I almost definitely notice breathing more than the average person. As a functional medicine doctor, I’ve learned that even the details patients think are insignificant can offer valuable information when you’re trying to understand what may be driving their symptoms.

I might notice someone’s breathing become faster or shallower as we move into a difficult part of their story. I might see their shoulders rise with every breath or realize that most of their breathing seems to be happening in their chest. And sometimes, I notice the exact same thing happening in my own body.

There’s a lot we can learn from the way we breathe.

“Even though we’re breathing all day long, most of us rarely pay attention to how we’re doing it.”

The funny thing is, even though we’re breathing all day long, most of us rarely pay attention to how we’re doing it. At a typical resting respiratory rate, you may take somewhere around 17,000 to 29,000 breaths in a single day and you won’t think about most of them.

But while breathing is something our bodies do automatically, it’s also something we can consciously observe and change. And the more I’ve learned about it, the more I’ve come to see our breath as both information and intervention. The way we breathe can offer clues about what our bodies are experiencing, and changing the way we breathe can sometimes change that experience in return.

So before we talk about how to breathe “better,” I think there’s a more interesting place to begin:

How are you breathing right now?

What your breathing patterns may be telling you

Before you try to change your breathing, spend a moment simply noticing it.

Sometimes I’ll encourage someone to sit or stand in front of a mirror and breathe normally. Don’t take the biggest, deepest breath you can. Don’t try to perform a “good” breath. Just watch and feel it.

“Before you try to change your breathing, spend a moment simply noticing it.”

Does your upper chest do most of the moving? Do your shoulders rise? Can you see your lower ribs expand? Are you holding your breath between tasks without realizing it? Are you always breathing through an open mouth rather than through your nose?

None of these observations alone can diagnose anything, and there isn’t one perfect way we’re supposed to breathe all day long. Our breathing patterns aren’t static. They shift constantly in response to what our bodies need. Exercise changes our breathing. So do sleep, pain, illness, stress, posture, and even the conversations we’re having. What interests me more are the patterns, particularly when they’re persistent or represent a change from what’s normal for you.

“Our breathing patterns aren’t static. They shift constantly in response to what our bodies need.”

If your breathing is consistently shallow or concentrated in your upper chest, stress may be one piece of the puzzle. When the body is activated, we tend to recruit more of the muscles in the chest, neck, and shoulders to breathe. But posture, pain, respiratory conditions, and habit can influence this pattern as well.

If you’re breathing faster than usual, context matters. A healthy adult at rest generally breathes somewhere around 12 to 20 times per minute, but respiratory rate naturally increases with exercise. Fever, pain, anxiety, respiratory illness, anemia, and certain cardiovascular or metabolic conditions can also affect how quickly we breathe. A single moment of rapid breathing isn’t necessarily meaningful; a persistent or unexplained change deserves more curiosity.

If you frequently sigh or feel like you can’t quite get a satisfying breath, you may be experiencing what’s sometimes described as air hunger. Anxiety and dysfunctional breathing patterns can contribute to this sensation, but I never want someone to assume shortness of breath is “just anxiety,” particularly when it’s new, persistent, or getting worse.

If you regularly breathe through your mouth, especially at night, it’s worth asking why. Maybe you’re temporarily congested. But persistent mouth breathing can also occur with allergies, nasal obstruction, or other issues affecting airflow. And if it’s accompanied by loud snoring, gasping, pauses in breathing, morning headaches, or significant daytime fatigue, I start thinking about sleep-disordered breathing and whether further evaluation might be helpful.

And then there’s becoming more winded than you used to be. Maybe the stairs you’ve climbed every day suddenly feel harder. Perhaps your usual workout leaves you unusually short of breath. Deconditioning can certainly affect exercise tolerance, but so can things like anemia, asthma, infection, and cardiovascular or respiratory conditions.

In all of these situations, the pattern itself is only one piece of the story. What I’m really interested in is change. What is different for you, and what else was happening when that difference began?

