Breathwork

Breathwork pacer for therapists — box breathing, 4-7-8, physiological sigh and more

This free breathwork app is the digital version of every paced-breathing handout. Pick a pattern — box, 4-7-8, physiological sigh, coherent 6-bpm, resonant 5.5-bpm, or long-exhale 4·8 — follow the animated circle, and count cycles. Mobile-first, no narrative required, and sendable to a client's phone in one tap.

The six patterns included

• Box breathing (4-4-4-4). Inhale 4, hold 4, exhale 4, hold 4. Used by Navy SEALs and first responders for pre-performance regulation.
• 4-7-8 breathing. Inhale 4, hold 7, exhale 8. Strong long-exhale pattern; popular for sleep onset and acute anxiety.
• Physiological sigh. Double inhale through the nose, long exhale through the mouth. Andrew Huberman's fastest documented stress-down regulator.
• Coherent breathing (6 bpm). Inhale 5, exhale 5. The reference pattern for HRV biofeedback work.
• Resonant breathing (5.5 bpm). Inhale ~5.5, exhale ~5.5. The individual resonance frequency for most adults — peak HRV amplitude.
• Long-exhale 4·8. Inhale 4, exhale 8. The minimal-instruction parasympathetic pattern when 4-7-8 feels like too much to remember.

How clinicians use the breathwork tool

• Pre-session regulation — open the pacer in the waiting room and ground both nervous systems before starting
• Panic and acute anxiety — long-exhale patterns interrupt the panic cycle within 60–90 seconds
• EMDR resourcing — establish coherent breathing as a resource before reprocessing
• Sleep work and CBT-I — 4-7-8 or resonant breathing as a wind-down ritual
• Trauma-informed pacing — when breathwork itself is activating, switch to the grounding tool

Pair the pacer with the rest of the regulation stack

• Grounding tool — TIPP, 5-4-3-2-1, trauma orientation. For attention-based regulation when breath-focus backfires.
• Polyvagal state tracker — track which patterns shift the client out of sympathetic or dorsal states.
• DBT skills toolbox — paced breathing is the P in TIPP; send it alongside the full distress-tolerance set.

Frequently asked questions

What breathing patterns does this tool include?

Six evidence-based patterns: box breathing (4-4-4-4), 4-7-8 breathing, the physiological sigh (double inhale + long exhale), coherent breathing at 6 breaths per minute, resonant breathing at 5.5 bpm, and long-exhale 4·8 pacing. Each runs as an animated pacer so the client follows a visual without needing to count.

Is this breathwork app free?

Yes. The breathwork pacer is free with no account required. Clinicians can sign up free to send specific patterns to a client's portal between sessions and track which patterns the client actually uses.

Which breathing pattern should I pick for which client?

Anxiety, panic, and sympathetic overdrive: long-exhale patterns (4·8, 4-7-8) and the physiological sigh — these lengthen the exhale to engage the vagal brake. Performance and pre-session regulation: box breathing (4-4-4-4) and coherent 6-bpm. Sleep onset: 4-7-8 or resonant 5.5-bpm. Trauma clients who get more activated by breathwork: skip to the grounding tool — grounding regulates by attention rather than breath.

How is this different from a grounding tool?

Breathwork regulates the autonomic system by changing the breath. Grounding regulates by changing attention — anchoring in the senses, room, or a mental task. For most anxiety, paced breathing works; for trauma clients where breath-focus can trigger more activation, grounding is the safer first step. Both live in the toolkit so clinicians can pick the right one per client.

Can clients use this between sessions on their phone?

Yes. The pacer is mobile-first and runs in any browser. The clinician sends a specific pattern and cycle count to the client's portal; the client opens the link and follows the animated circle.

Is paced breathing evidence-based?

Yes. Slow-paced breathing at ~5–6 breaths per minute increases heart rate variability (a marker of autonomic flexibility) and lowers anxiety, blood pressure, and PTSD symptoms in controlled trials. The physiological sigh has direct evidence for rapid reduction in stress and improved mood. 4-7-8 and box breathing have less direct trial evidence but share the long-exhale mechanism.