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Diaphragmatic (belly) breathing

Diaphragmatic breathing is a technique in which breathing is driven by the diaphragm and abdomen rather than the upper chest; it is often combined with a slow rate, so its evidence overlaps with slow-paced breathing. Systematic reviews of small trials report lower stress and anxiety measures, and reviews of clinical trials report better reflux symptom scores and less pain in some chronic pain conditions, with no serious adverse events noted. No claim reaches moderate or high certainty because the trials are mostly small, heterogeneous in protocol and at high or unclear risk of bias.

Evidence retrieved up to

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6 research claims

Marks

What the research shows

In adults, diaphragmatic breathing practice is associated with lower physiological stress markers (such as salivary cortisol, respiratory rate and blood pressure) and lower self-reported stress than no treatment or usual care.

No known concerns at usual amountsBenefit

Who this is about

adults

Details and sources

Practical note

Graded very-low: the 2019 JBI systematic review found only three studies (one randomised trial and two quasi-experimental studies) with small samples and heterogeneous protocols that could not be pooled; downgraded for risk of bias, imprecision and inconsistency of outcome measures. Interventions in the studies ranged from one 20-minute session to nine months.

Sources

Randomised trials in adults report lower anxiety scores after diaphragmatic breathing training than in control groups.

No known concerns at usual amountsBenefit

Who this is about

adults

Details and sources

Practical note

Graded low: a 2026 systematic review of 48 randomised trials found consistent benefit for anxiety, but only 2.12% of its outcomes were at low risk of bias and protocols varied widely (2-10 breaths a minute, 3-45 minute sessions, single session to 12 weeks); downgraded two levels for risk of bias and inconsistency. The cited anxiety trial ran an 8-week training programme.

Sources

In one small randomised trial of healthy adults, eight weeks of diaphragmatic breathing training was followed by better sustained attention, less negative affect and lower salivary cortisol, while the control group showed no change in cortisol.

No known concerns at usual amountsBenefit

Who this is about

healthy adults

Details and sources

Practical note

Graded very-low: a single randomised trial of 40 participants without an active control; downgraded for risk of bias, serious imprecision and indirectness, because training combined the technique with a real-time feedback device and a slow rate (about 4 breaths a minute) over 20 sessions in 8 weeks, so the effect of technique and rate cannot be separated.

Sources

In randomised trials of adults living with gastroesophageal reflux disease (GERD), diaphragmatic breathing exercises were associated with a modest improvement in reflux symptom scores, though not in quality of life; as part of a healthy lifestyle, the practice may help people living well with GERD.

No known concerns at usual amountsBenefit

Who this is about

adults living with gastroesophageal reflux disease

Details and sources

Practical note

Graded low: a 2026 meta-analysis of 10 randomised trials (476 patients) found a modest symptom-score benefit with substantial heterogeneity (I2 79.7%) and some concerns over randomisation and outcome reporting; downgraded for inconsistency and risk of bias. Sessions in the trials averaged about 20 minutes over about 5 weeks.

Sources

In adults living with chronic neck pain, chronic low back pain, fibromyalgia or tension-type headache, breathing therapy built on daily slow diaphragmatic breathing was associated with less pain in the lower-risk-of-bias trials; as part of a healthy lifestyle, it may help people living well with chronic neck pain or chronic low back pain.

No known concerns at usual amountsBenefit

Who this is about

adults living with chronic non-cancer pain

Details and sources

Practical note

Graded low: a 2026 systematic review of 10 randomised trials (638 participants) found improvement in six, and two low-risk-of-bias trials of daily 15-minute slow diaphragmatic breathing found pain reductions of up to 37%; downgraded for inconsistency and risk of bias across trials (quality ranged from high to critically low) and because results could not be pooled.

Sources

Randomised trials of diaphragmatic breathing in adults reported no serious adverse events, although fewer than one in five trials reported on safety.

No known concerns at usual amountsNo clear effect

Who this is about

adults

Details and sources

Practical note

Graded low: no serious adverse events were noted across a systematic review of 48 randomised trials, downgraded for sparse and selective harms reporting.

Safety note

Safety reporting in the trials was sparse (18.75% of studies), so rare harms cannot be ruled out.

Sources