Your breath can reflect what your nervous system is experiencing

Some of the most noticeable changes in our breathing happen in response to what we’re experiencing emotionally and energetically.

Think about what happens when you’re startled. Your breath catches. When you’re crying, your breathing becomes irregular. When you’re rushing from one thing to another, you may realize you’ve been taking short, shallow breaths for the past hour. And when you finally sit down next to someone you feel completely comfortable with, you might notice yourself letting out a long exhale you didn’t know you were holding.

“The autonomic nervous system regulates many of the things your body does automatically, including things like your heart rate, digestion, blood pressure, and breathing.”

They’re examples of how closely respiration and the autonomic nervous system communicate. The autonomic nervous system regulates many of the things your body does automatically, including things like your heart rate, digestion, blood pressure, and breathing.

Our stress response is incredibly useful when we need it. The problem is that many of us aren’t moving neatly from stress into recovery anymore. Our bodies are breathing like we’re in danger while we’re sitting on the couch scrolling our phones. We move from the alarm clock to traffic to work to notifications to family responsibilities to headlines to tomorrow’s to-do list, often without giving our bodies much opportunity to come back down.

And for some people, of course, the stressor is much larger than an overflowing inbox. Grief, trauma, financial insecurity, illness, caregiving, relationship conflict, and other genuinely difficult experiences can keep the body’s stress systems working overtime. If you felt yourself tense up just reading that list, maybe this is a good moment to take a breath.

Over time, repeated activation of the stress response can affect sleep, metabolic health, immune signaling, and inflammatory processes throughout the body. This doesn’t mean shallow breathing is causing all of those things. It means our breathing can sometimes be one visible clue that a body is spending a lot of time in a state of activation.

“Our breathing can sometimes be one visible clue that a body is spending a lot of time in a state of activation.”

I’ve noticed this in patients, and I’ve noticed it in myself. Sometimes my mind is telling me, I’m fine. I’ve got this. And then I notice my shoulders, my chest, and my breath telling a slightly different story.

The interesting thing about breath is that we can change it

This is where breathing differs from so many other processes happening inside of us.

You can’t simply decide to lower your cortisol or slow your digestion. You can’t just tell your heart to stop beating so fast, or your stomach to stop being lactose intolerant. But while breathing is automatically regulated by the body, we can also consciously change its pace and depth. It’s one of those rare places where we get to actively participate in our own physiology, using something as simple as our breath to influence both how we feel physically and how we experience our emotional state. And I think that’s a tool worth using.

“It’s one of those rare places where we get to actively participate in our own physiology.”

Research on slow, controlled breathing suggests that it can influence autonomic nervous system activity, including heart rate variability, and may help reduce feelings of stress and anxiety. One particularly interesting part of the physiology happens with each respiratory cycle: heart rate naturally tends to increase slightly when we inhale and decrease when we exhale. Longer, slower exhalations are one reason many breathwork practices emphasize the exhale when the goal is relaxation.

This is something virtually every breathwork practitioner I’ve learned from has brought me back to in one form or another: Slow down, and let yourself fully exhale.

I don’t think that means everyone needs an elaborate breathwork routine. One of my favorite simple practices is box breathing: Inhale slowly for four counts, hold for four, exhale for four, and hold again for four before repeating the cycle. It’s easy to remember, takes just a few minutes, and gives you something concrete to focus on when you want to slow down and reconnect with your breath.

Breathwork should feel like an opportunity to get in touch with your body, not another wellness metric to perfect. A really simple practice is building intentional breath breaks into the day, especially around moments when we know our bodies tend to shift into a more activated state. Maybe it’s a few slow breaths before opening your inbox, between meetings, after school pickup, before walking through the door at home, or while you’re lying in bed at night. 

“Breathwork should feel like an opportunity to get in touch with your body, not another wellness metric to perfect.”

These little pauses give your body more opportunities to move out of activation and toward recovery, rather than waiting until the end of the day and expecting yourself to suddenly relax on command.

Breathwork became personal for me

My interest in breathwork isn’t only from a professional perspective. It became particularly meaningful during my breast cancer journey.

