Diaphragmatic Breathing Exercises

Diaphragmatic Breathing Exercises focus on deep breathing using the diaphragm rather than shallow chest breathing. This technique enhances lung efficiency, reduces stress, and improves oxygenation.

It involves inhaling deeply through the nose, allowing the abdomen to rise while keeping the chest still, and exhaling slowly through the mouth. Common exercises include lying down breathing, seated diaphragmatic breathing, and paced breathing. Regular practice can help with relaxation, respiratory conditions, and core stability.

What is Breathing Exercises?

The autonomic nervous system regulates breathing. Breathing exercises are one type of exercise that might increase the effectiveness of the lungs overall. They may help people with healthy lungs as well as those with impaired lung function.

In the absence of illness, stress causes changes in our breathing, which, if untreated, can lead to abnormal breathing patterns. Disordered breathing may disrupt with the exchange of carbon dioxide and oxygen, as well as cause anxiety, panic attacks, fatigue, and other mental and physical health problems.

Breathing exercises are beneficial for several health-related reasons. For example, to boost breathing efficiency, strengthen respiratory muscles, improve ventilation, and lessen stress and anxiety.

Types of Breathing exercises:

• Diaphragmatic breathing
• Pursed- lip breathing
• Deep breathing
• Active cycle of breathing technique
• Box breathing

Diaphragmatic Breathing Exercises

The diaphragm: what is it?

The most effective breathing muscle is the diaphragm. It is a big muscle at the base of your lungs that has a dome shape. Your abdominal muscles provide you with extra force to expel air from your lungs by moving the diaphragm.

Introduction:

Diaphragmatic breathing is a kind of breathing exercise that helps to develop your diaphragm (a vital muscle) to facilitate breathing because it accounts for 80% of it. Another name for this breathing technique is abdominal breathing or belly breathing.

Ventilation is efficient and the muscles of ventilation use less oxygen during relaxed (tidal) breathing when the diaphragm is performing its duty as the main muscle of inspiration. The mechanical effort of breathing (oxygen consumption) rises and ventilation efficiency falls when a patient depends significantly on the auxiliary muscles of inspiration.

The goal of controlled breathing techniques, which emphasize diaphragmatic breathing, is to enhance gas exchange and oxygenation, reduce respiratory effort, increase diaphragm excursion, and improve ventilation efficiency. Additionally, slow breathing can be achieved by using the diaphragm to generate intra-abdominal pressure for posture control.

Aims 

• Is to teach breathing control and mobilize secretions.
• To clear secretions and teach coughing techniques.
• To impart relaxing skills.
• To provide knowledge about posture
• To move shoulder girdle and thorax

Impact on the Physiology

The physiological effects of diaphragmatic breathing are numerous.

It has the following effects on the respiratory system:

Consciously using the diaphragm during breathing expands lung capacity and enhances oxygen ventilation effectiveness by raising tidal volume and lowering respiratory rate.
Increasing arterial oxygen saturation and decreasing alveolar dead space to improve alveolar ventilation and blood oxygen levels

Additional physiological impacts consist of:

• Reduction of sympathetic nerve activity and activation of parasympathetic nerve activity
• Increasing the stability of the core muscles.
• Reduces the negative effects of the stress hormone cortisol on your body by promoting relaxation.
• Improved venous return efficiency
• Reduce your blood pressure.
• Managing post-traumatic stress disorder (PTSD) symptoms

Indication:

• Airway blockage (asthma, COPD)
• Sleep apnea
• Atelectasis
• Obesity or any musculoskeletal abnormalities
• Deficit in the central nervous system
• Neurological conditions.
• Surgical operations like abdominal or thoracic surgery.

Benefits of diaphragmatic breathing 

• Diaphragmatic breathing helps you relax, 
• Improves muscle function during exercise and prevents strain, 
• Increases oxygen levels, 
• Facilitates the release of gas waste from your lungs,
• Lowers blood pressure, and lowers heart rate.

Contraindications

• Patient with heart-related conditions or those who have undergone heart surgery should take their time to practice diaphragmatic breathing. It is also advisable for them to perform under the supervision of a qualified therapist.

• Additionally, patients recovering from head or neck injuries, severe osteoporosis, collarbone fractures, spinal injuries, or rib cage damage should proceed with caution. Those with a history of tuberculosis (TB) or severe asthma should also be careful.

• Diaphragmatic breathing should be stopped immediately if the patient feels that the deep breathing is causing suffocation. Connecting with this type of breathing can be challenging initially, especially if one’s breathing is shallow.

• Connecting to this type of breathing can be challenging at first, particularly if the breathing is shallow. In these situations, diaphragmatic breathing should be promoted while lying on one’s back and then progressively moved to a chair and the floor.

