Effect of breathwork on stress and mental health: a meta-analysis of randomised-controlled trials

Deliberate control of the breath (breathwork) has recently received an unprecedented surge in public interest and breathing techniques have therapeutic potential to improve mental health. Our meta-analysis primarily aimed to evaluate the efficacy of breathwork through examining whether, and to what extent, breathwork interventions were associated with lower levels of self-reported/subjective stress compared to non-breathwork controls. We searched PsycInfo, PubMed, ProQuest, Scopus, Web of Science, ClinicalTrials.gov and ISRCTN up to February 2022, initially identifying 1325 results. The primary outcome self-reported/subjective stress included 12 randomised-controlled trials (k?=?12) with a total of 785 adult participants. Most studies were deemed as being at moderate risk of bias. The random-effects analysis yielded a significant small-to-medium mean effect size, g?=?- 0.35 [95% CI - 0.55, - 0.14], z?=?3.32, p?=?0.0009, showing breathwork was associated with lower levels of stress than control conditions. Heterogeneity was intermediate and approaching significance, ?211?=?19, p?=?0.06, I2?=?42%. Meta-analyses for secondary outcomes of self-reported/subjective anxiety (k?=?20) and depressive symptoms (k?=?18) showed similar significant effect sizes: g?=?- 0.32, p?