Evidence map›Paper›PMID 36630953›Full record

Trial reportCell reports. Medicine2023

Brief structured respiration practices enhance mood and reduce physiological arousal.

Melis Yilmaz Balban, Eric Neri, Manuela M Kogon, Lara Weed, Bita Nouriani, Booil Jo, Gary Holl, Jamie M Zeitzer, David Spiegel, Andrew D Huberman

7 registry-linked trialsAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Cell reports. Medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 7 registered trials, which are not on this map. Cited by 112 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
112citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05304000 nacompletednot on this map

Psychophysiological Effects of Controlled Respiration: Noninvasive Relaxation Techniques

TypeinterventionalSponsorStanford UniversityRan2020 to 2020Enrolled108ConditionsStress, Physiological, Stress, Emotional, InsomniaArmsMindfulness Meditation, Cyclic Sighing Breathing, Box Breathing, Cyclic Hyperventilation with Retention
NCT06914167 nacompletednot on this mapstarted 2025, after this paper: background citation

The Effectiveness of Lavender Aromatherapy Combined With Slow Breathing Exercises in Improving Occupational Burnout and Sleep Disorders Among Nursing Staff

TypeinterventionalSponsorTri-Service General Hospital (TSGH)Ran2025 to 2025Enrolled70ConditionsSleep Wake DisordersArmsSlow Breathing Exercises, Lavender Essential Oil Inhalation, linalyl acetate essential oil Inhalation, linalool essential oil Inhalation
NCT07433790 nacompletednot on this mapstarted 2025, after this paper: background citation

Effects of Paced Breathing Versus Diaphragmatic Breathing Combined With Mat Pilates on Cardiopulmonary Endurance, Dyspnea, Stress, Anxiety, and Quality of Life in Patients With Stage II Hypertension: A Randomized Controlled Trial

TypeinterventionalSponsorUniversity of LahoreRan2025 to 2025Enrolled63ConditionsHypertension, Stage II Hypertension, Essential HypertensionArmsMat Pilates, Paced Breathing
NCT07464860 narecruitingnot on this mapstarted 2026, after this paper: background citation

A Box Breathing Intervention and the Surgical Stress Response in Older Adults Undergoing Total Knee Arthroplasty: A Randomized Controlled Feasibility Trial

TypeinterventionalSponsorUniversity of ArizonaRan2026 to 2026Enrolled32ConditionsSurgical Stress Response, Stress Physiological, Stress Physiology, Stress PsychologicalArmsA 5-minute Asynchronous Breathwork Intervention, A 5-minute Asynchronous Card Game Video
NCT07594873 nacompletednot on this mapstarted 2026, after this paper: background citation

The Acute Effects of Controlled Breathing Exercises and Music Therapy on the Autonomic Nervous System in Anxious Individuals: A Randomized Controlled Study

TypeinterventionalSponsorIstanbul Health and Technology UniversityRan2026 to 2026Enrolled30ConditionsAnxious IndividualsArmsControlled Breathing Exercises Group, Music-Assisted Breathing Group
NCT07621042 nanot yet recruitingnot on this mapstarted 2027, after this paper: background citation

Effect of Brief Breathwork and Mindfulness Interventions on Anxiety, Psychological Flexibility and Physiological Variables in Spanish-Speaking University Students: a Four-Arm Randomized Controlled Trial

TypeinterventionalSponsorValencian International University (VIU)Ran2027 to 2027Enrolled240ConditionsAnxiety, Psychological Flexibility, StressArmsBox Breathing, Cyclic Sighing, Mindfulness AH Exhalation, Mindful Cyclic Sighing
NCT07728890 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Effect of Box Breathing Exercise on Anxiety, Pain, and Pulmonary Function Tests in Patients Undergoing Colonoscopy: Randomized Controlled Trial

TypeinterventionalSponsorTarsus UniversityRan2026 to 2027Enrolled68ConditionsColonoscopyArmsbox breathing exercises
3 · Its place in the literature

Who cites it

112 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  4. Clinical effectiveness of diaphragmatic breathing for dental anxiety in 7- to 13-year-old children.European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry · 2026
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52 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Melis Yilmaz BalbanDepartment of Neurobiology, School of Medicine, Stanford University, Stanford, CA 94305, USA.
Eric NeriDepartment of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA.
Manuela M KogonDepartment of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA; Stanford Center for Integrative Medicine, Stanford Health Care, Palo Alto, CA 94304, USA.
Lara WeedDepartment of Bioengineering, School of Engineering and School of Medicine, Stanford University, Stanford, CA 94305, USA.
Bita NourianiDepartment of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA.
Booil JoDepartment of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA.
Gary HollDepartment of Neurobiology, School of Medicine, Stanford University, Stanford, CA 94305, USA.
Jamie M ZeitzerDepartment of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA; Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care Service, Palo Alto, CA 94304, USA.
David SpiegelDepartment of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA; Center for Stress and Health, School of Medicine, Stanford University, Stanford, CA 94305, USA. Electronic address: dspiegel@stanford.edu.
Andrew D HubermanDepartment of Neurobiology, School of Medicine, Stanford University, Stanford, CA 94305, USA; Department of Ophthalmology, School of Medicine, Stanford University, Stanford, CA 94305, USA; BioX, School of Medicine, Stanford University, Stanford, CA 94305, USA. Electronic address: adh1@stanford.edu.

Funding

Stanford Vision Research CoreP30EY026877 · NEI · STANFORD UNIVERSITY · PI Jeffrey L Goldberg · 2017 to 2026
$8.0M
NEI NIH HHS P30 EY026877
6 · The paper itself

Abstract

Controlled breathwork practices have emerged as potential tools for stress management and well-being. Here, we report a remote, randomized, controlled study (NCT05304000) of three different daily 5-min breathwork exercises compared with an equivalent period of mindfulness meditation over 1 month. The breathing conditions are (1) cyclic sighing, which emphasizes prolonged exhalations; (2) box breathing, which is equal duration of inhalations, breath retentions, and exhalations; and (3) cyclic hyperventilation with retention, with longer inhalations and shorter exhalations. The primary endpoints are improvement in mood and anxiety as well as reduced physiological arousal (respiratory rate, heart rate, and heart rate variability). Using a mixed-effects model, we show that breathwork, especially the exhale-focused cyclic sighing, produces greater improvement in mood (p < 0.05) and reduction in respiratory rate (p < 0.05) compared with mindfulness meditation. Daily 5-min cyclic sighing has promise as an effective stress management exercise.

Indexed as

MeditationAffectAnxietyArousalHumansRespirationanxietyautonomicbreathworkheart rate variabilitylimbicmindfulness meditationmoodphysiologysleepstresswearable

Identifiers

PMID36630953
PMCPMC9873947

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

and 1 more above

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.