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Effects of Diaphragmatic Breathing on Health: A Narrative Review
Open accessAbstract
Background: Breathing is an essential part of life. Diaphragmatic breathing (DB) is slow and deep breathing that affects the brain and the cardiovascular, respiratory, and gastrointestinal systems through the modulation of autonomic nervous functions. However, the effects of DB on human health need to be further investigated. Methods: The author conducted a PubMed search regarding the current evidence of the effect of DB on health. Results: This review consists of a total of 10 systematic reviews and 15 randomized controlled trials (RCTs). DB appears to be effective for improving the exercise capacity and respiratory function in patients with chronic obstructive pulmonary disease (COPD). Although the effect of DB on the quality of life (QoL) of patients with asthma needs to be investigated, it may also help in reducing stress; treating eating disorders, chronic functional constipation, hypertension, migraine, and anxiety; and improving the QoL of patients with cancer and gastroesophageal reflux disease (GERD) and the cardiorespiratory fitness of patients with heart failure. Conclusions: Based on this narrative review, the exact usefulness of DB in clinical practice is unclear due to the poor quality of studies. However, it may be a feasible and practical treatment method for various disorders.
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“Systematic reviews and meta-analyses demonstrate that evening exposure to bright or blue-enriched light suppresses melatonin production, delays sleep onset, and reduces overall sleep efficiency by signaling the brain to remain alert, whereas warm, dim lighting and blue-light filters on electronic devices during evening hours minimized circadian disruption [49].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [49]
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Perioperative respiratory rehabilitation: evolving concepts and clinical applications
Rhee, M., & Park, S. (2026) · Anesthesia and Pain Medicine · doi:10.17085/apm.25338 · Cited by 3
“This method not only enhances gas exchange, but also improves breathing, which can be particularly beneficial in the early postoperative phase during which pain or sedation may restrict normal respiratory patterns [30].”
Vera-Ponce, V. J., Talavera, J. E., Torres-Malca, J. R., Alvarado, L. R., García-Lara, R. A., & Cruz-Vargas, J. A. D. L. (2022) · Medicina Clínica y Social · doi:10.52379/mcs.v6i2.251 · Cited by 2
Pugh, S., Chan, F., Han, S., Lindo, R., Krzewski, D. G., D'Orazi, M. A., Narayanajaya, D., Gao, Z., & Norful, A. A. (2023) · JONA The Journal of Nursing Administration · doi:10.1097/nna.0000000000001285 · Cited by 2
Role of breathing training programs on quality of life in chronic kidney disease patients
Rubio-López, A. I., Ciuró, A. H., Marin-DelaRosa, J. L., Núñez, J. M., Santiago, M. G., Gracia-Guindo, M. C., & Valenza, M. C. (2023) · AIMS Public Health · doi:10.3934/publichealth.2023029 · Cited by 4
“In fact, breathing training techniques have shown positive effects on health in patients with different conditions such as chronic obstructive pulmonary disease (COPD), asthma, postoperative pulmonary function, and cardiorespiratory function, among others [18].”
Intervenções nas aulas de educação física e a saúde mental de escolares: Estudo de protocolo
da Cunha, G. D. O. K., Hartwig, T. W., & Bergmann, G. G. (2023) · Revista Brasileira de Atividade Física & Saúde · doi:10.12820/rbafs.28e0302 · Cited by 3
Kim, H., Jung, J., & Lee, S. (2023) · Physical therapy rehabilitation science · doi:10.14474/ptrs.2023.12.3.334 · Cited by 2
Gbr, A., Elimy, D. A., Amin, F., & Mohamed, A. A. (2023) · Benha International Journal of Physical Therapy · doi:10.21608/bijpt.2023.259119.1005 · Cited by 2
Yeşilyurt, S. Y., Birinci, T., Taş, S. A., Tosun, G., Özer, M., & Özengın, N. (2024) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.15799 · Cited by 2
“15 Slow breathing exercises might decrease sympathetic activity, thus enhancing both physical and mental health.”