Cancer can make your relationship with your body incredibly complicated. Suddenly, the body you’ve lived in your entire life can feel frightening, unpredictable, or strangely disconnected from you. During that season, I sought out practitioners who helped me understand breathwork in a way I hadn’t experienced from simply knowing the anatomy of breath.

I learned to feel my diaphragm engage. To notice my rib cage rising and falling. To recognize when I was breathing almost entirely from my chest. And, maybe most importantly, to actually feel the difference between understanding relaxation intellectually and allowing my body to experience it.

Breathwork became an important part of my healing during that time. Learning to slow my breathing, engage my diaphragm, and spend more time in a parasympathetic state gave my body opportunities to move out of constant activation and into a state that was more supportive of rest and recovery. It helped me manage stress, think more clearly, and process what I was experiencing rather than constantly feeling like I needed to escape my own body.

“The way we breathe can influence autonomic nervous system activity, heart rate, blood pressure, gas exchange, and other physiological processes.”

And there is real physiology behind some of what I was experiencing. The way we breathe can influence autonomic nervous system activity, heart rate, blood pressure, gas exchange, and other physiological processes involved in how our bodies respond to and recover from stress. For me, breathwork became one piece of creating an internal environment that felt more supportive of healing while my body was also going through something as intense as cancer treatment and recovery.

I think that’s an important distinction, especially when we talk about breathwork and trauma. Some people find that breathwork helps them process difficult experiences, reconnect with their bodies, and regulate emotions in ways that feel profoundly healing. At the same time, breath-focused practices can feel activating for some people, particularly when there is a history of trauma, which is why I think the way we practice, and who we practice with matters.

Sometimes the benefits show up where you don’t expect them

Years ago, I worked with a patient who began incorporating breathwork more intentionally into her life. One of the changes she eventually noticed surprised both of us: Her libido started to return.

“One of the changes she eventually noticed surprised both of us: Her libido started to return.”

Now, I want to be very clear that I’m not suggesting breathwork is a treatment for low libido based on one person’s experience. Sexuality is complex. Hormones, medications, relationships, sleep, stress, pain, mental health, and so many other factors can influence it.

What interested me was how she described the change. She felt like she could finally relax and settle into her body.

Her experience has stayed with me because it’s such a good reminder of how interconnected our bodies are. We often divide health into categories — hormonal health over here, mental health over there, digestive health somewhere else — but our physiology doesn’t organize itself into those same neat boxes.

Sometimes when we support the body’s ability to move from activation toward rest and recovery, we notice changes somewhere we weren’t even looking.

Before you try to fix your breath, notice it

If this article has you suddenly wondering whether you’ve been breathing incorrectly your entire life, that’s not what I want you to take away. You don’t need to spend your day policing every inhale. Instead, try getting curious about how your breathing changes as you move through your life.

Notice it when you first wake up. Notice it when you open your inbox or sit in traffic. Notice what happens during a difficult conversation. Pay attention when you’re outside, laughing with someone you love, praying, exercising, or lying in bed at the end of the day.

“When does your breath feel easy and expansive? When does it become shallow? When do you hold it?”

When does your breath feel easy and expansive? When does it become shallow? When do you hold it? What happens when you intentionally slow down and allow yourself a longer, comfortable exhale?

Personally, I love practicing breathwork outside whenever I can. Nature, fewer distractions, my feet on the ground, and a few minutes when I’m not trying to accomplish anything else can make it easier for me to actually pay attention to what I’m feeling.

You don’t need to force an enormous breath or follow some complicated formula. In fact, simply breathing more than your body needs can lower carbon dioxide levels in the blood, which changes your physiology and can contribute to sensations like lightheadedness, tingling, or that strange feeling that you can’t quite get a satisfying breath.

Interestingly, some breathwork practices intentionally create this effect. Methods that use short periods of faster or more forceful breathing deliberately shift oxygen and carbon dioxide balance and create a temporary physiological stress response, often followed by breath holds or periods of slower breathing. That controlled stress is part of the practice rather than an accidental side effect. It’s a very different context from habitually overbreathing throughout the day.

