Key takeaways
- Box breathing has four equal sides: breathe in for four counts, hold for four, breathe out for four and hold for four.
- Cleveland Clinic notes it is also known as sama vritti pranayama and is used by the US Navy SEALs.
- If each count is a second, one cycle takes 16 seconds, which is 3.75 breaths a minute, well below a typical resting rate of 12 to 15.
- A 2023 Stanford trial reported that daily five-minute breathwork, especially exhale-focused cyclic sighing, improved mood more than mindfulness meditation; box breathing was one of the techniques tested.
- Stay gentle and stop if you feel dizzy; shorter counts are fine while you learn.
Box breathing means breathing in for a count of four, holding for four, breathing out for four and holding for four, then repeating. Cleveland Clinic describes it as a form of yogic deep breathing, also known as sama vritti pranayama, that is used by the US Navy SEALs. This guide explains the steps, works out the timing and sets out what research has, and has not, found.
The four sides of the box
The name comes from the shape. A box has four sides, and the exercise has four equal counts:
| Side | What you do | Count |
|---|---|---|
| 1 | Breathe in through your nose | 4 |
| 2 | Hold the breath | 4 |
| 3 | Breathe out | 4 |
| 4 | Hold again, with the lungs empty | 4 |
Cleveland Clinic's steps begin by breathing out slowly, releasing all the air from your lungs, before the first count. Then repeat the cycle. Its specialist advises noticing how the air fills your lungs and stomach on the inhale, staying at your comfort level and breathing gently, without straining, and not going too slowly or too quickly at first.
Box breathing in seconds and breaths per minute
If each count lasts about a second, one cycle takes 16 seconds. That is 60 ÷ 16 = 3.75 breaths a minute. Wikipedia gives the typical resting rate for a healthy adult as 12 to 15 breaths a minute, so box breathing slows you to around a quarter to a third of your usual pace.
Over five minutes, 300 seconds, you complete 300 ÷ 16 ≈ 19 cycles. The NHS suggests at least five minutes for its own breathing exercise for stress, and five minutes a day is the session length used in the study described below.
That slow pace is the hardest part for beginners. Cleveland Clinic notes that you may find it hard at first to hold your breath steady for all four counts, and that it gets easier with practice. Shorter counts are one way to start. NHS inform's controlled breathing exercise uses the same four steps with three-second counts: in through the nose for 3 seconds, hold for 3, out through the mouth for 3 and hold for 3. That cycle takes 12 seconds, or 60 ÷ 12 = 5 breaths a minute.
Why the counting matters
The counting is part of the exercise, not just a timer. Cleveland Clinic's integrative medicine specialist describes silently counting while you breathe as "a kind of mantra meditation" that calms the nervous system and brings you into the present moment, and calls the technique's simplicity its greatest strength: it is just breathing and counting, with nothing to overthink. She also suggests practising when you are calm, not only when stressed, so the skill is familiar when you need it. Over time, she says, holding each count becomes easier, and you can slow the breath down further.
What the 2023 Stanford breathwork trial found
One trial that included box breathing was published in Cell Reports Medicine in 2023 by researchers at Stanford. It was a remote, randomised controlled study comparing three daily five-minute breathing exercises with the same amount of mindfulness meditation over a month:
- Cyclic sighing, which emphasises long exhalations;
- Box breathing, with equal inhalations, holds and exhalations;
- Cyclic hyperventilation with retention, with longer inhalations and shorter exhalations.
The researchers reported that breathwork, especially the exhale-focused cyclic sighing, produced greater improvement in mood and a greater reduction in breathing rate than mindfulness meditation. The abstract does not single out box breathing, so the trial shows that box breathing was one of the techniques tested, not that it was the most effective, and one month of a five-minute exercise is a short trial. Wider reviews of breathing practices are summarised in slow breathing and relaxation.
Cleveland Clinic presents the main benefit simply as relaxation, especially in times of stress, and suggests practising once or twice a day.
When box breathing may not suit you
The holds are what make box breathing different from plain slow breathing, and Cleveland Clinic's advice is to stay at your comfort level and not strain. Stop and breathe normally if you feel dizzy, light-headed or uncomfortable. If holding your breath is hard, shorten the counts. If you have a medical condition, or if anxiety or panic is persistent, speak to a healthcare professional rather than relying on a breathing exercise.
Box breathing with a guide
If keeping count is the hard part, a visual guide can keep time for you. Kawaii Cute Breathe Relax Care paces breathing with an animated guide and timer cues for inhale, hold and exhale, and its store screenshots show gentle breath holds and equal breathing among its routines; the app guide explains how to choose one. It is one of our health and nutrition apps. For a pattern with a longer exhale, see 4-7-8 breathing.
Good to know
Frequently asked questions
How do you do box breathing?
Does box breathing work?
How many breaths per minute is box breathing?
Why is it called box breathing?
Sources
- Box Breathing Benefits and Techniques (opens in a new tab)Cleveland Clinic — accessed
- Brief structured respiration practices enhance mood and reduce physiological arousal (Balban et al., Cell Reports Medicine, 2023) (opens in a new tab)PubMed — accessed
- Respiratory rate (opens in a new tab)Wikipedia — accessed
- Controlled breathing exercise (opens in a new tab)NHS inform — accessed
- Breathing exercises for stress (opens in a new tab)NHS — accessed
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