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Cited by 64Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychosomatic Disorders and Their TreatmentsMindfulness and Compassion Interventions

Breathwork Interventions for Adults with Clinically Diagnosed Anxiety Disorders: A Scoping Review

Open access
Banushi, Blerida, Brendle, Madeline, Ragnhildstveit, Anya, Murphy, Tara, Moore, Claire, Egberts, Johannes, Robison, Reid·2023·Brain Sciences
DOI 10.3390/brainsci13020256PMC PMC9954474
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Abstract

Anxiety disorders are the most common group of mental disorders, but they are often underrecognized and undertreated in primary care. Dysfunctional breathing is a hallmark of anxiety disorders; however, mainstays of treatments do not tackle breathing in patients suffering anxiety. This scoping review aims to identify the nature and extent of the available research literature on the efficacy of breathwork interventions for adults with clinically diagnosed anxiety disorders using the DSM-5 classification system. Using the PRISMA extension for scoping reviews, a search of PubMed, Embase, and Scopus was conducted using terms related to anxiety disorders and breathwork interventions. Only clinical studies using breathwork (without the combination of other interventions) and performed on adult patients diagnosed with an anxiety disorder using the DSM-5 classification system were included. From 1081 articles identified across three databases, sixteen were included for the review. A range of breathwork interventions yielded significant improvements in anxiety symptoms in patients clinically diagnosed with anxiety disorders. The results around the role of hyperventilation in treatment of anxiety were contradictory in few of the examined studies. This evidence-based review supports the clinical utility of breathwork interventions and discusses effective treatment options and protocols that are feasible and accessible to patients suffering anxiety. Current gaps in knowledge for future research directions have also been identified.

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Crossref · 10.3390/brainsci13020256

Cites

97 of 98 references verified0 citation errors · 0 not checkable

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  • Breathing practices, when used in isolation, are universally accessible, scalable, and cost-free, and are not limited by access to healthcare services nor burdened by side effects.

    “Breathing practices, when used in isolation, have the advantage of being universally accessible, scalable, and cost-free. They are not limited by access to healthcare services nor burdened by side effects and put potential treatment tools in the hands of the individual [23,24,25].”

    From Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature (2023) · cites this paper as [23]

    The Introduction (no page given) calls for cost-effective, self-administered therapies usable by large populations, and the Conclusions (no page given) describe breathwork options as feasible and accessible to patients with anxiety. The paper does not establish that breathing practices are universally accessible or cost-free, require no healthcare access, or have no side effects; it identifies side effects as a limitation of some existing treatments, not as an absence demonstrated for breathwork. (LLM, conf=0.84)

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  • Most reviews include breathing interventions incorporating biofeedback, which is not readily applicable to at-home practice.

    “In addition, most reviews include breathing interventions incorporating biofeedback [23,25,35,52], which is not readily applicable to at-home practice.”

    From Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature (2023) · cites this paper as [23]

    The Results (§3.4; page unavailable) show that this review includes biofeedback-assisted breathing interventions, supporting its use as an example of such a review. The paper does not establish that most reviews include them, and the Discussion (§4; page unavailable) describes biofeedback as implementable in real-world settings rather than saying it is unsuitable for at-home practice. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Intervention effectiveness was less likely during fast-only breathing versus any other pace.

    “Intervention effectiveness was less likely during fast-only breathing versus any other pace, consistent with other reviews finding benefits associated with slow-paced breathing practices [23,35].”

    From Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature (2023) · cites this paper as [23]

    The Results (section 3.6; page unavailable) report anxiety reductions in five studies using slow diaphragmatic, deep, or controlled breathing, supporting the sentence’s point about benefits associated with slower practices. The review does not report that fast-only breathing was less likely to be effective than every other pace, so it does not establish the claimed comparison. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Existing literature confirms widespread benefits of slow breathing practices for stress/anxiety reduction, but null or negative results are reported in some studies.

    “Although existing literature confirms the widespread benefits of slow breathing practices for stress/anxiety reduction [23,24,25,35,36,37,38], null or negative results are reported in some studies [39,40,41,42,43,44,45,46,47,48,49,50].”

    From Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature (2023) · cites this paper as [23]

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Research works printed but not linked: 2

  1. [23]Du Pasquier D. Fellrath J.M. Sauty A. Hyperventilation syndrome and dysfunctional breathing: Update Rev. Med. Suisse. 2020 16 1243 1249 32558453
  2. [97]Grof S. Beyond the Brain: Birth, Death, and Transcendence in Psychotherapy Suny Press Albany, NY, USA 1985

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Authors
Banushi, B., Brendle, M., Ragnhildstveit, A., Murphy, T., Moore, C., Egberts, J., & Robison, R.
Affiliations
  • The University of Queensland (AU)
  • University of Utah (US)
  • Duke University (US)
  • University of Wisconsin–Madison (US)
  • Numinus Wellness, Draper, UT 84020, USA
  • Breathless Expeditions, Manly, NSW 2095, Australia
Corresponding author
Banushi, Blerida
ORCID
Venue
Brain Sciences
Publisher
MDPI AG
Published
2023-02-02
Volume
13
Issue
2
Pages
256
ISSN
2076-3425 (ISSN-L)
DOI
10.3390/brainsci13020256
PMC
PMC9954474
OpenAlex
W4319083840
Cited by
58
References
97
Citations by year
2026: 15 · 2025: 27 · 2024: 11 · 2023: 5
FWCI
2.45
Type
journal article
Language
en
Open access
Licence
Locations
  • Brain Sciences (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Apollo (University of Cambridge) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Apollo
  • Apollo (cc-by)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Keywords
anxiety disorders, dysfunctional breathing, hyperventilation, anxiety symptom reduction, treatment efficacy, adults, primary care

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