The diaphragm is a large muscle that sits below the lungs and helps the lungs expand and contract. Diaphragmatic breathing is a deep breathing exercise that fully engages the diaphragm and increases the efficiency of the lungs.

In contrast, normal breathing is relatively shallow and does not use the full capacity of the lungs.

This article outlines how diaphragmatic breathing works, how to perform it, and the potential health benefits and risks of doing so.

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Diaphragmatic breathing may help improve stability in the core muscles. Getty Images

The diaphragm is a large muscle that sits at the base of the lungs. When a person inhales, their diaphragm contracts and flattens and the chest cavity enlarges. This contraction creates a vacuum, which pulls air into the lungs.

When a person exhales, the diaphragm relaxes and returns to its normal shape, and air is forced out of the lungs. Diaphragmatic breathing, or “belly breathing,” engages the diaphragm, intercostal, abdominal, and pelvic floor muscles.

This means actively pulling the diaphragm down with each inward breath. In this way, diaphragmatic breathing helps the lungs fill more efficiently.

Breathing is a natural process that usually occurs without conscious effort. However, the average breath tends to be shallow and does not engage the diaphragm very much.

During diaphragmatic breathing, a person consciously engages their diaphragm in order to take deeper breaths. A person will notice their stomach rising and falling. They will also feel an expanding or stretching sensation in the stomach, rather than solely in their chest and shoulders.

There are various forms of diaphragmatic breathing. Basic diaphragmatic breathing is the simplest form. To perform basic diaphragmatic breathing, follow the instructions below:

  • Lie down on a flat surface with a pillow under the head and pillows beneath the knees. Pillows will help keep the body in a comfortable position.
  • Place one hand on the middle of the upper chest.
  • Place the other hand on the stomach, just beneath the rib cage but above the diaphragm.
  • To inhale, slowly breathe in through the nose, drawing the breath down toward the stomach. The stomach should push upward against the hand, while the chest remains still.
  • To exhale, tighten the abdominal muscles and let the stomach fall downward while exhaling through pursed lips. Again, the chest should remain still.

People should practice this breathing exercise for 5–10 minutes at a time, around three to four times each day.

Once a person becomes comfortable with diaphragmatic breathing, they may start to practice the exercise while seated or standing. When practicing diaphragmatic breathing in these positions, it is important to keep the shoulders, head, and neck relaxed.

Diaphragmatic breathing helps a person engage the diaphragm fully while breathing. This may provide a number of health benefits, including:

  • strengthening the diaphragm
  • improving stability in the core muscles
  • slowing the breathing rate
  • lowering heart rate and blood pressure
  • reducing oxygen demand
  • promoting relaxation

Diaphragmatic breathing may be beneficial for a range of conditions. The following sections will outline these in more detail.

Stress and anxiety

A 2017 study notes that diaphragmatic breathing reduces levels of the stress hormone cortisol in the body. Because of this, it may help alleviate symptoms of stress and anxiety.

Chronic obstructive pulmonary disease

The term chronic obstructive pulmonary disease (COPD) refers to a group of lung conditions that affect a person’s breathing.

In COPD, the airways within the lungs become damaged and inflamed, obstructing airflow in and out of the lungs. The diaphragm also tends to be weaker. The body tries to compensate for this weakness by engaging the muscles in the back, neck, and shoulders while breathing.

Retraining the body to engage the diaphragm while breathing may help alleviate symptoms such as shortness of breath and fatigue.

People with COPD should first perform diaphragmatic breathing under the guidance of a healthcare professional. With time, a person may find that the technique improves their breathing during activities they find strenuous, such as climbing stairs or hiking.

Asthma

Asthma is a chronic lung condition in which certain triggers cause the airways to become swollen and inflamed. This makes it difficult for air to move in and out of the lungs.

According to one 2014 review, people who take medications to control their asthma often continue to experience ongoing symptoms and a poor quality of life (QOL). The review concluded that breathing exercises may be a beneficial add-on treatment for people with persistent asthma.

A 2013 review of three randomized controlled trials investigated the effects of diaphragmatic breathing on QOL among people with asthma. It found moderate evidence of short- and long-term improvements in QOL following diaphragmatic breathing exercises.

Diaphragmatic breathing is not always useful as a standalone treatment. People should not rely on diaphragmatic breathing alone to treat conditions such as anxiety, asthma, or COPD.

In fact, diaphragmatic breathing could actually worsen anxiety symptoms if a person feels that the treatment is not working. A person who has anxiety can practice diaphragmatic breathing, but they should also ask their doctor about effective anxiety treatments.

People who have respiratory conditions such as asthma or COPD should be careful when first practicing diaphragmatic breathing. It may initially cause labored breathing and increased fatigue. People will need to build up the practice gradually in order to see the benefits.

Diaphragmatic breathing may be beneficial alongside other treatments for different health conditions.

Treatments for anxiety include:

Treatments for COPD include medications and pulmonary rehabilitation.

Treatments for asthma include medications to control swelling and inflammation of the airways and quick-relief medications, such as inhalers.

A person’s first attempts at diaphragmatic breathing may feel strange or effortful. With practice, however, the exercise should become easier and more relaxing.

It may be best to practice diaphragmatic breathing in a relaxing area, such as a quiet room. People should also try to avoid distractions, such as cell phones, televisions, and other people. Instead, people should focus on the breathing technique and the bodily sensations they feel while practicing it.

Counting a number with each inhale and exhale may help a person feel relaxed. It can also help a person track their breaths.

Diaphragmatic breathing involves breathing deep into the stomach and fully engaging the diaphragm. This strengthens the diaphragm and helps the lungs work more efficiently. It may also promote a feeling of calm or relaxation.

Diaphragmatic breathing may be a beneficial add-on treatment for people with anxiety or respiratory conditions such as COPD or asthma. However, it is not an effective standalone treatment for these conditions.

A person should talk to their doctor about the potential risks and benefits of adding diaphragmatic breathing to their treatment plan.