Box Breathing: How to Do It, Plus Benefits and Safety

Box breathing is a slow breathing exercise where you breathe in for four counts, hold for four, breathe out for four, and hold for four, then repeat. It is also called square breathing or 4-4-4-4 breathing. Many people use it to feel calmer when they are stressed.

How to do box breathing

Sit comfortably, then breathe out slowly to empty your lungs.
Breathe in gently through your nose while you count slowly to four.
Hold your breath for a count of four.
Breathe out slowly through your mouth for a count of four.
Hold again for a count of four, with your lungs empty, before the next breath.
Repeat for three to four rounds. Keep every breath gentle, and never strain.

Picture each phase as one side of a square. If four counts feels too long, use three. The aim is to feel steady, not to get it perfect.

Key points

Four equal counts: in, hold, out, hold.
Three to four rounds is a common start.
Some studies suggest slow breathing may help with stress. Evidence for box breathing alone is limited.
Stop if you feel dizzy or breathless.
Check with your doctor first if you have a heart condition, a severe health condition or you are pregnant.

What is box breathing?

Box breathing is a controlled breathing pattern with four equal phases. Cleveland Clinic describes it as a form of yogic deep breathing, also known as sama vritti pranayama. Other names include equal breathing, square breathing and 4-4-4-4 breathing.

How does box breathing work?

Cleveland Clinic says slow, even breathing helps shift the body from the “fight or flight” state towards the “rest and digest” state. It also says that counting works a bit like a mantra, keeping your attention on the present moment. These are clinician explanations, not proof.

The “how” is not settled. A 2023 trial of breathing exercises found no significant changes in heart rate variability or resting heart rate.

What are the benefits of box breathing for anxiety and stress?

Cleveland Clinic says the biggest benefit is relaxation, especially at stressful times. The research adds this, with limits.

A small trial of box breathing. In a 2023 study in Cell Reports Medicine, 108 adults, mostly university psychology students, did one of three breathing exercises or mindfulness meditation for five minutes a day for 28 days. Only 21 people were in the box breathing group. Box breathing was not significantly better than mindfulness meditation, and state anxiety fell by a similar amount in both groups. The study was small, ran online and followed people for only four weeks.
A review of breathwork in general. A 2023 review in Scientific Reports pooled 12 randomised trials (785 adults) on stress and 20 studies on anxiety. It found small to medium benefits for self-reported stress and anxiety. The authors said results should be read cautiously, because most studies had a moderate risk of bias and all outcomes were self-reported. It covered many kinds of breathwork, not only box breathing.

In short, box breathing may help some people feel calmer. It is not a treatment for anxiety or any health condition.

How long and how often should you do box breathing?

Sources differ slightly, so treat these as a starting point.

Cleveland Clinic: repeat for three to four rounds, and practise one or two times a day.
Anxiety NZ: try three to five rounds to begin with, and continue for longer if it feels helpful.

Anxiety NZ also says practising when you feel calm may make it easier to use when you feel anxious. For a related gentle belly breathing exercise, the NHS says you get the most benefit if you do it regularly as part of your daily routine.

Is box breathing safe?

Healthline says box breathing is generally safe. Safety points from the sources:

Stop if you feel dizzy or breathless. Healthline says to stop straight away and go back to normal breathing. If the dizziness or breathlessness does not go away, get medical attention.
Check with your doctor first if you have a heart condition, a severe health condition or you are pregnant (Healthline).
Breathing or anxiety conditions. For belly breathing, Cleveland Clinic suggests talking to your health provider first if you have COPD, asthma or anxiety.
A little light-headedness can happen. Cleveland Clinic says some people feel lightheaded or short of breath when first learning to breathe more slowly (written about 4-7-8 breathing).
Not everyone enjoys it. In the 2023 trial, 10% of participants reported negative experiences with the exercises. The breathwork review found no reported lasting harms.

If anxiety or stress is affecting daily life, talk to your GP, or free call or text 1737 any time to talk with a trained counsellor. In an emergency, call 111.

What if holding your breath feels uncomfortable?

You can change the exercise so it feels manageable. The sources suggest:

Use shorter counts. Anxiety NZ teaches the exercise with a count of three, and says to adjust the counts if they feel too fast or too slow.
Stay at your comfort level. Cleveland Clinic says to breathe very gently, not strain, and lengthen the counts over time.
Breathe out gently through lips pursed “as if you were blowing through a straw” (Anxiety NZ).

How does box breathing compare with other breathing exercises?

Exercise	Pattern	When people use it
Box breathing	In 4, hold 4, out 4, hold 4	To relax, especially at stressful times (Cleveland Clinic)
4-7-8 breathing	In through the nose for 4, hold for 7, out through the mouth for 8	To calm down and help with sleep (Cleveland Clinic)
Slow belly (diaphragmatic) breathing	Breathe in slowly through the nose so the belly rises, then out through pursed lips; no breath hold	For relaxation, and with anxiety, asthma or COPD; start with five to 10 minutes, three to four times a day (Cleveland Clinic)

No source we found shows one is better for everyone, so pick what feels comfortable. For a guided session, try our Guided Meditation practice or read the Guided Meditation guide. For gentle movement, see the gentle yoga practice, or browse all practices.

FAQs about box breathing

What is the box breathing technique in simple terms?

It is a slow breathing exercise with four equal parts: breathe in, hold, breathe out, hold. Each part lasts the same number of counts, usually four, which is why it is also called square breathing or 4-4-4-4 breathing.

Does box breathing help with anxiety?

It may help some people feel calmer. A review of breathwork in general found small to medium benefits for self-reported anxiety, but evidence for box breathing alone is limited, and it is not a treatment.

How long should you do box breathing?

Cleveland Clinic suggests three to four rounds, one or two times a day. Anxiety NZ suggests three to five rounds to begin with. Stop if you feel dizzy.

Can box breathing make you dizzy?

It can in some people. Healthline advises stopping straight away and returning to normal breathing if you feel breathless or dizzy. Shorter counts can make it easier.

The Wellbeing Sessions is an independent library of free, self-guided practices. It is not a health provider or a crisis service, and it is not affiliated with any government agency or charity.

Box Breathing: How to Do It, Step by Step