Yogic Breathing and Mindfulness as Stress Coping Mediate Positive Health Outcomes of Yoga
Open accessAbstract
Objectives: Despite accumulating research on yoga and its positive impact on both physiological and psychological health, it is still unclear how yoga improves health. Two central components of yoga,yogic breathing and mindfulness, may be important mechanisms by which individuals learn to cope with their daily stressors, and thereby reduce their risk of developing stress-related illness. In this study, we experimentally tested whether yogic breathing as a stress coping mechanism and increased mindfulness mediates the psychological health benefits of a yoga intervention Methods: Seventy-one middle-aged adults (78% women;Mage 53.5 ± 6.9) who self-rated as moderately stressed were randomly assigned to either a control group or a 5-week yoga intervention called the Yoga and Mindfulness Intervention (YOMI) program. The YOMI combines 60 min of yin yoga practice with 30 min of psychoeducation, administered twice weekly; participants also completed a 5-min breathing exercise as homework daily. Results: The YOMI group showed greater reductions in anxiety, depression, and sleep problems compared with controls (R2 varied between .09 to .23), and these reductions were statistically mediated by increased use of yogic breathing and a related increase in participants’ overall mindfulness. Conclusions: These mediation results provide new insights into how yoga improves psychological health and suggests promising implications for policymakers aimed at improving public health.
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Combining yoga with elements of mindfulness is more likely to draw positive outcomes than conventional treatment approaches.
“Some researchers found that combining yoga with elements of mindfulness is more likely to draw positive outcomes than conventional treatment approaches [29, 30].”
From The effectiveness of mindfulness yoga on patients with major depressive disorder: a systematic review and meta-analysis of randomized controlled trials (2023) · cites this paper as [30]
The Abstract and Between-Group Comparisons of Study Outcomes report better psychological outcomes after a yoga-and-mindfulness intervention than in the control group. But the Procedures describe that group as waiting and instructed not to practice yoga; it did not receive a conventional treatment. The paper therefore does not support the claimed comparison with conventional treatment approaches. (LLM, conf=0.89)
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Campoamor-Olegario, L. A., Guinto, M. L. M., Camitan, D. S., Gomez, M. G. A., Pituk, C. S., Yleaña, C. J. A. T., Edilo, I. G. F., DİAZ, F. C. B., Bajin, L. N., & Jamon, K. G. G. (2024) · Advances in educational technologies and instructional design book series · doi:10.4018/979-8-3693-3952-7.ch010 · Cited by 8 · see citing works
Akartuna, D., Menon, P., & Küçük, Z. D. (2025) · Journal for the Study of Spirituality · doi:10.1080/20440243.2024.2439807 · Cited by 7 · see citing works
“…form of yoga involving long-held postures and mindful breathing, has been associated with numerous physical and mental health benefits, highlighted by research for enhancing stress coping, reducing anxiety, and improving mindfulness (Lemay, Hoolahan, and Buchanan 2021; Tellhed et al. 2019).”
Siu, O. L., Yang, Y., Li, A., Wang, H., & Ng, T. K. (2025) · Stress and Health · doi:10.1002/smi.70093 · Cited by 6 · see citing works
“Using the MLmed approach, the results showed (see Table 6) that the intervention significantly employee To test hypothesis 6, we conducted a serial mediation analysis using PROCESS by computing a difference score of studied variables (c.f., Tellhed et al. 2019).”
