Slow Breathing for Anxiety: A Critical Perspective Towards Personalization

While breathing practices are increasingly popular to improve health and wellbeing, scientific research on the effectiveness of breathing interventions lacks consistency and conclusiveness, and the causal mechanisms of breathing in health and wellbeing remain unclear. This chapter aims to critically review the research gaps and challenges in understanding the mechanisms of slow breathing for anxiety, and health and wellbeing more broadly. More specifically, we elaborate on challenges in experimental respiratory research, including demand and expectation effects, and potential confounding by changes in respiratory parameters other than intended, increased attention to and awareness of breathing, distraction and cognitive engagement. Moreover, we discuss research gaps highlighting training effects, transferability of effects, comparisons between different breathing techniques, adherence, compliance and adverse side effects. Based on the discussed limitations, we propose a more personalized, individually tailored approach of breathing practices, based on individual traits, individual breathing patterns, and individual preferences in the execution and implementation of breathing exercises in daily life.