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Box Breathing Counts Compared: Comfortable Options and No-Hold Alternatives
Sep
Box breathing is simple to describe: breathe in, hold, breathe out, hold, each for the same length of time. The usual instruction is a count of four for each side of the “box”. What most guides leave out is that four is a convention, not a requirement, and that the holds are the part many people find uncomfortable. This article compares the options so you can find a version that suits you, or decide to skip the holds altogether. Our main guide to breathing techniques that actually work covers the background.
What box breathing is
In the research literature, box breathing is defined as equal-duration inhalations, breath retentions and exhalations. The equal sides are what make it a “box”. Nothing in that definition fixes the length of each side, which is why you can scale it to suit you.
Comparing the counts
| Pattern | What it feels like | Who it may suit |
|---|---|---|
| 3 in, 3 hold, 3 out, 3 hold | Light and easy. The holds are barely noticeable. | Beginners, or anyone who finds breath holds unpleasant. |
| 4 in, 4 hold, 4 out, 4 hold | The conventional version. A noticeable but manageable pause. | Most people, once three feels comfortable. |
| 5 or 6 on each side | Slow. The second hold, after breathing out, can feel demanding. | People with some practice who find it comfortable. We know of no evidence that longer is better. |
| In and out only, no holds | Steady and gentle. | Anyone who dislikes holding their breath. This is the NHS pattern. |
These counts are a way of pacing yourself, not doses. We are not aware of research showing that one count works better than another, so choose by comfort. “Seconds” do not need to be exact. A steady mental count is enough.
How to practise it
- Sit in a chair that supports your back, with both feet flat on the floor, or lie down. Our guide to comfortable diaphragmatic breathing covers posture in detail.
- Breathe in gently through your nose for your chosen count.
- Pause for the same count. Keep your throat and shoulders relaxed. This is a pause, not a clamp.
- Breathe out gently for the same count.
- Pause again for the same count, then begin the next round.
- Continue for a few minutes. In the main trial discussed below, participants practised for five minutes a day.
When to shorten or drop the holds
Drop to a shorter count, or remove the holds, if you notice any of the following:
- a feeling of air hunger or an urge to gasp;
- light-headedness or tingling;
- tension building in your chest, throat or shoulders;
- a rising sense of anxiety instead of calm.
If the hold after the out-breath is the uncomfortable one, keep the hold after breathing in and skip the one after breathing out, which turns the box into a triangle. If both bother you, remove them and breathe in and out to a steady count.
The no-hold alternative
The NHS breathing exercise for stress has no breath holds at all. It asks you to let your breath flow as deep into your belly as is comfortable without forcing it, breathing in gently and regularly. Some people find it helpful to count steadily from one to five on the in-breath and again on the out-breath, and the NHS notes that you may not reach five at first. It recommends continuing for at least five minutes and doing it regularly. If holds do not suit you, this is a well-established alternative, and nothing is lost by choosing it.
What the research says
A 2023 randomised controlled study from Stanford compared three daily five-minute breathing exercises with an equivalent period of mindfulness meditation over one month. The three were box breathing, “cyclic sighing”, which emphasises prolonged exhalations, and cyclic hyperventilation with retention. Breathwork as a group produced a greater improvement in mood and a greater reduction in breathing rate than mindfulness meditation. The authors singled out exhale-focused cyclic sighing as the most promising of the three.
Two points follow. First, box breathing was part of a group of practices that performed well, so it is a reasonable choice. Second, the practice that stood out was the one with long out-breaths and no equal holds, which suggests that equal holds are not essential. It was a single study conducted remotely, so it should not be over-read. It does support choosing the version you find comfortable.
Safety and when to get help
If it feels uncomfortable, stop. Breathing exercises are not right for everyone, and they are not a replacement for mental-health care. If the holds or the focus on your breath make you feel more anxious, light-headed or unsettled, let your breathing return to normal and do something else, such as naming objects you can see, taking a short walk, or simply stopping. Do not push through discomfort.
Avoid breath-holding exercises, and check with a health professional before starting any breathing practice, if you have a respiratory or heart condition, are pregnant, or have other health needs. Never practise breath holds in or near water, or while driving.
The US National Center for Complementary and Integrative Health notes that relaxation techniques are generally considered safe for healthy people, but that occasionally people report increased anxiety, intrusive thoughts or fear of losing control. The NHS advises seeing a GP if you are struggling to cope with stress or what you are trying yourself is not helping.
The bottom line
Box breathing is a flexible pattern, not a fixed formula. Start with a count of three, move to four only if it feels easy, and shorten or remove the holds the moment they become uncomfortable. The no-hold NHS version is a perfectly good alternative, and the best current trial suggests that a relaxed, slightly longer out-breath matters more than holding your breath.
Sources
- Balban et al., “Brief structured respiration practices enhance mood and reduce physiological arousal,” Cell Reports Medicine (2023)
- NHS, “Breathing exercises for stress”
- National Center for Complementary and Integrative Health, “Relaxation Techniques: What You Need To Know”
- NHS, “Get help with stress”
Last reviewed: 19 September 2026. This article is general information about everyday relaxation and is not medical advice.
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