Sadu, B., Dhawo, M. S., & Wicaksono, U. (2022) · Science Midwifery · doi:10.35335/midwifery.v10i5.886 · Cited by 2
Dangmei, G., Kalita, A., & Dutta, A. (2023) · International Journal of Life Science and Pharma Research · doi:10.22376/ijlpr.2023.13.4.l88-l100 · Cited by 2
“Diaphragmatic (abdominal) breathing (DB) is defined as an outward motion of the abdominal wall while reducing movement of the upper rib cage during inspiration.(13) Along with respiration, the diaphragm also plays a role in swallowing and vocalization.”
BackgroundGu, Y., You, Y., Guo, G., Xie, F., Guan, C., Xie, C., Cheng, Y., Ji, Q., & Yao, F. (2023) · PLoS ONE · doi:10.1371/journal.pone.0287287 · Cited by 2
BREATHING TECHNIQUES FOR PULMONARY REHABILITATION
Fedorchenko, Y. (2024) · Anti-Aging Eastern Europe · doi:10.56543/aaeeu.2024.3.1.04 · Cited by 1
Khan, H., Hussain, G., Majeed, R., Shafiq, A., & Mustafa, M. (2024) · Journal of Health and Rehabilitation Research · doi:10.61919/jhrr.v4i2.680 · Cited by 2
Functional Breathing and Approaches in Pulmonary Rehabilitation: A Literature Review
Widjanantie, S. C., Attamimy, V., & Putu Duhita Ayuningtyas, W. (2024) · Indonesian Journal of Physical Medicine and Rehabilitation · doi:10.36803/indojpmr.v13i01.414 · Cited by 1
“12,15,26 Standard diaphragm exercises are performed in an upright position and stabilize posture.”
BackgroundSawant, K. U., Rai, R. H., Kalra, S., Sharma, A., Chahal, A., & Sharma, N. (2024) · Journal of Datta Meghe Institute of Medical Sciences University · doi:10.4103/jdmimsu.jdmimsu_675_23 · Cited by 1
The Effects of a Novel Deep Breathing Program for Weight Reduction and Cholesterol Metabolism
Laymon, M. S., McKivigan, J. M., McWhinney, S. R., & Eng, H. (2024) · International Journal of Healthcare and Medical Sciences · doi:10.32861/ijhms.103.20.26 · Cited by 1
Brummett, M., Oglesby, C., Barkus, S., Wheelock, N. M., & Tate, A. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1488903 · Cited by 1
“Diaphragmatic breathing is a slow, deep breathing method that involves the contraction of the diaphragm, expansion of the belly, and deepening of inhalation and exhalation maneuvers (Hamasaki, 2020; Ma et al., 2017).”
BackgroundBahramian, Z., Kazemi, M., Vazirinejad, R., & Hasani, H. (2025) · Journal of Cardiothoracic Surgery · doi:10.1186/s13019-024-03254-0 · Cited by 1
Gitler, A., Kula, Y., Katz, C., & Gidron, Y. (2025) · IntechOpen eBooks · doi:10.5772/intechopen.1008771 · Cited by 1
Ji, D., Fu, Y., Wu, L. S., Tian, C., & Jin, S. (2025) · European journal of medical research · doi:10.1186/s40001-025-02610-7 · Cited by 1
“Abdominal breathing [30] is mainly based on training patients’diaphragmatic contractile and diastolic ability.”
The role of mindfulness and mobile apps in managing stress and anxiety in children with ADHD
Zografou, M., Drigas, A. S., & Antoniou, A. (2025) · Scientific Electronic Archives · doi:10.36560/18420252098 · Cited by 1
Multidisciplinary Assessment and Management of Functional Dysphagia
Anderson, J., Blonski, W. C., Gaziano, J. E., Thélin, C. S., Klam, R., Slone, S., Utianski, R. L., & Jacobs, J. (2025) · Gastro Hep Advances · doi:10.1016/j.gastha.2025.100762 · Cited by 1
“…extrinsic laryngeal musculature leads to elevated hyoid and larynx position which is thought to be a main contributor to MTDg. 67 Treatment may include stretches for neck, shoulder, or jaw tension; diaphragmatic breathing 68 ; circumlaryngeal manual therapy (CMT) 67 and voice therapy techniques.”