For everyday breath awareness, though, more isn’t necessarily better. Start gently. And if breathwork consistently makes you feel anxious, dizzy, or distressed, stop and consider working with an appropriately trained practitioner.

And sometimes, your breath is telling you to see a professional

Breathing is how we bring oxygen into the body and remove carbon dioxide. When something interferes with our ability to move air effectively, exchange those gases in the lungs, or carry oxygen through the bloodstream, our breathing may change in response. Asthma, for example, can narrow and inflame the airways, while anemia can affect the blood’s ability to carry oxygen. Heart and lung conditions can affect this system in other ways.

Our breathing while we sleep can offer clues, too. I pay particular attention to habitual mouth breathing. Our noses help filter, warm, and humidify the air we breathe, and regularly sleeping with your mouth open can contribute to dry mouth, snoring, and disrupted sleep. It can also be a clue that something is making nasal breathing difficult.

“Our noses help filter, warm, and humidify the air we breathe, and regularly sleeping with your mouth open can contribute to dry mouth, snoring, and disrupted sleep.”

I was actually a huge mouth breather myself. There are plenty of unflattering photos of me asleep with my mouth wide open to prove it! Once I started paying more attention to nasal breathing at night (thank you, mouth tape), I noticed a real difference in how rested I felt when I woke up and even in my mental clarity during the day.

Persistent mouth breathing, especially alongside loud snoring, gasping or choking during sleep, morning headaches, or unexplained daytime fatigue, can also point to sleep-disordered breathing such as obstructive sleep apnea. With sleep apnea, breathing repeatedly stops or becomes restricted during sleep, disrupting sleep and sometimes causing intermittent drops in blood oxygen. Left untreated, it’s associated with increased risks for high blood pressure, cardiovascular disease, metabolic problems, and other health concerns.

“This is why changes from your normal matter.”

This is why changes from your normal matter. New or persistent shortness of breath, an unexplained change in respiratory rate, wheezing, chest tightness, or becoming significantly more winded than usual are all worth discussing with a healthcare professional. Severe difficulty breathing, particularly with chest pain, fainting, confusion, or blue or gray discoloration of the lips or skin, requires urgent medical attention.

Breathwork can be a wonderful tool, but it shouldn’t be used to explain away a symptom that needs medical evaluation.

Again, it comes back to curiosity: What changed? When did it change? And what might my body be trying to communicate?

Breathwork is a practice in awareness

One of the humbling things about being a physician is realizing that knowing what your body needs doesn’t make you immune to being human.

I’m in a season of significant transition right now as I build my private practice, and I’ve found myself wanting to return even more intentionally to breathwork. Part of what keeps drawing me back is how fascinated I still am by something we do every moment of every day. The more I learn about the breath, the more I realize there is still more to learn.

“The more I learn about the breath, the more I realize there is still more to learn.”

I may be a physician, but I’m very much a student of this too. I know the physiology. I’ve studied it. I’ve practiced it. And I still catch myself breathing from my chest. I still need moments when I consciously slow down, reconnect with my body, and remind it that it can exhale.

That’s why I think of breathwork as an evolving practice. We can become incredibly skilled at recognizing our patterns and knowing how to work with our breath, but our lives change. Our stress changes. Our bodies change. And sometimes we need to return to the practice or being aware and rediscover what our bodies need in that season.

You don’t need to monitor every breath you take. Your body knows how to breathe without you.

But every once in a while, pay attention. Your breath is a beautiful place to start listening.

Dr. Jaclyn Tolentino is a board-certified family medicine physician specializing in functional medicine, women’s health, hormone optimization, metabolic health, and longevity. She has been featured in Vogue, The Wall Street Journal, and Women’s Health. As both a physician and a breast cancer survivor, she is passionate about delivering thoughtful, personalized care that empowers patients to better understand their health. Follow her on Instagram for updates and insights.