Box breathing means breathing in for four, holding for four, breathing out for four and holding for four, then going round again. The evidence is for stress and mood rather than sleep itself, but as a way to wind down it's worth a go.
Box breathing in brief
Breathe in for four, hold for four, breathe out for four, hold for four, then repeat. Don't expect it to send you off: a month-long trial found daily 5-minute breathwork, box breathing included, lifted mood more than mindfulness meditation, and it wasn't a sleep study. Use it to wind down before bed, without making falling asleep another task to get right. The NHS's calming breath for stress leaves the holds out: count 1 to 5 in and out for at least 5 minutes.
Box breathing is four equal counts: in, hold, out, hold
Sit or lie comfortably, then go round the box. If counting to four feels long at first, give yourself time to get used to the rhythm. It gets easier with practice, so there's no need to rush. Start with four rounds and build up from there.
Try four rounds of box breathing
- Breathe in slowly for a count of four.
- Hold for four.
- Breathe out slowly for four.
- Hold for four, then go round again.
Four rounds takes about a minute, and you can keep going for longer once it feels natural.
A month-long trial found breathwork lifted mood more than meditation
Breathwork, especially cyclic sighing, improved mood and slowed breathing more than mindfulness meditation in Balban and colleagues' remote randomised trial at Stanford.1 Over a month, participants practised either a breathing exercise or mindfulness meditation for five minutes daily. The researchers compared cyclic sighing, which lengthens the breath out, with box breathing and with cyclic hyperventilation with breath holds. The meditation group spent the same amount of time practising each day.
The trial's headline results were about mood and breathing rate, not sleep, and box breathing wasn't the exercise that came out best. I'd give it a go with feeling calmer as the aim. Expecting it to send you to sleep asks more than these results support.
In Balban's month-long trial, which breathing exercise improved mood the most?
- Box breathing
- Cyclic hyperventilation with breath holds
- Cyclic sighing, with long breaths out
The exhale-focused cyclic sighing did best. Breathwork in general beat the same time spent on mindfulness meditation for mood and breathing rate.
The NHS's calming breath for stress leaves out the holds
For stress, anxiety and panic, the NHS recommends getting comfortable in a chair supporting your back or lying on a bed.2 Loosen anything tight. Let your breath flow deep into your belly without forcing it, breathing in through your nose and out through your mouth. If helpful, count 1 to 5 in and 1 to 5 out, for at least 5 minutes. You may not reach 5 at first.
The NHS calming breath, for five minutes
- Breathe in gently through your nose for a count of five.
- Let it flow out through your mouth for a count of five.
If the holds in box breathing make you feel like you're doing it wrong, this one is the gentler place to start.
Use it as part of winding down, and put the phone out of reach
The NHS suggests relaxing for at least an hour before bed.3 Its breathing exercise page says the exercise works best done regularly as part of your daily routine. My view on breathing exercises and sleep stories is simple: they're an excuse to stop scrolling, and I say that as someone who browses Vinted until she drops off with the phone still in her hand. Put your phone out of reach. If you've stopped holding it, that's already a useful result. If you'd rather spend that time with a book, try our guide to reading in bed.
A breathing exercise gives you something to do instead of scrolling, so leave the phone across the room.
Box breathing, the NHS breath and cyclic sighing compared
I'd choose the breathing pattern you find easiest to follow when you're tired.
| Box breathing | NHS calming breath | Cyclic sighing |
|---|
| The pattern | In, hold, out, hold, equal counts | In through the nose, out through the mouth, counting 1 to 5 each way | Built around long breaths out |
|---|
| Breath holds | Yes | No | No |
|---|
| How long | 5 minutes a day in the Stanford trial | At least 5 minutes | 5 minutes a day in the Stanford trial |
|---|
| What the evidence says | Part of the breathwork group that beat meditation on mood | NHS advice for stress and anxiety | Lifted mood most in the trial |
|---|
If you're lying awake, a few rounds are better than clock-watching
Breathing exercises give you something to do while you wait to feel sleepy again. My rule after about twenty minutes awake: get up, keep the light dim and do something boring, then return when sleepy. If this happens most nights for a month, have a chat with your GP. For more help, try our guide to what to do when you can't sleep.
Questions people ask about box breathing
Not on the evidence so far, though it may help you wind down. The NHS recommends calm breathing for stress. The Stanford trial's headline results were about mood and breathing rate, not sleep. Relaxing before bed is part of NHS insomnia advice, so treat breathing as a way to spend some quiet time before bed.
Five minutes a day is the box breathing practice used in the Stanford trial. Participants kept that up for a month, which gives you a better guide to the commitment involved than expecting a result from one evening. The NHS recommends at least five minutes for its calming breath and says regular practice brings the most benefit. For a shorter introduction, try four rounds, which takes about a minute.
For the NHS calming breath, breathe in through your nose and out through your mouth. Box breathing instructions vary, so choose the route that feels comfortable for you rather than treating one version as compulsory. Keep the breath gentle: the NHS advises letting it flow without forcing it. Count steadily, and don't worry if you can't reach five at first, because the NHS says that's normal.
