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Air enters the lungs as the diaphragm strongly contracts, but unlike traditional relaxed breathing ( eupnea ) the intercostal muscles of the chest do minimal work in this process. The belly also expands during this type of breathing to make room for the contraction of the diaphragm. [ 3 ] Physiology [ edit ] During diaphragmatic breathing, contraction of the diaphragm increases thoracic volume and lowers intrathoracic pressure, facilitating venous return to the heart and lung expansion. Baroreceptors in the aortic arch and carotid sinus respond to the resulting changes in blood pressure, modulating activity of the vagus nerve and influencing heart rate variability (HRV). [ 4 ] Slow diaphragmatic breathing, typically defined as fewer than 10 breaths per minute, has been associated with increased parasympathetic activity via enhanced respiratory sinus arrhythmia (RSA). [ 5 ] Clinical applications [ edit ] Diaphragmatic breathing is used as an adjunct intervention in several clinical contexts. A 2017 randomized controlled trial found that slow diaphragmatic breathing (6 breaths/min) significantly reduced cortisol levels and improved sustained attention in healthy adults. [ 6 ] It is commonly recommended for patients with chronic obstructive pulmonary disease (COPD) to reduce the work of breathing, though evidence for its effect on exercise tolerance in COPD is mixed. [ 7 ] Diaphragmatic breathing exercises are also incorporated into cognitive behavioral therapy protocols for anxiety disorders and panic disorder . [ 8 ] See also [ edit ] Breath Buteyko method Circular breathing Kussmaul breathing Pranayama – a traditional Yogic practice of slowing and extending the breaths, used during meditation Shallow breathing – a type of breathing that is mutually exclusive to diaphragmatic breathing and is associated with multiple anxiety disorders Wim Hof method Complete breathing References [ edit ] ^ "Learning diaphragmatic breathing" . Harvard Health . 2016-03-10 . Retrieved 2023-02-23 . ^ Saladin. Anatomy & Physiology: The Unity of Form and Function (7 ed.). p. 337. ^ "39.10: Breathing - Types of Breathing" . Biology LibreTexts . 2018-07-17 . Retrieved 2023-02-23 . ^ Zaccaro 2018 . sfn error: no target: CITEREFZaccaro2018 ( help ) ^ Russo 2017 . sfn error: no target: CITEREFRusso2017 ( help ) ^ Ma 2017 . ^ Cahalin 2002 . sfn error: no target: CITEREFCahalin2002 ( help ) ^ Clark 1986 . sfn error: no target: CITEREFClark1986 ( help ) Zaccaro, Andrea; Piarulli, Andrea; Laurino, Marco (2018). "How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing" . Frontiers in Human Neuroscience . 12 353. doi : 10.3389/fnhum.2018.00353 . PMC   6137615 . PMID   30245619 . Russo, Marc A.; Santarelli, Danielle M.; O'Rourke, Dean (2017). "The physiological effects of slow breathing in the healthy human" . Breathe . 13 (4): 298– 309. doi : 10.1183/20734735.009817 . PMC   5709795 . PMID   29209423 . Ma, Xiao (2017). "The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults" . Frontiers in Psychology . 8 874: 1. doi : 10.3389/fpsyg.2017.00874 . PMC   5455070 . 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