Common Obstacles in Breathing Practice: Lightheadedness, Boredom, Anxiety and Frustration

Urgent first

Call 911 in the US for severe difficulty breathing, a tight or heavy chest, pale, blue or grey lips or skin, or sudden confusion. [1] After a faint, chest pain or a pounding, fluttering or irregular heartbeat also needs emergency help. [2] MedlinePlus says rapid breathing for the first time may be a medical emergency. [3] If you are in emotional crisis or thinking of harming yourself, call or text 988 in the US. Breathing practice is not a substitute for emergency care.

Quick guide

Lightheadedness and tingling

MedlinePlus describes overbreathing as rapid and deep breathing that leaves a low level of carbon dioxide in the blood, causing lightheadedness, dizziness, weakness, muscle spasms and numbness or tingling in the arms or around the mouth. [3] You may not notice you are breathing fast and deep. [3] If this happens, the cause is often trying too hard. The NHS technique says to let breath flow "without forcing it". [7] Stop the exercise and go back to normal, unforced breathing.

The NHS says to lie down until dizziness passes, then get up slowly, and not to drive, climb a ladder or use heavy machinery while dizzy. [4] If you feel about to faint, it suggests lying down with your legs raised or sitting with your head lowered between your knees. [2] See a doctor if you have fainted. [2] Dizziness has other causes, including ear problems, dehydration, low blood sugar and stress or anxiety, so do not assume the exercise is the only reason. [4] Full guidance: dizziness, tingling and fainting during breathing exercises.

MedlinePlus describes a home technique for overbreathing, but only for people whose provider has said it is due to anxiety, stress or panic. [3] We do not copy it here. Ask your clinician. To tell comfortable breathing from too much, see how to tell comfortable breathing from too much.

Anxiety when you focus on the breath

For some people, slowing down brings worry rather than calm. NCCIH says relaxation techniques occasionally lead to increased anxiety, intrusive thoughts or fear of losing control. [5] Researchers call a spike in anxiety during relaxation training "relaxation induced anxiety". [8] Evidence on whether it affects results is mixed: in one secondary analysis of 41 people with generalized anxiety disorder, everyone improved regardless of it, though lower peak levels predicted better outcomes. [9] A lab study of people with generalized anxiety disorder, major depression and healthy controls reported that sensitivity to negative emotional contrast explained the link between those diagnoses and this anxiety spike. [8] Those were small studies of relaxation training in general, not breathing exercises alone.

What may help, as precautions rather than proven fixes: keep your eyes open if closing them feels unsafe, shorten the session, change position, or choose a different relaxation approach. NCCIH names other options, including progressive muscle relaxation and guided imagery. [5] If breath focus keeps raising anxiety, see when focusing on breath makes you anxious and breathing practices with anxiety or panic history. The NHS lists breathing exercises among things that may help panic, [10] but a persistent problem deserves care from a health professional. [5]

Boredom and losing interest

Proper evidence not found on boredom with breathing practice specifically. We searched PubMed on adherence and dropout in breathing practice and found no study that explains it. What is known: in 12 breathwork trials, dropout after starting ranged from 3 to 40%. [6] Practical, non-evidence-based ideas: keep it brief, vary the setting within safe places, and see building a breathing habit.

Frustration: "it's not working"

Check what you expect. A meta-analysis of 12 randomized trials found a small-to-medium average reduction in self-reported stress, with most studies at moderate risk of bias. [6] In a 400-person trial, coherent breathing did no better than a matched breathing placebo, and both groups improved. [11] So improvement may come partly from expectation, attention or time, and it will not be dramatic for everyone. Also check whether breathing practice suits your problem. NCCIH advises seeing a health care provider for severe or long-lasting symptoms of any kind. [5] The NHS says shortness of breath that gets worse during normal activities or when you lie down should be seen by a GP. [1]