Murayama, Y., & Ohya, A. (2021) · Journal of Eating Disorders · doi:10.1186/s40337-021-00477-7 · Cited by 6 · see citing works
War-Related Mental Health Issues and Need for Yoga Intervention Studies
Anand, A., Ghani, A., Sharma, K., Kaur, G., Khosla, R., Devi, C., Podder, V., Sivapuram, M. S., Maity, K., & Kaur, H. (2021) · International Journal of Yoga · doi:10.4103/ijoy.ijoy_60_21 · Cited by 6 · see citing works
“International Journal of Yoga | Volume 14 | Issue 3 | September‐December 2021 178 conditions highlight the importance of carrying out studies that examine the effects of mindfulness and yoga, because studies have shown the positive effects of yoga practices in stress.[59,60] However, it cannot be ignored as mentioned…”
BackgroundTellhed, U., Sollvén, A., Tamas, A., & Hägerklint, E. (2022) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12823 · Cited by 5 · see citing works
Self-citationThomson, C., Lesser, I., & Hatfield, G. (2024) · Journal of American College Health · doi:10.1080/07448481.2024.2308267 · Cited by 5 · see citing works
“25 In addition, yoga can be practiced with minimal equipment prior to writing a test.”
Szaszkó, B., Tschenett, H., Ulrich Ansorge, A., & Nater, U. M. (2024) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2024.107191 · Cited by 5 · see citing works
“The practice of yoga is also meant to teach people acceptance and non-reactivity, both of which might contribute to increased psychological well-being without changes in the underlying physiology (Tellhed et al., 2019).”
BackgroundMediators of improved PTSD symptoms in veterans and civilians following a yoga program
Davis, L. W., Schmid, A. A., Daggy, J., & Yang, Z. (2023) · Acta Neuropsychiatrica · doi:10.1017/neu.2023.5 · Cited by 5 · see citing works
Yoga as an adjunct treatment for the eating disorders: A qualitive enquiry of clinician perspectives
Trethewey, E., McIver, S., Evans, S., O’Brien, J. L., & O’Shea, M. (2023) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2023.101796 · Cited by 5 · see citing works
Kramer-Kostecka, E. N., Fulkerson, J. A., Sherwood, N. E., Barr‐Anderson, D. J., Larson, N., & Neumark‐Sztainer, D. (2022) · Journal of Integrative and Complementary Medicine · doi:10.1089/jicm.2021.0445 · Cited by 3 · see citing works
Comparison of Pranayama Yoga and Surya Namaskar Yoga Towards Dysmenorrhea in Adolescent Girl
Widiastini, L. P., Sumawati, N. M. R., & Udayani, N. P. M. Y. (2023) · Jurnal Aisyah Jurnal Ilmu Kesehatan · doi:10.30604/jika.v8i1.1573 · Cited by 3 · see citing works
Beauchamp, F. E., & Kampman, H. (2023) · American Journal of Qualitative Research · doi:10.29333/ajqr/13080 · Cited by 2 · see citing works
Laughlin, E., & Chun, S. (2025) · Leisure/Loisir · doi:10.1080/14927713.2025.2489348 · Cited by 2 · see citing works
“These activities were emphasized as effective in managing psychological stress, grounding the participants, renewing their sense of self, and calming their minds (Jain et al., 2007; Tellhed et al., 2019).”
Coping and Adapting to Climate Change in Australia: Yoga Perspectives
David, T., Buchan, J., & Nalau, J. (2022) · International Journal of Yoga Therapy · doi:10.17761/2022-d-22-00016 · Cited by 2 · see citing works
Psychological and Cardiovascular Effects of Meditation and Yoga
Bigliassi, M. (2020) · Springer eBooks · doi:10.1007/978-3-319-90305-7_57-1 · Cited by 2 · see citing works
Development and validation of Yogic Personal Excellence Inventory
Bhandari, R. B., & Chaudhry, N. (2025) · Journal of Ayurveda and Integrative Medicine · doi:10.1016/j.jaim.2024.101122 · Cited by 1 · see citing works
“The tamas is assessed through 22 items (2, 6, 7, 11, 14, 15, 19, 24, 29, 32, 33, 35, 36, 40, 41, 43, 45, 47, 52, 53, 54, and 55).”
