Breathing to fall asleep: what helps and what's hype

Start an hour before bed

Breathing works best as part of an evening that is already slowing down. The NHS suggests relaxing for at least an hour before bed and keeping screens away for about that hour. Go to bed only when you feel sleepy, keep the bedroom dark and quiet, and wake up at the same time every day. Breathing exercises are on the NHS list of relaxing things to try before sleep.

If you are still awake after about 20 minutes, do not lie there fighting it. Get up, do something calm, and go back to bed when you feel sleepy.

Slow breathing in bed

The simplest option is to breathe slowly and evenly, with the breath out a little longer than the breath in. The app’s slow 4-6 rhythm, in for four and out for six, is gentle and has no breath holds.

What does the research say? A little, and not all of it agrees:

• In a small study of 14 people with insomnia, 20 minutes of breathing at about six breaths a minute before bed was followed by falling asleep faster and waking less during the night.
• In 64 young adults who already slept well, 15 minutes of slow breathing every evening for a month improved their sleep scores slightly compared with 15 minutes on social media.
• In 20 young adults measured at home, 30 minutes of slow breathing about an hour before bed did not change how quickly they fell asleep or how well they slept.

So slow breathing may help some people settle, and it is unlikely to hurt. It is not a proven sleep treatment.

4-7-8 breathing

4-7-8 was popularised by the American doctor Andrew Weil and has roots in yoga breathing. Rest the tip of your tongue behind your upper front teeth, breathe out fully through your mouth with a whoosh, then:

1. Breathe in quietly through your nose for four counts.
2. Hold your breath for seven counts.
3. Breathe out through your mouth for eight counts, with a whoosh.
4. Repeat for four rounds.

You may feel lightheaded or short of breath while you are learning it. If so, shorten the hold or switch to slow 4-6.

There is very little research on 4-7-8 and sleep. In a study of 43 young adults, one session of 4-7-8 lowered heart rate and blood pressure right afterwards, but the study was not randomised and did not measure sleep. No randomised trial has yet tested whether it helps people with insomnia fall asleep faster. If it relaxes you, use it; just do not expect miracles.

A body scan

If counting keeps you awake, try moving your attention instead. In a body scan you move slowly from your feet up to your head, noticing each part of the body. Harvard Health says it takes 10 to 15 minutes and works especially well in bed before sleep. See the body scan guide for how to do it.

When to see a doctor

Insomnia that lasts less than three months is called short-term; three months or longer is long-term. See a GP if better sleep habits have not helped, if you have had trouble sleeping for months, or if it makes daily life hard to cope with.

The first treatment doctors recommend for long-term insomnia is cognitive behavioural therapy for insomnia, CBT-I. It is a short course of talking therapy, sometimes online, and it often includes relaxation and breathing as one part. Sleeping pills are rarely prescribed, and then usually only for a few days or weeks.