To Relax or Not to Relax for Anxious Youth? Findings from a Survey of Exposure Specialists
Becker‐Haimes, E. M., Jamison, J., Young, S., Brady, M., Houlahan, K., & Bilek, E. L. (2025) · Evidence-Based Practice in Child and Adolescent Mental Health · doi:10.1080/23794925.2025.2541348 · Cited by 1
A légzésmanipulációs eljárások pszichofiziológiája. Elméleti és gyakorlati vonatkozások
Tihanyi, B. T., Drozdovszky, O., & Köteles, F. G. (2025) · Mentálhigiéné és Pszichoszomatika · doi:10.1556/0406.2025.00095 · Cited by 1
Chyad, H. A., & Majeed, H. M. (2025) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_394_25 · Cited by 1
Breathwork in embodied psychotherapies: a systematic review and meta-analysis
Lomas, C. (2026) · Body Movement and Dance in Psychotherapy · doi:10.1080/17432979.2025.2609283 · Cited by 1
“…the increasing application of breathwork in clinical settings, there remains a lack of consensus regarding which breathwork techniques are most effective for which psychological conditions, and the neurobiological mechanisms underlying their effects are not yet fully understood (Hamasaki, 2020).”
Hafez, E., Ashraf, E., Saeed, S., Essam, M., Raigangar, V. L., & Ahmed, H. (2026) · Cureus · doi:10.7759/cureus.101118 · Cited by 1
“Diaphragmatic breathing has been associated with increased chest expansion, reduced respiratory rate, and improved oxygenation efficiency [9].”
Song, D., Zhang, J., Zhao, Z., Feng, X., Zhao, L., Yang, J., & Jing, X. (2026) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2025.1738390 · Cited by 1
“Moreover, after regular diaphragmatic breathing exercises, the size and kinematics of the abdomen and chest of asthmatics can be significantly improved, which helps to improve lung function (47).”
Pérez-García, R., Porras, V. A., Cueva-Reguera, M. D.-L., Riquelme-Aguado, V., Villafañe, J. H., González-Fernández, L., & Robledo‐Do‐Nascimento, Y. (2026) · Topics in Geriatric Rehabilitation · doi:10.1097/tgr.0000000000000503 · Cited by 1
Stress Management Programme on the Stress of Chiang Mai University Students: A Pilot Study
Joompathong, N., Bunrayong, W., & Chupradit, S. (2022) · Journal of Experimental Biology and Agricultural Sciences · doi:10.18006/2022.10(4).879.885 · Cited by 1
Pulmonary rehabilitation care: Current perspective
Kumar, A., & Kant, S. (2023) · IP Indian Journal of Immunology and Respiratory Medicine · doi:10.18231/j.ijirm.2023.003 · Cited by 2
Metadata
- Authors
- Hamasaki, H.
- Affiliations
- Hamasaki Clinic, 2-21-4 Nishida, Kagoshima, Kagoshima 890-0046, Japan
- Corresponding author
- Hamasaki, Hidetaka
- ORCID
- Hamasaki, Hidetaka
- Venue
- Medicines
- Publisher
- MDPI AG
- Published
- 2020-10-15
- Volume
- 7
- Issue
- 10
- Pages
- 65
- ISSN
- 2305-6320 (ISSN-L)
- PMC
- PMC7602530
- OpenAlex
- W3093114155
- Cited by
- 173
- References
- 116
- Citations by year
- 2026: 28 · 2025: 42 · 2024: 43 · 2023: 35 · 2022: 21 · 2021: 4
- FWCI
- 2.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Medicines (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
- Keywords
- diaphragmatic breathing, slow deep breathing, autonomic nervous system modulation, chronic obstructive pulmonary disease, asthma, stress reduction, eating disorders, chronic functional constipation, hypertension, migraine, anxiety, cancer, gastroesophageal reflux disease, heart failure, cardiorespiratory fitness, quality of life, respiratory function
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