Breathing Exercises for Sleep

How to breathe to fall asleep

Make each out-breath a little longer than the in-breath, and put no effort into it. If the breath feels forced, you are doing too much.

1. Lie in your usual sleep position. Let your jaw and shoulders go loose. Rest one hand on your belly if that helps you notice the breath.
2. Breathe in through your nose. Keep it quiet and small, about as deep as a sigh you are holding back.
3. Make the out-breath longer. Let it run out slowly, for roughly 1.5 times the length of the in-breath. In the tool, 4 in and 6 out does this.
4. Keep it soft. A slightly short breath is fine. Pause between breaths only if it comes naturally.
5. Let go of the count. After a few rounds you can stop counting and just let the exhale be long. Do this for 5 to 10 minutes, then stop and rest.

Which breathing exercise is best for sleep?

The one that is easiest to keep doing while your mind is busy.

• If your thoughts keep racing, try body scan breathing. Your attention goes to a body area on each breath, so there is no counting to lose track of.
• If your body feels wired, try 4-6 breathing. The long exhale is easy to follow and has the most research behind the pace.
• If you need a count to keep thoughts out, try 4-7-8. It is short, and a fixed number of rounds gives it a clear end.
• If holding your breath makes you uneasy, skip 4-7-8 and use 4-6. Neither of the other two has a hold.
• If you have tried breathing for a few weeks and still lie awake, breathing is probably not the main fix. The treatment sleep doctors recommend first for long-lasting insomnia is CBT-I, cognitive behavioral therapy for insomnia (see the evidence below), and what to do when you can't sleep has steps to start tonight.

4-6 and body scan breathing run for 5 to 10 minutes; 4 rounds of 4-7-8 take about 76 seconds. You can switch between them from night to night.

4-6 breathing: the longer exhale

One round of 4-6 breathing takes 10 seconds, which is 6 breaths a minute; 5 minutes is 30 rounds. Breathe in for 4 counts and out for 6.

A systematic review of 15 studies in healthy people found that breathing slower than 10 breaths a minute increased heart rate variability and respiratory sinus arrhythmia, which are signs of vagal activity ^[1]. In a small study, 14 people with insomnia who practiced slow paced breathing for 20 minutes before sleep, at one breath every 10 seconds, had shorter sleep onset latency and fewer awakenings ^[2].

The pace seems to count for more than the split between in and out. In a crossover study, 6 breaths a minute raised heart rate variability more than square breathing or 4-7-8 did, and it also led to mild over-breathing ^[3]. Keep the breath small for that reason. If you feel dizzy or tingly, breathe normally.

4-7-8 breathing for sleep

Dr. Andrew Weil's instructions are to do four rounds at a time during your first month, and later, if you wish, up to eight ^[4]. Our tool follows that rule.

1. Tongue. Rest the tip of your tongue against the ridge behind your upper front teeth and keep it there.
2. Breathe in quietly through your nose for 4.
3. Hold for 7. If this is hard, speed up all three counts but keep the 4:7:8 ratio.
4. Breathe out through your mouth for 8, with a soft whoosh.

One round is 19 seconds, so 4 rounds take 76 seconds. Weil's pages make no claims from studies. The one randomized trial we reviewed that measured sleep with 4-7-8 was in people with tinnitus, where an insomnia score fell over 6 weeks ^[5]. That tells us little about people without tinnitus. The full steps, safety notes and research are on the 4-7-8 breathing page.

Body scan breathing

Your feet are on the mattress. Breathe in and notice only your feet, the weight and the temperature. Breathe out and let them sink. Next breath, calves.

Each breath names one body area, from feet to head: feet, calves, knees, thighs, hips, belly, chest, hands, arms, shoulders, neck, face and head. Breathe in for about 5 seconds and out for about 7, but the timing is only a guide. There is nothing to count, which suits a mind that turns counting into a task.

We did not find a sleep trial of this exact breath-by-area routine. The nearest evidence is on mindfulness meditation. A meta-analysis of 18 trials with 1,654 people found that mindfulness improved sleep quality more than a nonspecific control such as time and attention (effect size 0.33). Against established sleep treatments the difference was close to zero (0.03), with low strength of evidence ^[6]. Body scan breathing borrows from mindfulness but is a different routine, so that result is only a rough guide here.

For a longer version, see the body scan script. If you prefer muscle tensing to breath, try progressive muscle relaxation.

Do breathing exercises really help you sleep?

Slow breathing changes your body in measurable ways, but trials that test it as a sleep treatment are few and small, and their results differ.

Slow breathing shifts heart rate patterns, and some people find it easier to settle. Whether it makes you fall asleep faster is not settled. For chronic insomnia, the American Academy of Sleep Medicine strongly recommends CBT-I and only conditionally suggests relaxation therapy as a treatment option ^[11]. Relaxation is a broad category, and it does not single out breathing exercises.

When and how long to practice

Learn the pattern in the daytime, then use it at night. It is easier to follow a 4-6 count when you are not already worried about sleep.

For bedtime, 5 to 10 minutes in bed is a sensible range. It is our suggestion, based on the pace and session lengths above. The older adults in the Kakuei trial practiced 30 minutes every night ^[8], and the Tsai and Kuula protocols used 20 and 30 minutes ^[2][7]. Longer sessions are not shown to work better than short ones. Try 5 first and extend if you enjoy it.

Practice most nights for a couple of weeks before you judge it. Then judge it by how you feel at bedtime as well as how fast you fell asleep. The full wind-down routine is on the fall asleep fast page.

If breathing keeps you awake

Counting can turn into a task, and watching your breath can make you notice it too much.

Counting wakes you up? Drop the count and switch to body scan breathing.

Short of air? Shorten the in-breath and drop the holds.

Checking whether it works? Stop checking and let the breath be ordinary.

Dizzy or tingly? Breathe normally for a minute.

Wide awake after about 20 minutes? Get up for a while.

The full routine for that last case is on what to do when you can't sleep.

Frequently asked questions