Parasympathetic breathing is a simple technique that activates the body's relaxation response, helping support healing after an illness, injury or surgery. By engaging the parasympathetic nervous system, deep breathing can reduce stress, improve participation in therapy and promote physical and emotional recovery.
In stressful situations, your heart rate may increase, you might sweat excessively and your blood pressure can rise. These are signs your body is in a fight-or-flight response. Often, those symptoms begin to subside when you calm down and focus on your breathing.
That’s where the parasympathetic nervous system plays a vital role. As part of the autonomic nervous system, it helps the body relax and recover during stressful situations. Most importantly, it balances the sympathetic nervous system, which triggers the fight-or-flight response.
Deep breathing and other breathing exercises can help reduce stress and anxiety, especially for individuals with chronic conditions. These breathing techniques are simple yet powerful tools to support emotional and physical recovery.
“I use parasympathetic breathing techniques in my therapy sessions every day,” said James Pope, a physical therapist at Rehabilitation Hospital of Henry. “Many patients arrive after surgery in significant pain. For those recovering from an acute event such as a stroke or heart attack who have been independent their whole lives, the prospect of not walking again can bring a great deal of fear and anxiety.”
What is parasympathetic breathing?
Parasympathetic breathing is a deep breathing technique used to activate the parasympathetic nervous system. This practice can positively affect your health in several areas, including:
- Heart rate
- Blood pressure
- Digestion
- Bowel and bladder
“The sympathetic and parasympathetic nervous systems works in conjunction. The sympathetic nervous system triggers the body’s stress response, often known as the fight-or-flight reaction,” Pope said. “Prolonged exposure to high stress and elevated cortisol levels has been linked to an increased risk of heart disease, hypertension and serious health events such as heart attacks and strokes.”
How the parasympathetic nervous system supports healing
The parasympathetic nervous system acts as the body’s built-in stress relief system, gently slowing the heart rate. It lowers blood pressure and guides the body back to calm. This nervous system is often referred to as the “rest and digest” system because it supports relaxation, recovery and healthy body functions.
When activated through breathing exercises, the body can shift its focus away from stress and toward healing. This may help improve relaxation, sleep quality and overall well-being during rehabilitation.
Signs of parasympathetic nervous system dysfunction
Parasympathetic dysfunction occurs when the body remains in a fight-or-flight response for an extended period. Common stressors including environmental factors, lifestyle habits, diet and chronic health conditions — can contribute to parasympathetic dysfunction.
Conditions associated with parasympathetic dysfunction include:
- Type 2 diabetes
- Parkinson’s disease
- Alzheimer’s disease
- Gastrointestinal problems
- Swallowing difficulties
“Symptoms of parasympathetic nervous system dysfunction can show up in several ways. Digestive issues like constipation or slowed gut motility may be early indicators,” Pope said. “In addition, increased anxiety, sleep disturbances or irregular heart rhythms can also signal an imbalance in the parasympathetic nervous system.”
Parasympathetic breathing techniques for therapy and stress relief
Pope advises clinicians, patients and caregivers to use parasympathetic breathing techniques to support recovery and improve independence.
Box breathing (4-4-4-4 breathing)
Visualize your breathing forming a box. Inhale for four seconds, hold for four seconds, exhale for four seconds, hold again for four seconds, then repeat.
4-7-8 breathing
Take a deep breath in for four seconds, hold for seven seconds and slowly exhale for eight seconds.
Diaphragmatic breathing
Place a hand over your belly. Inhale slowly through your nose, hold for a few seconds, then exhale through pursed lips. Imagine your lungs inflating like a balloon as you breathe in and deflating as you breathe out.
Concentrate on the flow of air and your breathing pattern. Focused breathing exercises can reduce anxiety, improve participation in therapy and promote better sleep.
“I start by easing a patient’s anxiety through guided breathing and sound awareness. I ask them to close their eyes and focus on five distinct sounds while maintaining steady breaths,” Pope said. “This simple practice enhances focus and engagement and eases muscle tension and pain. Many of my patients have shared that it helps them sleep more soundly.”
Benefits of parasympathetic breathing during inpatient rehabilitation
Deep breathing may be especially beneficial for individuals recovering from a serious illness or injury. These breathing techniques can help increase mood, enhance exercise tolerance and overall mental clarity during recovery.
“Parasympathetic breathing can be a powerful tool in inpatient rehabilitation, especially for patients coping with fear or pain management,” Pope said. “Take someone healing from a hip fracture; they may be hesitant to move or have a fear of falling. By guiding them through calming breathwork, you can help quiet their fears, ease pain and support their confidence to engage fully in therapy sessions.”
Pope encourages clinicians to integrate these breathing techniques into therapy sessions to support patients’ recovery.
“Clinicians could enhance patient outcomes by incorporating parasympathetic breathing in therapy sessions. Starting or ending sessions with these techniques is beneficial,” he said. “Rehabilitation professionals can pair breathing with stretching, relaxation and therapeutic exercises. Teach patients to align their breathing with movement. For example, patients exhaling during exertion can generate more power and promote recovery.”
