# Alternate nostril breathing (nadi shodhana): how to do it Source: https://breathingexercises.uk/exercises/alternate-nostril-breathing/ Author: Nell Avery ยท Updated 2026-11-04 **Short answer:** Alternate nostril breathing is a yoga technique where you close one nostril with your thumb, breathe in through the other, then switch sides to breathe out. One round goes in left, out right, in right, out left. It slows your breathing and many people find it calming. Small trials suggest it may lower blood pressure, but they vary widely. **Evidence grade:** Weak evidence. Small or short studies, surveys, or results that are mixed. ## What is alternate nostril breathing? Alternate nostril breathing comes from yoga, where it is called nadi shodhana, usually translated as channel cleaning. You use your right hand to close one nostril at a time: the thumb closes the right nostril and the ring finger closes the left. Your index and middle fingers can fold into your palm or rest lightly between your eyebrows. Breathing through one nostril slows the airflow, so each breath naturally becomes longer and quieter. The guide above sets a gentle pace of four seconds each way, which works out at about seven and a half breaths a minute, close to the slow pace used in most breathing trials. The switching gives your mind something to follow, which many people find helps them settle. ## When should you use it? - **As a wind-down**, for five minutes at a quiet moment or before bed. - **Before meditation or yoga**, as it is traditionally used. - **Not on the go.** You need a free hand and a clear nose, so for a quick calm in public, [cyclic sighing](/exercises/cyclic-sighing/) or [box breathing](/exercises/box-breathing/) are easier. ## What the research shows A 2024 review found 14 studies of alternate nostril breathing and pooled six randomised trials, with 525 people, in a meta-analysis. Compared with no treatment, it lowered systolic blood pressure by about 7 mmHg and diastolic by about 5 mmHg. But the results varied a great deal between trials, and most were not blinded, which is hard to do with a breathing exercise. Some trials combined it with other yoga practices, so its own effect is hard to separate. The effect is similar in size to that of slow breathing in general, which lowered systolic pressure by about 5.6 mmHg across 17 studies. Alternate nostril breathing may simply work because it is a form of slow breathing. We found no good evidence for the popular claim that it balances the left and right sides of the brain. Overall we grade it as weak: promising, pleasant and safe, but not well enough tested to rely on. See [breathing exercises and blood pressure](/benefits/blood-pressure/). ## Common mistakes - **Pressing hard.** A light touch is enough to close a nostril. Pressing hard is uncomfortable and distracting. - **Breathing loudly.** The breath should be quiet and smooth. If you can hear it rushing, slow down. - **Letting your arm tire.** Rest your right elbow on your left hand, a cushion or a table so your shoulder can relax. - **Adding long breath-holds too soon.** Some yoga versions hold the breath between sides. Leave those out at first, and skip them if you are pregnant or have a heart condition. ## Make it easier or harder - **Easier:** shorten each step to a count of 3. If raising your hand is awkward, rest it on your knee between rounds. - **Harder:** lengthen each step to a count of 5 or 6, or make the out-breath longer than the in-breath, for example in for 4 and out for 6. ## Frequently asked questions ### Does alternate nostril breathing lower blood pressure? Possibly. A 2024 review pooled six trials with 525 people and found systolic pressure fell by about 7 mmHg. But results varied a lot between trials and most were not blinded, so the true effect is uncertain. Don't use it instead of blood pressure medicine. ### Which nostril do you start with? Most teachers start by breathing in through the left nostril, with the right one closed by your thumb. There is no good evidence that the order matters, so pick one and keep to it. ### Can I do alternate nostril breathing with a blocked nose? It's best to skip it. Forcing air through a blocked nostril is uncomfortable and tends to make you breathe faster. Try resonance breathing instead until your nose clears. ## References 1. [Nam TG et al. Effectiveness of alternative nostril breathing on blood pressure: a systematic review and meta-analysis of randomized controlled trials. Complementary Medicine Research, 2024.](https://pubmed.ncbi.nlm.nih.gov/39008954/) 2. [Chaddha A et al. Device and non-device-guided slow breathing to reduce blood pressure: a systematic review and meta-analysis. Complementary Therapies in Medicine, 2019.](https://pubmed.ncbi.nlm.nih.gov/31331557/) 3. [Zaccaro A et al. How breath-control can change your life: a systematic review on psycho-physiological correlates of slow breathing. Frontiers in Human Neuroscience, 2018.](https://pubmed.ncbi.nlm.nih.gov/30245619/)