How to Do Box Breathing (4-4-4-4)

The steps

1. Exhale fully. Breathe out completely through your mouth, emptying your lungs.
2. Inhale for 4. Breathe in slowly through your nose for a count of four.
3. Hold for 4. Hold the breath gently, without straining, for a count of four.
4. Exhale for 4. Breathe out slowly through your mouth for a count of four.
5. Hold for 4. Hold again with your lungs empty for a count of four.
6. Repeat. Continue for four to six rounds — about a minute — or longer if it's helping.

When to use it

• Right before a stressful conversation, presentation, or decision
• The moment you notice your heart rate or breathing speed up
• Between back-to-back high-pressure meetings, as a quick reset
• Before sleep, if your body feels wired
• Anywhere — a desk, a hallway, a car, a flight line

Why it works

Box breathing is a form of slow, paced breathing. Research on breathing at a similarly slow pace has found measurable increases in baroreflex sensitivity — the reflex the body uses to help stabilize heart rate — and in heart-rate variability, a marker of active self-regulation (Bernardi et al., Circulation, 2002).

The 4-4-4-4 pattern itself is documented in U.S. Navy and U.S. Air Force training material as a way to help personnel regulate their breathing and stay focused under stress.

Sources: U.S. Navy, Combat Tactical Breathing (PDF) · U.S. Air Force Medical Service, "Ready, Set, Focus" · Bernardi et al., Circulation, 2002. Full citations on the science page.

Box breathing is a self-regulation skill, not a medical treatment. It isn't a cure or treatment for anxiety, PTSD, high blood pressure, or any other condition, and it isn't a substitute for professional care — talk to a qualified professional if you're struggling, or before starting a new breathing practice if you have a heart or breathing condition. PPR is an independent app; it is not affiliated with, or endorsed by, any air force.

Box breathing is close to the breath-and-body-scan focus trained in Step 1 of the PPR course, "Basic Awareness." Read more about the method →