds differently to each rhythm — and the ratio of inhale to exhale is the key variable.

Not all breathing is the same — and not all breathwork is trying to do the same thing.

The nervous system responds differently depending on the rate, depth, and ratio of your breathing. Understanding why gives you a practical toolkit for shifting your physiological state on demand.

The inhale activates, the exhale calms.

This is the core principle underlying most breathwork research. Inhalation is associated with sympathetic nervous system activity — heart rate increases slightly, alertness tends to rise. Exhalation is associated with parasympathetic activity via the vagus nerve — heart rate decreases, the body begins to settle. The ratio between the two is thought to influence which branch predominates.

Extended exhale patterns: calming.

Techniques like 4-7-8 breathing (inhale for 4, hold for 7, exhale for 8), a technique popularised by Dr Andrew Weil, or simple 3:6 ratios tend to favour the parasympathetic branch. The longer exhale is thought to amplify vagal stimulation, slowing the heart and signalling safety to the brain. These patterns are commonly used when seeking to wind down from a state of stress or agitation.

Box breathing: balancing.

Box breathing (equal inhale, hold, exhale, hold — typically 4:4:4:4) doesn't favour one branch over the other. Instead, it creates a rhythmic equilibrium that steadies the nervous system without pushing it in either direction. This is why it's favoured by military personnel and first responders — it produces calm alertness rather than drowsiness.

Rapid breathing: energising.

Techniques like Wim Hof breathing or kapalabhati involve fast, deep inhalations with short, passive exhalations. This appears to tip the balance towards sympathetic activation — increasing heart rate, and rapidly cycling air through the lungs, lowering CO₂ levels and shifting blood chemistry. The reported result is heightened energy and alertness. A 2017 review by Russo, Santarelli, and O'Rourke, published in the European Respiratory Society journal Breathe, found that slow breathing techniques (around 6 breaths per minute) enhance autonomic, cerebral, and psychological flexibility — a reminder that these techniques should be used intentionally and with caution, particularly by people prone to anxiety. Hyperventilation-based techniques should never be practised near water or while driving, and may not be suitable for everyone — consult a healthcare professional if you have a respiratory or cardiovascular condition.

The key takeaway is specificity.

"Just breathe" is incomplete advice. How you breathe appears to influence what happens next. A calming pattern before bed, an energising pattern before exercise, a balancing pattern before a meeting — each serves a different purpose, and research suggests the nervous system responds differently to each. The breath isn't just a relaxation tool. It's a variable worth understanding.

From reading to practice Explore Anxiety sessions
Unlock every session — start your free trial

References

Zaccaro, A., Piarulli, A., Laurino, M., Garbella, E., Menicucci, D., Neri, B., & Gemignani, A. (2018). How breath-control can change your life: A systematic review on psycho-physiological correlates of slow breathing. Frontiers in Human Neuroscience, 12, 353. doi:10.3389/fnhum.2018.00353

Balban, M. Y., Neri, E., Kogon, M. M., Weed, L., Nouriani, B., Jo, B., Holl, G., Zeitzer, J. M., Spiegel, D., & Huberman, A. D. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine, 4(1), 100895. doi:10.1016/j.xcrm.2022.100895

Russo, M. A., Santarelli, D. M., & O'Rourke, D. (2017). The physiological effects of slow breathing in the healthy human. Breathe, 13(4), 298–309. doi:10.1183/20734735.009817

Important Notice
While meditation and breathwork are generally well-tolerated, some people may experience uncomfortable sensations including anxiety, dizziness, or distressing thoughts. If you experience significant discomfort, stop and speak to a healthcare professional. These practices are not suitable replacements for professional treatment.
This article is for educational purposes only and is not a substitute for professional medical or psychological advice, diagnosis, or treatment. If you are experiencing mental health difficulties, please speak to your GP or contact the Samaritans on 116 123 (free, 24/7), Mind on 0300 123 3393, or text SHOUT to 85258.
All Learn topics