Ahmadi, S. E., Park, C. L., & Osherow, E. K. (2025) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2025.102040 · Cited by 1 · see citing works
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Dagar, C., Chhajer, R., & Rai, H. (2024) · Mindfulness · doi:10.1007/s12671-024-02476-6 · Cited by 1 · see citing works
“In this context, mind–body practices including mindfulness, yoga, and meditation are instrumental in nurturing the skills of self-management to thrive in life (Fincham et al., 2023; Tellhed et al., 2019).”
Loree, A. M., Santarossa, S., Coyne, P., Haley, E. N., Boulay, M., Pappas, C., Braciszewski, J. M., Miller-Matero, L. R., & Hicks, L. M. (2025) · Contemporary Clinical Trials · doi:10.1016/j.cct.2025.108032 · Cited by 1 · see citing works
Psychological and Cardiovascular Effects of Meditation and Yoga
Bigliassi, M. (2020) · Springer eBooks · doi:10.1007/978-3-030-28008-6_57 · Cited by 1 · see citing works
Varnika, S., & Vd, R. S. (2023) · Journal of Natural & Ayurvedic Medicine · doi:10.23880/jonam-16000372
Integrative Medicine as a Panpharmacon for COVID-19 Pandemic: A Call for Global Advocacy
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Impact of COVID-19 on Sleep and Role of Yoga as a Non – Pharmacological Intervention
Rai, S., Kumar, V., & Singh, V. (2023) · Japan Journal of Clinical & Medical Research · doi:10.47363/jjcmr/2023(3)147
Pandey, A. O. P., Mishra, N., & Vishvakarma, S. (2023) · BMJ Military Health · doi:10.1136/military-2023-002450
Latihan Pernapasan dalam Meningkatkan Kontrol Asma dan Kualitas Hidup Pasien Asma Dewasa
Silva, E. M. D., Dewi, Y. S., Mar'ah, E. M., & Hasanudin, H. (2023) · Jurnal Keperawatan Silampari · doi:10.31539/jks.v6i2.4495
“Sejumlah 71 orang dewasa dengan masalah stres berpartisipasi dalam melakukan yoga dua kali seminggu, selama 5 minggu, dengan durasi waktu selama 30-60 menit terbukti dapat meningkatkan kesehatan psikologis pasien (Tellhed et al., 2019).”
BackgroundPandey, A. O. P., Mishra, N., & Vishvakarma, S. K. (2023) · BMJ Military Health · doi:10.1136/military-2023-002539
Bienestar psicológico en un grupo de profesores de hatha yoga
Huamaní, Y. H., & Herrera, J. K. (2023) · Revista Costarricense de Psicología · doi:10.22544/rcps.v42i02.08
“Por otra parte, el significado del yoga, más allá de la práctica física, es importante por el estilo de vida y el deseo por contribuir cambios positivos en los demás, pues así el practicante percibe un equilibrio interior (Menezes et al., 2015; Tellhed et al., 2019).”
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Creating Attunement with Breathwork
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Navigating Mental Wellness, Physical Health, Addiction, and Human Well-Being
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The Beneficial Effects of Yoga on Stress: A Positive Psychology Perspective
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Davis, G. P., Balasubramanian, S., Bridges, K. H., McCoy, N. C., Condon, C. M., Wolf, B. J., Massman, K., & Hebbar, L. (2025) · Journal of Integrative and Complementary Medicine · doi:10.1177/27683605251370945
Pandey, A. O. P., Mishra, N., & Vishvakarma, S. K. (2025) · BMC Psychology · doi:10.1186/s40359-025-03257-z
“Through the cautious and persistent practice of yoga, they learn to direct their attention to present bodily sensations, perceptions, thoughts, changes in the breath pattern, and emotions when experiencing stress, which increases the mindfulness and psychological health of the practitioners [50].”
