# Diaphragmatic breathing: how to do it, step by step Source: https://breathingexercises.uk/exercises/diaphragmatic-breathing/ Author: Nell Avery ยท Updated 2026-11-04 **Short answer:** Diaphragmatic breathing means breathing slowly and gently into your tummy rather than your upper chest, so your diaphragm does most of the work. Physiotherapists call it breathing control. Breathe in through your nose for about 4 seconds, out for about 6, for 5 to 10 minutes a day. It is the basis of most breathing retraining. **Evidence grade:** Moderate evidence. Trials point the same way but are small or few, or large long-term studies agree but cannot prove cause and effect. ## What is diaphragmatic breathing? Your diaphragm is a dome-shaped sheet of muscle under your lungs. When it tightens it flattens and pulls air into your lungs, pushing your tummy out a little. When you are calm, it does most of the work of breathing. When you are stressed, breathless or in pain, many people switch to faster, shallower breathing from the upper chest, using the muscles in the neck and shoulders. That uses more effort and can keep the stress response going. Diaphragmatic breathing retrains the calm pattern on purpose: low, slow and quiet. Physiotherapists call it **breathing control**, and it is the foundation of breathing retraining for asthma and [breathing pattern disorder](/conditions/breathing-pattern-disorder/). [How your lungs and diaphragm work](/how-breathing-works/lungs-and-diaphragm/) explains the mechanics. ## When should you use it? - Daily, for 5 to 10 minutes, to make relaxed breathing your habit. - When you feel stressed or anxious, to slow things down. - In bed, to help you wind down. - To recover after exertion, once you are resting (with [pursed-lip breathing](/exercises/pursed-lip-breathing/) if you are breathless). ## What the research shows Diaphragmatic breathing has rarely been tested on its own, but it is the main ingredient of the breathing retraining programmes that have been. A Cochrane review of 22 trials with 2,880 adults with asthma found breathing exercises improved quality of life, by about 0.4 points on the asthma quality of life scale at three months, with moderate-certainty evidence. The largest trial, run in 34 UK GP surgeries with 655 people, found that breathing retraining taught by a DVD and booklet or by a physiotherapist improved quality of life over a year, though it did not change lung function. In healthy adults, a small randomised trial of 40 people found that 8 weeks of diaphragmatic breathing training lowered negative mood and the stress hormone cortisol and improved sustained attention compared with no training. There is one important exception. In a small study of people with severe COPD, deliberate diaphragmatic breathing made breathing less efficient and tended to increase breathlessness. If you have severe COPD, use the techniques your physiotherapist recommends, such as [pursed-lip breathing](/exercises/pursed-lip-breathing/). ## Common mistakes - **Breathing too deeply.** It is a low breath, not a big one. Huge breaths can make you light-headed. - **Pushing your tummy out.** Let the breath move it. Forcing your stomach out is not the same thing. - **Lifting your shoulders.** Check the hand on your chest. If it rises, slow down and soften the breath. - **Practising only when stressed.** It works best as a habit you have already built. ## Make it easier or harder - **Easier:** lie on your back with your knees bent and a light book on your tummy, and watch it rise and fall. Use shorter counts, such as 3 in and 4 out. - **Harder:** practise sitting, then standing, then while walking. Lengthen the out-breath towards 8 seconds, keeping it comfortable. ## Frequently asked questions ### Is diaphragmatic breathing the same as belly breathing? Yes. Belly breathing, abdominal breathing, diaphragmatic breathing and breathing control all describe the same thing: slow, relaxed breathing where your tummy rises as you breathe in and your upper chest and shoulders stay still. ### How long does it take to learn? Most people get the feel of it in a few sessions, but it takes a few weeks of daily practice before it becomes your natural way of breathing when you are calm. Practise lying down first, where it is easiest. ### Should I breathe in through my nose or mouth? In through your nose if you can, because the nose warms, filters and slows the air. Breathe out through your nose or through loosely pursed lips, whichever feels easier. ### Can diaphragmatic breathing help anxiety? It can ease the physical feelings of stress, and slow breathing like this lowered stress in trials. It is a useful tool alongside other treatment, but it is not a treatment for an anxiety disorder on its own. ## References 1. [Ma X et al. The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Frontiers in Psychology, 2017.](https://pubmed.ncbi.nlm.nih.gov/28626434/) 2. [Santino TA et al. Breathing exercises for adults with asthma. Cochrane Database of Systematic Reviews, 2020.](https://pubmed.ncbi.nlm.nih.gov/32212422/) 3. [Bruton A et al. Physiotherapy breathing retraining for asthma: a randomised controlled trial. Lancet Respiratory Medicine, 2018.](https://pubmed.ncbi.nlm.nih.gov/29248433/) 4. [Gosselink RA et al. Diaphragmatic breathing reduces efficiency of breathing in patients with chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 1995.](https://pubmed.ncbi.nlm.nih.gov/7697243/) 5. [Hamasaki H. Effects of diaphragmatic breathing on health: a narrative review. Medicines, 2020.](https://pubmed.ncbi.nlm.nih.gov/33076360/) 6. [NHS. Breathing exercises for stress.](https://www.nhs.uk/mental-health/self-help/guides-tools-and-activities/breathing-exercises-for-stress/)