Extended exhale breathing, for a body that is racing

When anxiety speeds you up, your heart beats faster, your breathing gets shallow and high in the chest, and your thoughts start to run ahead. Extended exhale breathing does one thing: it makes each breath out longer than each breath in. That small change is enough for most people to feel their body begin to slow within a minute or two.

How to do it

1. Breathe in gently through your nose for about four seconds.
2. Let the breath rest at the top for two seconds. Don't strain to hold it.
3. Breathe out slowly, through your nose or softly parted lips, for about six seconds.
4. Repeat. Five minutes is enough.

That rhythm works out to five breaths a minute. You don't need to count. In Calmalo, a circle grows while you breathe in, rests, and softens while you breathe out. Your breath can simply follow it.

Why it works

Your heart doesn't beat at a perfectly steady rate. It speeds up slightly each time you breathe in and slows slightly each time you breathe out. This is called respiratory sinus arrhythmia, and it's a sign of a healthy, flexible nervous system. The slowing on the out-breath is carried largely by the vagus nerve, the main pathway of the parasympathetic "rest and digest" system.

When the exhale is longer than the inhale, you spend more of each minute in the part of the breath where the heart is slowing. Breathing slowly, at around five or six breaths per minute, also tends to increase heart rate variability. That's the measure of how well your heart adapts from moment to moment, and it's generally associated with better stress regulation (Lehrer & Gevirtz, 2014).

A systematic review of slow-breathing studies found consistent links between slow breathing and increased parasympathetic activity, alongside reports of greater comfort and relaxation and less anxiety (Zaccaro et al., 2018). Even a single session of slow, deep breathing has been shown to increase vagal markers and reduce reported anxiety (Magnon et al., 2021).

There's a psychological side too. Following a slow rhythm gives attention somewhere to rest that isn't the worry. You aren't arguing with anxious thoughts. You're simply occupied with something slower.

When it helps

• Your heart is racing and you can feel it
• You're about to walk into something stressful: a call, a meeting, an exam
• You have been anxious for a while and feel "wired"
• You can't tell exactly what you feel. This is Calmalo's default for that reason.

Read more in how to calm down from anxiety in five minutes and why breathing out slowly calms you down.

If it feels uncomfortable

Some people feel light-headed, or feel that they are "not getting enough air" when they first slow their breathing. If that happens, breathe a little less deeply rather than more. The goal is slow and soft, not big. Shorten the counts if you need to. Three in and five out keeps the same idea. If breathing exercises make you more anxious, try grounding instead, which doesn't ask anything of your breath.

References

1. Lehrer, P. M., & Gevirtz, R. (2014). Heart rate variability biofeedback: how and why does it work? Frontiers in Psychology, 5, 756.
2. Zaccaro, A., et al. (2018). How breath-control can change your life: a systematic review on psycho-physiological correlates of slow breathing. Frontiers in Human Neuroscience, 12, 353.
3. Magnon, V., Dutheil, F., & Vallet, G. T. (2021). Benefits from one session of deep and slow breathing on vagal tone and anxiety in young and older adults. Scientific Reports, 11, 19267.