Sleep
Box breathing for sleep: how to do it in bed, and what it really does
In for four, hold for four, out for four, hold for four. It’s simple enough to do in the dark, and it gives a busy mind a shape to follow. Here’s how, and an honest look at what it does.
By Kim Palmer, Founder of Clementine
· 3 min read
In short
- Box breathing means four equal counts: breathe in for 4, hold for 4, breathe out for 4, hold for 4. Three or four rounds is plenty.
- In a Stanford study, five minutes a day of breathing exercises, box breathing included, left people calmer and in a better mood. When the researchers measured sleep, it didn’t change.
- If the holds make you tense or dizzy, shorten the counts or drop the holds. Breathing that puts the weight on a long, slow breath out may suit bedtime better.
Box breathing gets its name from its shape: four sides, all the same length. You breathe in, hold, breathe out and hold, each for a count of four. It’s also called square breathing or 4-4-4-4 breathing (Cleveland Clinic).
It won’t send you to sleep on command. What it can do is give your mind something steady to count when it won’t stop racing, and slow everything down a notch.
Of all the breathing tricks, it’s the one I reach for most, because it’s so simple to remember in the dark.
Where it comes from
Box breathing is often linked to the military. The Cleveland Clinic describes it as a technique used by the US Navy SEALs, and the Stanford researchers below note that this “tactical” breathing has been used by members of the military to manage stress. It also has roots in yoga, where equal breathing is called sama vritti.
How to do it in bed
- Lie on your back or your side. You can do this lying down; you don’t need to sit up.
- Breathe out slowly, emptying your lungs.
- Breathe in gently through your nose for a count of 4.
- Hold for a count of 4.
- Breathe out for a count of 4.
- Hold again for a count of 4. That’s one round.
- Do three or four rounds, then let your breathing go back to normal.
Stay comfortable and don’t strain. If the holds feel hard, count to 3, or even 2, instead. If you feel breathless or dizzy, stop and breathe normally. If you have a heart condition or another serious health condition, or you’re pregnant, check with your GP before trying breathing exercises with holds.
What the research says (honestly)
The best study we found is from Stanford, published in 2023 in Cell Reports Medicine. 108 people, most of them students, practised for five minutes a day for about a month. One group did box breathing, others did different breathing exercises, and one group did mindfulness meditation.
Every group ended up less anxious and in a better mood. But box breathing wasn’t the standout. The winner was “cyclic sighing”, a pattern that puts the emphasis on a long, slow breath out.
The researchers also tracked people’s sleep with wearable trackers, and found no change in how long or how well anyone slept, in any group. So box breathing is a good way to calm down. There’s no evidence yet that it makes you sleep better, and we’d be wary of anything online that promises it does.
Box breathing or 4-7-8?
They’re cousins. Box breathing keeps every count the same and has two holds. 4-7-8 breathing has one long hold and a breath out that’s twice as long as the breath in.
Box breathing is my favourite. It’s just so easy: every count is the same, so there’s nothing to remember, and I find the longer breaths in 4-7-8 a bit harder. If that’s you too, start here.
If holds make you feel wound up rather than calm, try something without them. The NHS breathing exercise for stress is simply in through your nose for 5 and out through your mouth for 5, for at least five minutes. Or trace your hand with 5 finger breathing, which gives your fingers something to do as well.
When counting stops working
Some nights, keeping count is one more job your tired brain doesn’t want. That’s when it helps to hand over: a calm voice in your ears does the counting for you, and all you have to do is listen. If you keep waking in the night, our article on waking up at 3am explains why it happens.
Questions
How do you do box breathing?
Breathe in through your nose for a count of 4, hold for 4, breathe out for 4, then hold for 4. That’s one round. Three or four rounds is a good start.
Does box breathing help you sleep?
It can help you calm down before bed, but there’s no good evidence that it improves sleep. In a 2023 Stanford study, breathing exercises including box breathing lifted people’s mood, but their sleep didn’t change.
Can you do box breathing lying down?
Yes. You can do it lying on your back or your side in bed.
Is box breathing better than 4-7-8 for sleep?
Neither has good evidence for sleep itself. Box breathing keeps every count equal; 4-7-8 has a longer breath out. If holding your breath feels uncomfortable, try the NHS version instead: in for 5, out for 5, no holds.
Why does box breathing make me dizzy?
You’re breathing in an unusual pattern, and the holds can feel strange at first. Shorten the counts, and if you feel breathless or dizzy, stop and breathe normally.