• This type of breathing should not be required of pregnant women because it will put strain on their abdomen. They can do the same, pausing occasionally to rest and unwind. Diaphragmatic breathing should be done carefully and under supervision if dyspnea is diagnosed.

• People with dyspnea could not benefit from this practice because it lowers the number of breaths in a minute with practice. Therefore, the activity should be avoided or handled carefully.

Precautions

• Patients should never be permitted to force expiration. Breathing should be easy or moderately regulated. Bronchospasm or increased airway limitation result from forced expiration, which merely makes the airways more turbulent.

• Don’t let a patient take an extremely long expiration. With the subsequent inspiration, the patient gasps as a result. At that point, the patient’s breathing rhythm becomes inadequate and irregular.

• Don’t let the patient use their upper chest and auxiliary muscles to start inspiration.
• To prevent hyperventilation, only let the patient breathe deeply for a maximum of four inspirations and expirations at a time.

What is GI Patients’ Diaphragmatic Breathing?

Diaphragmatic breathing, sometimes referred to as belly breathing or deep breathing, is a basic method that GI patients are taught to help them cope with the stress that comes with GI disorders.

One useful technique for promoting relaxation in the body is to concentrate on one’s breathing. The stomach, not the chest, moves with each breath when diaphragmatic breathing is practiced. It expands during inhalation and contracts with exhalation. The mind is diverted and calmed by consciously focusing on each breath.

How Is It Beneficial?

Learning diaphragmatic breathing has several benefits:

• Reduces blood pressure and heart rate
• Reduces muscle tension and raises oxygen levels
• Warms the hands and feet and boosts motivation
• Increases focus and lower stress hormones
• Triggers the relaxation reaction in the body, which in turn counteracts the stress response.
• It Is simple to use and doesn’t involve any expenses or medication.

There are particular advantages to diaphragmatic breathing for people with GI symptoms:

• Reduced abdominal pain, urgency, bloating, and constipation might result from the diaphragm’s mild massaging action, which is felt by internal organs such as the stomach and intestines.

• The parasympathetic nervous system, also known as the body’s relaxation response or rest and digest state, is activated when you breathe diaphragmatically. In certain GI-related circumstances, diaphragmatic breathing can be beneficial:

• Urgency and diarrhea: Diaphragmatic breathing helps reduce panic attacks and soothe the digestive system.

• Constipation: To relax and massage the system, try using diaphragmatic breathing while sitting on the toilet and trying to make a bowel movement. A more thorough bowel movement could be the outcome.

How can I practice diaphragmatic breathing?

Diaphragmatic breathing can be practiced in two ways:

1. Supine lying position
2. Sitting Position

Diaphragmatic breathing method in supine lying

It could be simpler for you to follow the directions while lying down when you are initially learning the diaphragmatic breathing technique.

With your head supported and your knees bent, lie over your back on a level surface or on a bed. To support your legs, place a pillow beneath your knees.

Grasp your upper chest with one hand and your rib cage with the other.

Breathe in deeply through your nose until your hand rises and your stomach moves out.

As you exhale through pursed lips, tighten your abdominal muscles such that your hand descends as your stomach moves in Try to keep the hand on your upper chest as still as you can.

Diaphragmatic breathing method in Sitting Position:

You can try the diaphragmatic breathing technique while seated in a chair as you get more comfortable with it.

Take a comfortable seat with your head and neck relaxed, shoulders relaxed, and knees bent.

Grasp your upper chest with one hand and your rib cage with the other. This will allow you to feel how your diaphragm moves while you breathe.

Take a slow, deep breath through your nose, allowing your tummy to press against your palm.

Contract your abdominal muscles to bring your stomach back in as you release the breath through pursed lips. You need to keep the hand on your upper chest as still as you can.

Diaphragmatic Breathing for children

Diaphragmatic Breathing  Benefits for Children

Children might benefit from practicing the abdominal breathing method in several ways. Breathing through the abdomen can be helpful whether they are going through a stressful circumstance or just feeling overburdened and worried.

Calms the nervous system.
The parasympathetic nervous system can be activated in children by deep breathing and relaxation practices. When this occurs, the brain receives a signal informing anxiety that it is safe. The fight, flight, or freeze reaction is lowered as a result.

How to teach belly breathing to your children

When your child is struggling with stressful or overwhelming situations, try this breathing technique for children.