Miao, C., Gao, Y., Li, X., Zhou, Y., Chung, J. W. Y., & Smith, G. D. (2024) · Figshare · doi:10.6084/m9.figshare.26615980
Ahmadi, S. E., Park, C. L., & Carney, L. M. (2026) · Journal of Health Psychology · doi:10.1177/13591053261417464
“Indeed, many studies have demonstrated the beneficial impacts of yogic breathing practices on a variety of outcomes, including posttraumatic stress disorder, anxiety, and depression (Haller et al., 2023; Lata et al., 2022; Tellhed et al., 2019).”
Trait mindfulness and acute stress: a test of the stress-buffering mechanism
Herms, S., Sutton, A., & Näswall, K. (2026) · Current Psychology · doi:10.1007/s12144-026-09181-8
“…risk and can even be beneficial by increasing productivity (Alsulami et al., 2018 ) but prolonged stress and repeated negative stress appraisals can result in serious health concerns such as anxi - ety, depression, headaches and sleep disturbances (Baghurst & Kelly, 2014 ; Tellhed et al., 2019).”
Bhat, D. P., Sharma, K. K., & Subramanya, P. (2026) · Indian Journal of Community Medicine · doi:10.4103/ijcm.ijcm_541_25
“[14] Cyclical metabolic shifts induced by fasting, such as enhanced fat metabolism, insulin sensitivity, autophagy, and reduced oxidative stress, may work in tandem with yoga’s effects on autonomic balance, cortisol reduction, vagal tone, and emotional regulation.”
Datta, S. S., Ghosh, U., Mohapatra, A., & Kumar, S. (2026) · Indian Journal of Community Medicine · doi:10.4103/ijcm.ijcm_694_25
“[12,16] Evidence from RCT indicated that yoga intervention showed greater improvements across all three Gunas compared with those in the physical exercise control group.”
Tan, P., Song, Y., Zhang, X., Chen, J., Lu, J., Ji, Y., Zheng, L., Ren, X., & Zhang, H. (2026) · Computers in Human Behavior Reports · doi:10.1016/j.chbr.2026.101153
Physiotherapy and Rehabilitation in Menopause
Demirtürk, F. (2026) · Springer eBooks · doi:10.1007/978-3-032-28741-0_21
Yan, L., Li, R., Zhang, G., & Liu, W. (2026) · Behavioral Sciences · doi:10.3390/bs16091596
“Tellhed et al. (2019) identified yogic breathing and mindfulness as relevant indirect processes associated with psychological health outcomes, while Parkinson and Smith (2022) examined several psychological factors, including mind-fulness, self-compassion, interoceptive awareness, and emotion…”
Tornóczky, G. J., Yadav, S. S., Nagy, H., Ilbak, İ., Klier, V., Bosnyak, D., Szabó, A., & Kovács, R. E. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1941678
- Authors
- Tellhed, U., Daukantaitė, D., Maddux, R. E., Svensson, T., & Melander, O.
- Affiliations
- Lund University (SE)
- Corresponding author
- Tellhed, Una
- Venue
- Mindfulness
- Published
- 2019-11-11
- Volume
- 10
- Issue
- 12
- Pages
- 2703-2715
- ISSN
- 1868-8527 (ISSN-L)
- 1868-8535
- OpenAlex
- W2970875470
- Cited by
- 63
- References
- 86
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 13 · 2023: 15 · 2022: 6 · 2021: 4 · 2020: 6
- FWCI
- 4.67
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Mindfulness (publishedVersion, cc-by)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Knut och Alice Wallenbergs Stiftelse (2015 0304)
- Göran Gustafssons Stiftelse för Naturvetenskaplig och Medicinsk Forskning (GG 2015-0020)
- Hjärt-Lungfonden (2015 0307)
- Vetenskapsrådet (2018-02760)
- Novo Nordisk Fonden (NNF17OC0026936)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- yoga, pranayama, stress coping, mediation, anxiety, depression, sleep disorders, yin yoga, psychoeducation, middle-aged adults, mental health, public health policy
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