Holds and breath training

Inspiratory muscle training: 30 hard breaths a day

By GyroscopeUpdated November 15, 202612 sources

Family

Holds and breath training

Breaths

30 breaths in about 5 minutes

Carbon dioxide

Rises

How well tested

Moderate

Risk

Low

Inspiratory muscle training means breathing in hard through a small handheld trainer that pushes back against you. Done as 30 hard breaths a day, six days a week, it lowered the top blood pressure number about 9 points in six weeks. Those trials were small, and they compared it with fake training. Nobody knows yet whether the drop lasts for years. Of all the breathing practices on this site, it has the best-controlled blood pressure result.

Most people picture a breathing exercise for blood pressure as slow and calm. It makes sense, since slow breathing calms you within minutes. But when researchers pooled blinded trials of devices that pace slow breathing, the devices did no better than listening to music or using a fake device. Can breathing exercises lower blood pressure? has the details.

The breathing practice that did beat a fake version is the opposite of calm. It’s about five minutes of hard effort a day, with a kind of trainer that was mostly a tool for athletes and people with lung conditions like COPD.

What it is and where it comes from

In 1976, Leith and Bradley had four young volunteers breathe in and out as hard as they could against a blocked airway. They did it 30 to 45 minutes a day, five days a week. After five weeks, the pressure they could produce had gone up about 55 percent. For decades after that, breathing muscle training meant long sessions at light resistance.

Then E. Fiona Bailey’s lab at the University of Arizona tried a few hard breaths instead. In 2015, her team trained healthy adults in five different ways for six weeks. Only the groups that made big pressure swings inside the chest saw their blood pressure fall, by about 9 points on the top number. The group that took big breaths at low pressure got nothing. In 2016 the lab tried it on people with sleep apnea. In 2021 a team at the University of Colorado Boulder ran a double-blind trial in midlife and older adults.

How to do it

The Colorado trial used this routine.

1. Find your maximum. The researchers measured each person’s strongest possible breath in against a blocked tube, called maximal inspiratory pressure. Ask your doctor where you can get yours measured.
2. Set the trainer. Week one at 55 percent of that maximum, week two at 65 percent, then 75 percent from week three on.
3. Do 30 breaths. Five sets of six hard breaths in, with a minute’s rest between sets. It takes about five minutes.
4. Six days a week, for six weeks. People in the trial finished 94 percent of their sessions.
5. Sit down to train, in case you get lightheaded.

Every trial in a 2022 review taught people in person and checked their sessions daily or weekly. Nobody knows yet whether training alone at home works as well.

A simple way to picture it

It’s closer to a short set at the gym than to meditation. You do a few hard reps, rest, and do a few more, and the change comes from how hard each rep is.

What happens in your body

The Colorado trial found some clues. After six weeks, a standard test of how well the artery in the upper arm widens came out about 45 percent better. Blood serum from after training also made lab-grown blood vessel cells produce more nitric oxide, which relaxes blood vessels.

It doesn’t seem to come down to stronger muscles. In a 2022 analysis of five trials, how much stronger people’s breathing got didn’t predict how much their blood pressure fell. Systolic vs diastolic explains the top and bottom numbers.

What the evidence shows

The Colorado trial took 36 adults aged 50 to 79 whose top number was 120 or more. Half trained at 75 percent and half at 15, and neither they nor the researchers knew who was in which group. The top number fell from 135 to 126 in the training group and from 134 to 131 in the fake group. Six weeks after they stopped, the 15 trained people who came back were still at 128.

These are good results, but small ones, and the 2022 analysis pooled pilot trials written up by the researchers who developed the method. The Seoul trial is a useful outside check. Its drop had faded four weeks after people stopped, while the cardio group’s held. In Colorado, most of the drop was still there six weeks after stopping.

Nobody has shown yet whether the drop lasts for years or prevents heart attacks and strokes. A six-month trial in adults with sleep apnea was registered in 2021, and we couldn’t find its results yet.

Who should skip it

Each hard breath drops the pressure inside your chest, throat, inner ears and sinuses. For that reason, a 2021 UCLA study of the trainer left out people with these conditions, and they should talk to a doctor before using one.

• A collapsed lung that happened on its own, or one from an injury that hasn’t fully healed.
• A burst eardrum or any eardrum problem, including recent ear surgery.
• Asthma that isn’t under control, or trouble sensing when you’re short of breath.
• Heart or lung disease. Ask your doctor first.

Keep taking any blood pressure medicine. People in the Colorado trial stayed on theirs, and 2 of 18 had minor side effects, a sore neck and lightheadedness. Neither quit. To check your own result, measure at home for a week before you start and again after six weeks.

A trainer is an add-on. The free moves come first, from moving most days to breathing through your nose, and how to breathe better naturally goes through them.