Cultivate Your Breathing Practice [End-of-Year Breathing Challenge: Part 1]
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A research study at the University of Southern California involved 108 adults of varying ages, investigating the effects of different relaxation practices.
Half of the participants engaged in a daily routine of visualizing a calming place, closing their eyes, and listening to relaxing sounds. The other group practiced slow-paced breathing, following a computer screen’s prompts to inhale for five seconds and exhale for another five.
After four weeks of practicing their respective activities twice a day, the researchers measured biomarkers linked to Alzheimer’s disease, including amyloid beta 40 and 42.
The results were striking: the group practicing breathing exercises showed significantly higher heart rate variability (HRV) and lower amyloid beta levels, while the group practicing visualization had decreased HRV and higher amyloid beta levels.
“This is an intriguing finding because, in healthy adults, lower plasma levels of amyloid beta are associated with lower risk of getting Alzheimer’s disease later,” said Mara Mather, one of the researchers in this BBC article. “Slow-paced breathing might have benefits not only for emotional well-being—but also for improving biomarkers associated with Alzheimer’s disease.”
This adds to the growing body of evidence supporting the health benefits of slow-paced breathing.
I’m particularly drawn to slow-paced breathing for many reasons: it’s free, carries little to no risk (studies have found no adverse effects), offers immediate results, and can be practiced anywhere—except, of course, while driving.
When I came across this study, I immediately thought that a breathing challenge would be perfect this time of year. The holidays can be stressful, but before we dive into the details of the challenge, let’s take a moment to explore the health benefits of slow breathing for midlife women.
Breathing slowly boosts heart rate variability
The study above aimed to manipulate heart rate variability (HRV) by selecting two distinct activities: one designed to increase HRV and the other to decrease it.
According to the researchers, higher HRV helps reduce chronic sympathetic activity, which may improve the body’s ability to clear waste products, including amyloid beta and tau.
HRV is a measure of autonomic nervous system (ANS) functioning, reflecting the slight variations between heartbeats.
When HRV is high, the ANS is better able to adapt to stress. When HRV is low, it indicates that the body is not recovering as efficiently from stress.
HRV is “regarded as a qualitative index of “sympathovagal balance”, reflecting the weight of parasympathetic versus sympathetic autonomic control,” as a 2017 review in the journal Breathe puts it.
In short, HRV serves as a key indicator of overall health, and low HRV is a significant risk factor for mortality across all age groups.
HRV decreases with Aging Pause
As I point out in my Meet Your Nervous System post, women experience an increase in sympathetic activity (fight or flight) after 30. Yet most women don’t feel the effects until their 40s when hormonal changes also complicate the picture.
This is not only a contributing factor to women’s anxiety at midlife but also a hidden source of chronic, low-grade inflammation. According to researchers in a 2023 review in the Journal of Physiology, this issue may be especially important for the heart and brain health of women going through menopause:
Notably, the autonomic nervous system, the main heart–brain axis physiological orchestrator, has been suggested to play a role in the incidence of adverse cardiovascular events in middle-aged women because of decreases in oestrogen-related signalling during transition into menopause.
Research clearly shows that slow breathing can increase vagal tone, boost heart rate variability (HRV), and promote parasympathetic (rest and digest) activity.
Since better autonomic functioning is associated with a healthier heart, brain, and digestive system, slow breathing offers an easy and effective way to support the nervous system during aging.
Studies have demonstrated that slow breathing improves oxygenation, promotes relaxation, enhances focus and decision-making, reduces symptoms of anxiety and depression, lowers blood pressure and heartrate, improves sleep quality, and increases cardiac vagal activity (CVA). It has also been shown to help alleviate gastrointestinal issues such as GERD and IBS.
And as a health practice, it certainly isn’t new. As far back as two thousand years ago, the Yoga Sutra of Patanjali suggested that “expiration is linked to mood stability.”
The link to vasomotor symptoms
Did you know that scientists still don’t fully understand why hot flashes occur?
One theory is that they are triggered by elevated sympathetic tone, which narrows the thermoregulatory zone. After all, the vasomotor nervous system is part of the autonomic nervous system (ANS).
Interestingly, women who experience more severe hot flashes tend to have lower HRV, and during a hot flash, HRV typically plummets. A recent study adds to the evidence of this relationship between menopause symptoms and ANS function.
“The study suggest that postmenopausal symptoms are associated with altered autonomic control of heart rate. In particular, hot flashes and sleep problems in moderate or severe degree are related to increase of sympathetic nerve activity.” - Sahu et al, European Journal of Cardiovascular Medicine, 2024
And get this: studies have shown that slow-paced breathing can help reduce hot flashes—though placebo groups also experience reductions.
For example, in one trial with three groups, two groups practiced paced breathing at six breaths per minute for 15 minutes. One group did this once a day, while the other did it twice a day. A third group practiced regular breathing at 14 breaths per minute for 10 minutes.
Out of 92 participants, 74% completed the study, and most found the intervention easy to follow. The group that practiced paced breathing twice a day saw a 52% reduction in hot flashes, while the once-a-day breathing group experienced a 42% reduction. The regular breathing group saw a 46% reduction.
Another study also showed that slow-paced breathing reduced hot flashes, but surprisingly, listening to music was even more effective.
This raises an interesting question: If HRV is a key biomarker of ANS functioning, shouldn’t it be measured in these studies? After all, music also increases HRV, so perhaps that’s why they both had an effect.
The most recent study I found (2019) included a non-HRV-related control and was conducted on women who underwent surgical menopause. One group practiced slow-paced breathing (6–8 breaths per minute) for 15 minutes twice a day, and at the start of each hot flash episode, for three weeks. The other group was instructed to practice "hot flash hygiene," which included wearing cotton clothing and drinking water during hot flashes.
By the end of the third week, the slow-breathing group saw a 50% reduction in the frequency of hot flashes and a 66.6% reduction in severity. The control group, on the other hand, experienced a 19.6% reduction in frequency and a 19.4% reduction in severity.
I’d love to see larger, longer trials that include HRV measurements.
Breaths per minute
One aspect of aging that we might not even be aware of is an increase in respiratory rate. Most people typically breathe between 12 and 20 times per minute.
The only study I could find on aging-related respiratory rates was one with 634 people aged 59 and older. At 60 years old, the average breathing rate was 14.8 breaths per minute. By age 70, this had increased to 15.5, 80 it was 16.37 and by 90, it was 17.1.
While these increases may seem small, the reality is that if we don't pay attention to our breathing, our breathing rate will likely continue to climb and become less efficient as we age.
To reap the benefits of slow breathing, there are three key aspects of the practice you need to know about. Today, we’ll cover the first one - breaths per minute- and we’ll discuss the next two in the coming weeks.
Faster breathing = more sympathetic nervous system activity
Research shows that for a breathing practice ,the ideal breathing rate to stimulate the vagus nerve and increase heart rate variability (HRV) is between 5 and 6 breaths per minute.
While longer exhales can help boost parasympathetic activity, one study found that a 5-second inhale followed by a 5-second exhale was the most effective breathing pattern for improving HRV in college students.
Taking time every day to purposely slow your breathing can be a game changer for midlife women. So, let’s get started with the very first step of cultivating a breathing practice.