What are breathing techniques?
Breathing is something we do automatically – all day, all our lives. In fact, we breathe on average between 12 and 20 times per minute, which is the equivalent of over 17,000 breaths per day. This continuous process is absolutely essential for the body to function at its best. Yet few people realize how important breathing is for the brain, especially after a concussion or persistent symptoms of post-concussion.
“Breathwork”, or breathing techniques, is about consciously regulating your breath to affect both body and mind. Such techniques have roots in various traditions around the world, including yoga and meditation, but are also well-established in modern research today. Concussions often involve disruptions in the body’s regulatory systems – particularly the autonomic nervous system, which controls things like heart rate, blood pressure, stress response and breathing. Here, conscious breathing can be a simple but powerful tool to support recovery and symptom management.
What happens in the body after a concussion?
After a concussion, several systems can be affected:
- Altered blood flow to the brain
- Disturbed balance between oxygen (O₂) and carbon dioxide (CO₂)
- Increased sensitivity in the nervous system (often more “fight or flight”)
- Dysregulation of the autonomic nervous system
Many people experience symptoms such as:
- Headache
- Dizziness
- Difficulty concentrating
- Fatigue
- Anxiety/inner turmoil
What many people don't know is that breathing patterns often change after a concussion – for example, more shallow, rapid or mouth-based breathing. This can worsen the symptoms experienced after a head injury.
Why is breathing so important?
Breathing affects several key factors that are particularly relevant to concussions:
1. Oxygen and energy production in the brain
The brain is extremely dependent on a stable oxygen supply. After a concussion, energy metabolism may be reduced, making efficient breathing even more important.
2. Carbon dioxide – the “forgotten” factor
CO₂ is not just a waste product – it plays an important role in regulating:
- Blood flow to the brain
- The pH balance in the blood
Breathing too fast (hyperventilation) can lead to too low CO₂ levels → this can reduce blood flow to the brain and worsen symptoms such as dizziness and “brain fog”.
3. Autonomous regulation
Breathing is a direct input to the autonomic nervous system.
- Fast, shallow breathing → activates stress response (sympathetic)
- Calm, deep breathing → activates the relaxation system (parasympathetic via the vagus nerve)
In late-life injuries following a concussion, persistent “overactivation” is often seen. Here, breathing can be a key to calming the system.
How breathing can help with concussions
Research and clinical experience suggest that conscious breathing can contribute to:
- Better regulation of the autonomic nervous system
- Increased blood flow to the brain
- Reduced dizziness and restlessness
- Better stress management
- Increased tolerance for activity
This makes breathing a low-threshold tool in a rehabilitation phase.
Recommended breathing techniques
We don't all breathe the same way. Some breathe mostly with their chest, others with their stomach, some through their nose and others through their mouth. With a concussion, the goal is not to "breathe as much as possible", but to breathe calmer, more efficiently and more regulated.
1. Diaphragmatic breathing (belly breathing)
One of the most important techniques, here you breathe deeply into your stomach so that your stomach expands when you breathe in.
Benefits:
- Increases oxygen utilization and improves lung capacity
- Stabilizes CO₂ levels
- Activates the vagus nerve → calms the nervous system
2. Calm nose breathing
Breathe in and out slowly through your nose, benefits:
- Better filtration and humidification of air
- Increased production of nitric oxide (NO) → better blood flow
- More stable breathing rhythm
3. Prolonged exhalation
E.g. 4 sec in – 6–8 sec out. Effect:
- Suppresses stress response
- Increases parasympathetic activity
- Can reduce heart rate and inner restlessness
4. “Physiological sigh” - (Physiological sigh)
This is a simple and effective breathing technique that can quickly calm the body by balancing our oxygen and carbon dioxide levels. It is based on the body's natural way of regulating stress and was made famous by Andrew Huberman.
Here's how:
- Take a deep breath through your nose.
- Take a short extra breath at the top
- Breathe out slowly and deeply through your mouth.
- Repeat 2–5 times.
Effect:
- Quickly reduce stress and anxiety to help the body return to a more relaxed state
- Lowering heart rate and activation in the autonomic nervous system
- Rebalances O₂/CO₂
- Can reduce dizziness and stress quickly
- Prevent migraine attacks/headaches
Breathing techniques for the more advanced
5. Bow breathing
A structured breathing technique where all parts of the breath are of equal length. Here's how to do it:
- Breathe in – 4 seconds
- Hold – 4 seconds
- Exhale – 4 seconds
- Hold – 4 seconds
5. Bow breathing
You breathe in through your nose and exhale slowly through slightly pursed lips (as if you were blowing out a candle). Can help with heavy breathing and improve ventilation, especially with asthma or COPD. Here's how:
- Breathe in through your nose (about 2 seconds)
- Exhale through pursed lips (about 4 seconds)
4. 4-7-8 breaths
A simple relaxation and sleep technique, popularized by Dr. Andrew Weil. Can reduce anxiety, lower heart rate, and make it easier to fall asleep. Here's how:
- Breathe in – 4 seconds
- Hold your breath – 7 seconds
- Exhale – 8 seconds
5. Alternate nasal breathing (Nadi Shodhana)
A yoga-based technique where you alternate breathing between your nostrils. Can contribute to better balance in the autonomic nervous system, increased focus and cognitive performance, and less stress. Here's how:
- Close the right nostril → inhale through the left
- Close left → exhale through right
- Inhale through right → switch → exhale through left
- continue alternating between nostrils
Important to be aware of
For concussions, breathing exercises should be gentle and gradual. The breathing technique you choose should not trigger your symptoms, such as dizziness, nausea or headaches. For some, advanced techniques or breath holding may be too stressful at first, so try it slowly!
After a concussion, rehabilitation is not just about rest – it’s also about restoring balance to the body’s regulatory systems. Breathing is one of the most direct ways to influence oxygen delivery and blood flow to the brain, as well as regulation of the autonomic nervous system. Working with your breath can help calm down an overactive system and support the brain’s natural recovery. You don’t need much, just a few minutes a day with the right focus can make a noticeable difference!
Sources
- American Thoracic Society. Pursed-Lip Breathing for COPD Management.
- Balban, MY, Neri, E., Kogon, MM, Weed, L., Nouriani, B., Jo, B., Holl, G., Zeitzer, JM, Spiegel, D., & Huberman, AD (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine , 4 (1), 100895. https://doi.org/10.1016/j.xcrm.2022.100895
- Bayrak, O. et al. 2024. Effects of Nasal and Oral Breathing on Respiratory Muscle and Brain Function: A review. Doi: 10.4274.
- Jerath, R., et al. (2006). Physiology of long pranayamic breathing . Medical Hypotheses
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- Ogoh, S. (2019). Interaction between the respiratory system and cerebral blood flow regulation. Journal of Applied Physiology , 127 (5), 1197–1205. https://doi.org/10.1152/japplphysiol.00057.2019
- Pertab, JL, Merkley, TL, Cramond, AJ, Cramond, K., Paxton, H., & Wu, T. (2018). Concussion and the autonomic nervous system: An introduction to the field and the results of a systematic review. Neurorehabilitation , 42 (4), 397–427. https://doi.org/10.3233/nre-172298
- Telles, S., et al. (2013). Immediate effect of alternate nostril breathing on autonomic functions. International Journal of Yoga.
- Uryga, A., Najdek, M., Urbański, P., Kasprowicz, M., & Buchner, T. (2025). Relationship between the autonomic nervous system and cerebral autoregulation during controlled breathing. European Journal of Applied Physiology . https://doi.org/10.1007/s00421-025-05933-9
- Weil, A. (2015). Breathing: The Master Key to Self-Healing.