1. Assume a comfortable position, such as sitting upright or resting on your back.
2. Place one hand on your child’s chest and one on their abdomen to support normal breathing. Another option is to put a plush animal on their stomach. Ask your child what they observe after that. How do they feel? When they breathe, which hand moves more? Is the stuffed animal rising and falling?
3. Ask your child to hold their breath for four seconds, then ask them to slowly exhale all of the air out.
4. If they are having trouble doing so, a great trick is to have them do it through a straw or pursed lips. Until the air fills their chest and reaches their abdomen, have your child take four deep breaths.
5. Let your child breathe in this manner until you both feel at ease.
6.  A few minutes later, ask your child if they feel different than they did at the beginning. Inquire about the types of bodily sensations they experience and their emotional state.

Remember that your child can do this children’s breathing method anytime you’re feeling anxious. Include this belly breathing exercise in your child’s daily routine to help them learn and retain it.

Advantages of diaphragmatic breathing in various conditions:

Advantages of diaphragmatic breathing for those with COPD Patients:

• Reduced dyspnea: More efficient use of the diaphragm reduces the feeling of being out of breath, especially when engaging in activities that could cause it.

• Increased tidal volume: By enabling a greater volume of air to be inhaled with each breath, diaphragmatic breathing enhances oxygen intake.

• Reduced respiratory rate: A slower breathing rate results from more effective use of the diaphragm, which lessens the demand for quick, shallow breaths.

• Better ventilation: By distributing air more uniformly across the lungs, diaphragmatic breathing maximizes gas exchange.

• Increased exercise tolerance: Diaphragmatic breathing can help those who have trouble breathing by making it easier for them to engage in physical activity.

• Stress reduction and relaxation: Diaphragmatic breathing’s regulated breathing rhythm can help induce relaxation.

Advantages of Diaphragmatic Breathing for Anxiety Patients:

• Stress management: You can control your worry and stress by taking deep breaths.
• Relaxation: You can feel more relaxed by using diaphragmatic breathing.
• Better muscular function: During exercise, deep breathing can help stabilize your core muscles and avoid strain.

• Improved oxygen exchange: Diaphragmatic breathing can raise blood oxygen levels and enhance your body’s capacity to withstand physical activity.
• Lower blood pressure and heart rate: You can lower your blood pressure and heart rate by taking deep breaths.
• Decreased negative effects of cortisol: The stress hormone cortisol can have negative impacts on your body, but diaphragmatic breathing can help lessen those effects.

Advantages of diaphragmatic breathing for TB patients:

• Enhanced lung performance
• Exercises involving deep breathing can help patients increase their oxygenation and restore lung capacity.

• Breathing techniques can aid in lowering fatigue, which has a effect on performance, sleep, nutrition, and quality of life.
• Better Health
• By raising SpO₂ levels and lowering anxiety and dyspnea, breathing exercises can enhance general well-being and reduce stress levels.

Advantages of Diaphragmatic breathing for Asthma Patients:

• Better lung function: More air can be breathed and expelled when the diaphragm is engaged correctly, which improves oxygen intake and lung capacity.
• Decreased respiration rate

• To control rapid breathing during asthma attacks, diaphragmatic breathing promotes slower.
• Reduced anxiety: Deep breathing exercises, which are frequently linked to diaphragmatic breathing, can help people relax and feel less anxious, which can lessen asthma symptoms.
• Muscle strengthening: The diaphragm muscle becomes stronger with regular diaphragmatic breathing practice, increasing its ability to support breathing.
• Improved symptom management: Diaphragmatic breathing can help control asthma symptoms including chest tightness and wheeze by enhancing breathing mechanics.

Advantages of Diaphragmatic Breathing for Bronchiectasis Patients:

• Better lung ventilation: More air may enter the deeper lung regions by aggressively contracting the diaphragm, which helps in the removal of mucus accumulation in the dilated bronchi.
• Decreased shortness of breath, or dyspnea: By reducing the breathing rate, diaphragmatic breathing minimizes the feeling of dyspnea and permits deeper inhalations.
• Mucus mobilization: Deep breaths produced by diaphragmatic breathing can facilitate coughing by releasing and moving mucus in the airways.
• Increased relaxation: The parasympathetic nervous system can be activated by the controlled breathing pattern of diaphragmatic breathing, which promotes relaxation and lowers stress. This can further enhance breathing.
• Decreased load on accessory muscles: By depending more on the diaphragm, breathing exhaustion is avoided by reducing the effort on the neck and chest muscles.

FAQs

Reference

• Diaphragmatic breathing for GI patients | University of Michigan Health. (n.d.). https://www.uofmhealth.org/conditions-treatments/digestive-and-liver-health/diaphragmatic-breathing-gi-patients

• Professional, C. C. M. (2025, January 24). Diaphragmatic breathing. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing

• Belly breathing for kids. (2024, February 7). Mental Health Center Kids. https://mentalhealthcenterkids.com/blogs/articles/belly-breathing-for-kids