Gentle Breathing and Relaxation Practices: Diaphragmatic and Paced Breathing, Progressive Muscle Relaxation, Guided Imagery and Autogenic Training

Purpose and who it suits

These are the low-intensity end of breathwork and relaxation: no forced breathing, no long breath holds, no special equipment. This page is a map. It says what each practice is, how strong the research is, and where to read more. The goal-level overviews are on breathing exercises for stress and relaxation techniques.

Check with a health professional first if you have epilepsy, a psychiatric condition, or a history of abuse or trauma, because NCCIH reports rare cases where relaxation techniques caused or worsened symptoms in these groups. [1] If you have lung disease, heart disease or are pregnant, ask your clinician too; the sources we read do not list who must avoid these practices, so that is general caution. Read breathwork safety first if you are unsure.

At a glance

Diaphragmatic (belly) breathing

The NHS describes it this way: sit with back support, stand, or lie down; loosen restrictive clothing; let the breath flow into the belly as far as is comfortable without forcing it; breathe in through the nose and out through the mouth; repeat for at least 5 minutes. [2] A systematic review found only three studies (one randomized trial, two quasi-experimental); all reported lower stress, but results could not be pooled. [3] A 2026 review of 48 trials found benefits for some conditions but weak study quality. [4]

Paced breathing and extended exhale

Paced breathing means following a steady rhythm, often counted. The NHS count of 1 to 5 in and 1 to 5 out is one example, and it says you may not reach 5 at first. [2] Extended-exhale breathing makes the out-breath longer than the in-breath. In a remote randomized study, 5 minutes a day for a month of "cyclic sighing" (which emphasizes prolonged exhalations) improved mood and lowered breathing rate more than mindfulness meditation. [5] It was one trial, and participants knew which practice they were doing. NCCIH describes a 2019 review of four studies in which paced breathing could significantly improve hot flashes. [1]

A named count such as 4-7-8 or box breathing is not shown to beat plain slow breathing: in one comparison of 84 students, breathing at 6 breaths a minute raised heart rate variability more than square or 4-7-8 breathing. [6] See box breathing, 4-7-8 breathing and the named methods overview.

Pursed-lip breathing

The NHS lists breathing through pursed lips among techniques for people with COPD who are more active. [7] A 2025 review found low-quality evidence that it may moderately reduce breathlessness in obstructive lung disease. [8] See the full guide.

Breath awareness

Simply noticing the breath without changing it is a common starting point in meditation. NCCIH notes that some meditation involves maintaining mental focus on a particular sensation, such as breathing. [9] See mindful breathing practices and meditation for stress, sleep and anxiety.

Progressive muscle relaxation, imagery and autogenic training

These are owned by the Meditation & Mindfulness library, so only a summary is here. NCCIH describes progressive relaxation as tensing different muscles and then releasing the tension, guided imagery as picturing calming scenes, and autogenic training as mental exercises with self-suggestion. [1]

• A systematic review of 46 publications (more than 3,400 adults) concluded that progressive muscle relaxation reduced stress, anxiety and depression. [10] A 2026 meta-analysis of 31 trials (2,277 people) found better sleep quality and less anxiety, with very high variation between studies. [11]
• A meta-analysis of pre-surgery guided imagery trials found lower trait anxiety in adults and slightly less pain after surgery; effects on adult state anxiety were not significant. [12]
• A meta-analysis of 13 autogenic training trials (576 people) found moderate pain reduction versus no treatment, no difference versus other psychological treatments, and "some concerns" about bias. [13] A systematic review found lower anxiety and depression. [14]

What to expect and stop signs

The NHS says you get the most benefit by doing breathing exercises regularly. [2] Stop if you feel lightheaded, tingling or breathless, since overbreathing causes those symptoms. [15] Stop and consider support if relaxation brings more anxiety, intrusive thoughts or fear of losing control. [1] Do not practice while driving, bathing, swimming, near water or at heights.