Abstract
Modern society faces a growing prevalence of mental disorders, with stress emerging as a critical factor affecting mental well-being. In recent years, breathwork has gained public and scientific recognition as a promising approach for enhancing psychological health. Despite the rapid growth in research, the field remains fragmented due to the diversity of breathing techniques. Moreover, recent findings have challenged several foundational concepts traditionally believed to underlie the therapeutic effects of breathwork. This review offers a comprehensive overview and comparison of the most widely practiced breathing techniques, with a focus on addressing key theoretical issues. We examine the primary psychophysiological pathways and mechanisms of breathwork, highlighting its influence on the nervous system as central to its effectiveness. We critically evaluate the role of breathing variables, including pace, ratio, breathing route, attention, and the use of biofeedback, in promoting the long-term neurobiological changes that have been associated with improved mental health. We argue that most breathwork techniques share core neurophysiological mechanisms that benefit well-being, regardless of the theoretical differences between specific techniques. Accumulating evidence suggests breathwork may serve as both a preventive and adjunctive therapy for chronic stress, anxiety, and depression, given its potential to target key risk factors and produce clinically relevant outcomes. Contemporary breathwork research, however, is limited by inconsistent study quality and methodological heterogeneity. By synthesizing current evidence and identifying critical knowledge gaps, this review aims to guide future research and advance understanding of breathwork's therapeutic potential.