4-7-8 breathing: How to use the technique for sleep or anxiety

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CNN
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Falling asleep or coming down from anxiety might never be as easy as 1-2-3, but some experts believe a different set of numbers – 4-7-8 – comes much closer to doing the trick.

The 4-7-8 technique is a relaxation exercise that involves breathing in for four counts, holding that breath for seven counts and exhaling for eight counts, said Dr. Raj Dasgupta, a clinical associate professor of medicine at the University of Southern California’s Keck School of Medicine, via email.

Also known as the “relaxing breath,” 4-7-8 has ancient roots in pranayama, which is the yogic practice of breath regulation, but was popularized by integrative medicine specialist Dr. Andrew Weil in 2015.

“What a lot of sleep difficulties are all about is people who struggle to fall asleep because their mind is buzzing,” said Rebecca Robbins, an instructor in medicine at Harvard Medical School and associate scientist in the division of sleep and circadian disorders at Brigham and Women’s Hospital in Boston. “But exercises like the 4-7-8 technique give you the opportunity to practice being at peace. And that’s exactly what we need to do before we go to bed.”

“It does not ‘put you to sleep,’ but rather it may reduce anxiety to increase likelihood of falling asleep,” said Joshua Tal, a New York state-based clinical psychologist.

The 4-7-8 method doesn’t require any equipment or specific setting, but when you’re initially learning the exercise, you should sit with your back straight, according to Weil. Practicing in a calm, quiet place could help, said Robbins. Once you get the hang of it, you can use the technique while lying in bed.

During the entire practice, place the tip of your tongue against the ridge of tissue behind your upper front teeth, as you’ll be exhaling through your mouth around your tongue. Then follow these steps, according to Weil:

Keeping to the ratio of four, then seven and then eight counts is more important than the time you spend on each phase, according to Weil.

“If you have trouble holding your breath, speed the exercise up but keep the ratio (consistent) for the three phases. With practice you can slow it all down and get used to inhaling and exhaling more and more deeply,” his website advised.

When you’re stressed out, your sympathetic nervous system – responsible for your fight-or-flight response – is overly active, which makes you feel overstimulated and not ready to relax and transition into sleep, Dasgupta said. “An active sympathetic nervous system can cause a fast heart rate as well as rapid and shallow breathing.”

The 4-7-8 breathing practice can help activate your parasympathetic nervous system – responsible for resting and digesting – which reduces sympathetic activity, he added, putting the body in a state more conducive to restful sleep. Activating the parasympathetic system also gives an anxious brain something to focus on besides “why am I not sleeping?” Tal said.

While proponents may swear by the method, more research is needed to establish clearer links between 4-7-8 and sleep and other health benefits, he added.

“There is some evidence that 4-7-8 breathing helps reduce anxious, depressive and insomniac symptoms when comparing pre- and post-intervention, however, there are no large randomized control trials specifically on 4-7-8 breathing to my knowledge,” Tal said. “The research on (the effect of) diaphragmatic breathing on these symptoms in general is spotty, with no clear connection due to the poor quality of the studies.”

A team of researchers based in Thailand studied the immediate effects of 4-7-8 breathing on heart rate and blood pressure among 43 healthy young adults. After participants had these health factors and their fasting blood glucose measured, they performed 4-7-8 breathing for six cycles per set for three sets, interspersed with one minute of normal breathing between each set. Researchers found the technique improved participants’ heart rate and blood pressure, according to a study published in July.

“If you’re practicing some of these activities, what we do see is (an) increase in the amplitude of theta and…