Do Breathing Practices Promote Health? An Evidence-Based Review of the Wim Hof Method, Diaphragmatic Breathing, and Breath-Holding Risks

Breathing for Health: Some Practices May Help as Adjuncts, but No Breathing Method Is a Cure-All

The conclusion in one sentence

Breathing exercises may benefit some psychological and physical measures, and diaphragmatic breathing may help selected patients with gastroesophageal reflux. The evidence does not, however, support claims that the Wim Hof Method can prevent or treat multiple major diseases, and repeated, prolonged breath-holding should not be treated as a risk-free health practice. (PMID: 38179185; PMID: 40843749; PMID: 35842548; PMID: 38478473; PMID: 27389622; PMID: 28228118; PMID: 22908840)

First, distinguish among the different “breathing methods”

What people call breathing for health may refer to slower breathing, long and deep breaths, or diaphragmatic breathing characterized by abdominal movement. It may also refer to cycles of hyperventilation, breath-holding, cold exposure, or breath-hold diving. These practices differ in stimulus, purpose, and risk. A finding about one method cannot be transferred to another merely because both involve breathing, and a short-term physiological change cannot justify the leap to a claim that a person will “never get sick again.”

An important contribution of Professor Lin's original article was precisely its separation of marketing claims from the research itself. The frequently cited study of the Wim Hof Method did not test Wim Hof alone. Its participants received training in meditation, cyclic hyperventilation followed by breath-holding, and cold exposure. What the researchers observed was suppression of the innate immune response, which cannot be recast as a broad “boost” to immunity. (PMID: 24799686)

The Wim Hof Method has not been shown to ward off major diseases

Extending an experimentally observed change in immune response into a claim that the method can prevent hypertension, diabetes, cancer, and depression goes beyond the evidence. Subsequent systematic reviews have still not established that the method prevents or treats these conditions. Although findings related to inflammation provide signals worth studying, the appropriate conclusion is that the approach is promising and requires further research—not that it has become a treatment. (PMID: 38478473)

Professor Lin's skepticism toward the claims made in books and promotional materials is therefore consistent with the direction of the current literature. This does not mean that no participant can feel energized or subjectively comfortable. It means that personal experience cannot substitute for disease endpoints, suitable controls, and reproducible validation. Anyone receiving treatment for hypertension, diabetes, cancer, or depression should not use breathing exercises as a replacement for standard medical care. (PMID: 38478473)

Diaphragmatic breathing and gastroesophageal reflux: Plausible, but claims should remain conservative

The antireflux barrier at the gastroesophageal junction is related to diaphragm function, and the diaphragm can be trained voluntarily to some extent. Diaphragmatic breathing therefore has physiological plausibility as an adjunctive approach. Existing studies suggest that it may improve symptoms in selected patients with gastroesophageal reflux. The key terms are “selected patients” and “adjunct”: the practice is not suitable for everyone, nor does it guarantee a cure. (PMID: 35842548)

As the literature has evolved, a newer meta-analysis supports the possibility of a small improvement in symptoms, but heterogeneity among studies is high and improved quality of life has not been established. The original statement that the practice could “relieve symptoms and improve quality of life” should therefore now be narrowed to “it may help some patients improve their symptoms, while any benefit to quality of life remains uncertain.” (PMID: 42123139; PMID: 35842548)

This is an update in wording prompted by the evolution of science; it does not alter Professor Lin's historical position when he introduced diaphragmatic breathing through its physiological mechanism and the evidence available at the time. In practice, diaphragmatic breathing may be used alongside medical evaluation, lifestyle changes, and existing treatment. If symptoms persist or worsen, or if the diagnosis is unclear, the priority remains proper medical evaluation rather than repeatedly intensifying self-directed practice.

Breathing exercises in general: Some benefits, but not every claimed benefit at once

Evidence syntheses suggest that breathing exercises may help some cardiovascular and psychological outcomes. This is partly consistent with Professor Lin's view that appropriate long, deep breathing may confer benefits to both body and mind. Yet the available studies also contain bias and heterogeneity. They cannot collectively establish every claimed benefit involving cardiopulmonary function, immunity, pain, stress, anxiety, and cognition. (PMID: 38179185; PMID: 40843749)

For the general public, it is more appropriate to view breathing exercises as an accessible tool for self-regulation. They can serve as a supportive daily habit, but should not be packaged as a treatment spanning multiple diseases. To judge whether a claim is reliable, ask what the study actually measured, who was studied, which specific method was used, and whether the effect went beyond a fleeting sensation and was reproduced across independent studies. (PMID: 38179185; PMID: 40843749)

With breath-holding and breath-hold diving, longer does not mean healthier

Studies of long-term, repeated breath-holding or breath-hold diving have identified potential injury signals involving brain biomarkers, kidney function, and pulmonary symptoms. These findings support Professor Lin's warning that such practices may pose risks to the brain, kidneys, and lungs. (PMID: 27389622; PMID: 28228118; PMID: 22908840)

The evidence also has limits. The relevant data come from small biomarker studies, cross-sectional associations, and retrospective surveys, so they cannot precisely determine causation or the magnitude of harm from ordinary breath-holding exercises. The correct interpretation is not that every brief breath-hold inevitably damages organs. Rather, uncertainty about the exact degree of harm cannot be reversed into a claim that prolonged breath-holding promotes health or carries no risk. (PMID: 27389622; PMID: 28228118; PMID: 22908840)

How to assess claims about breathing for health

A credible claim should specify the type of breathing training, whether the study involved healthy people or patients, and whether it measured subjective sensations, physiological markers, or disease outcomes. Promotional language that jumps directly from a short-term marker to cancer prevention, treatment of depression, or a promise of never becoming ill has exceeded the available evidence. Immune research on the Wim Hof Method does not prove prevention of multiple diseases, and evidence on diaphragmatic breathing for gastroesophageal reflux cannot be generalized into a claim that every breathing method works. (PMID: 24799686; PMID: 38478473; PMID: 35842548)

The most defensible conclusion is that appropriate breathing exercises can be considered a form of supportive self-care, but each method and purpose must be evaluated separately. Claims of efficacy in treating disease require restraint, and intense stimuli such as hyperventilation, prolonged breath-holding, and cold exposure call for particular caution. Feeling better does not mean that a disease has been treated, and a physiological response does not amount to a comprehensive enhancement of immunity.