Box breathing vs 4-7-8: is there a right count for stress?

In a 2024 episode of Quarks, the science show of the German public broadcaster WDR, presenters Katrin Ewert and Lena Bültena tested breathing techniques against stress: Wim Hof, mouth taping, alternate-nostril breathing, then the counted ones. Box breathing (in for four, hold for four, out for four, hold for four) and 4-7-8 both hold the breath, the presenters noted, which can mean stress goes up at first rather than down. Then they handed over to the psychologist Ulrich Ott, who said you shouldn't focus too much on exact counts. There is no single right way to breathe, Ott said, and it bothers him whenever box breathing is presented as the best there is.

"Das ist so ein bisschen Zahlenmagie, die da betrieben wird."

In English: "It's a bit of number magic that's being worked there."

Ulrich Ott, Quarks (WDR), 2024

The pattern is symmetrical, Ott added: in, hold, out, hold, all the same length. But physiologically, it isn't anything special.

What the trials say

One note first: this is about the surge of an ordinary overloaded day. The program this read comes from says it plainly: "It isn't for burnout, anxiety disorders, depression or trauma."

Ott's point holds up. In a trial with 100 healthy adults over 12 weeks, a breath with a longer out-breath did no better than one with an even in and out; the differences weren't statistically significant (Birdee and colleagues, 2023). After Ott's clip, the video recommends a slow, longer out-breath without fixing on a number of seconds. That's a reasonable way to breathe. The trial suggests the exact ratio matters less than the slowing down.

How much does slow breathing help at all? A 2023 review of 12 trials with 785 adults found breathing practices lowered self-reported stress a little. Half the trials were in people with a physical health condition, and the authors warn against hype (Fincham and colleagues, 2023). And once people were already worked up, a review of anger studies found calming activities had a small effect that wasn't statistically significant (Kjærvik and Bushman, 2024).

One breath, then a decision

So keep the breath small and give it a job.

How this fits the Manage everyday stress program

The 1h Protocol to Manage Everyday Stress teaches the breath once, in chapter 6, for the collision, the moment it all lands at once. It's the first of four quick moves: breathe out slowly, once; write down what's landing; pick the one that matters now; give the rest a when, or someone to hand it to. The program says plainly that you don't need a special count and that the breath is a small help, not a fix. The first chapter is free and finds your stress pattern, and the whole program takes about an hour.

Source: Quarks (WDR), Welche Atemtechnik hilft WIRKLICH gegen Stress?, 25 Aug 2024 Research: Birdee and colleagues, 2023 · Fincham and colleagues, 2023 · Kjærvik and Bushman, 2024