Pranayama Prescription: What’s the Right Kumbhaka (Breath Hold) for You?

Pranayama Prescription: What’s the Right Kumbhaka (Breath Hold) for You?

In This Article

Dealing with Stress

Have you ever noticed your breath when you’re stressed? We have all heard of hyperventilation, which typically happens when someone has a panic attack or is extremely stressed out. The home remedy is to breathe into a paper bag, in order to rebreathe carbon dioxide (CO2) and calm you down.1 

The reason why breathing into a paper bag works is because CO2 is a natural nervous system tranquilizer or sedative.1 When CO2 levels rise, we calm down. When CO2 levels fall and oxygen (O2) levels rise, we become stimulated. Oxygen has a stimulatory effect on the nervous system, while CO2 has a calming effect—a perfect balance of these must be maintained.1,2 

During a panic or stressed state, breathing tends to become shallow and more rapid. Shallow, rapid breathing will cause you to overbreathe oxygen (O2), which means more oxygen in and more CO2 out. In short, this is the definition of hyperventilation.  

During stress and states of anxiety, overbreathing can overexcite the nervous system due to increased levels of O2 and decreased levels of CO2.2 

Pranayama Breath Holds on Inhale or Exhale 

Pranayama breathing has long employed the knowledge of how to delicately balance or therapeutically manipulate the O2/CO2 balance in the body. Some breathing techniques will shift the balance to holding onto more O2 and others will hold more CO2

Many  of these O2/CO2 adjustments can be made during states of breath retention, called kumbhaka. Many experts in pranayama claim the original intention of pranayama in Yoga Sutras and Hatha Yoga Pradipika was to always include a kumbhaka. Put simply, if the breathwork is not combined with a kumbhaka (hold), it is not a pranayama technique.3  

Pranayama kumbhaka (breath retention) is classically performed on either the inhale, exhale, or both. In general, there was always an emphasis on either extending the exhale or inhale hold. 

An exhale breath hold is called bahih kumbhaka and an inhale breath hold is called an antah kumbhaka

Prescribing the Correct Kumbhaka (Breath hold on Inhale or Exhale) 

4 Parts of Pranayama4 

  1. Inhale (puraka
  2. Exhale (rechaka)  
  3. Breath retention on inhale (antah kumbhaka
  4. Breath retention on exhale (bahih kumbhaka

Note: There is also an advanced stage of pranayama called kevala kumbhaka, a spontaneous breath retention during meditation.4 

We recommend "The Performance-Enhancing Effects of Breath Retention + Pranayama":

Antah Kumbhaka 

During an antah kumbhaka (or inhalation breath hold), the emphasis is on breathing in maximum levels of oxygen (O2). In this practice, the O2/CO2 balance is shifted to be oxygen-dominant.  

This is typically prescribed to boost energy and mood for lethargic, depressed, and hypometabolic individuals.5 Remember, a rise in O2 will act as a nervous system stimulant. Overbreathing O2 in excess can lead to hyperventilation, panic, and anxiety. 

Bahih Kumbhaka 

During a bahih kumbhaka or exhalation breath hold, the emphasis is on holding the breath after a full exhalation. In this situation, the lungs are emptied and quickly CO2 levels begin to rise. Typically, it is much easier to hold the breath after a full inhale than after a full exhale. 

lifespa image, Breathe Deeply sign with clouds and sky background

During bahih kumbhaka, CO2 levels rise, eliciting a sedative, calming effect on the nervous system. Again, this is why breathing into a paper bag will calm someone in a panic due to hyperventilation. Traditionally, bahih kumbhaka is prescribed for overactive, hypermetabolic, stressed, anxious, worried individuals. Bahih kumbhaka was used to quiet and still the mind in order to enhance self-awareness and spirituality.5 

So, which breath hold do I choose? 

Traditionally, each of the breath holds was prescribed as needed. Today, it seems that few really need the benefits of stimulating the nervous system (with antah kumbhaka), as we all seem to be chronically overstimulated and extremely fast-paced.  

If one is exhausted due to being overstimulated, the better practice would be long, slow, deep ujjayi breathing to restore and rebuild the nervous system without stimulating an already exhausted individual. 

If you feel you are in either of these categories, choose the exhalation breath hold, bahih kumbhaka. 

However, if you normally function with lower energy and tends to be a bit melancholy, then you may want to consider the inhalation breath hold, antah kumbhaka. 

We recommend "The 10 Second Breath for Lungs, Nervous System + More":

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Dr. John


  1.  NCBI: Hyperventilation as a Cause of Panic Attacks. 
  3. Kuvalayananda, Swami. Pranayama1931, 1978. Sky Foundation, PA. 
  5. Light on Pranayama. Unwin paperbacks, London 1981. Iyengar, BKS.  

16 thoughts on “Pranayama Prescription: What’s the Right Kumbhaka (Breath Hold) for You?”

  1. Dr Douillard,
    I really love to listen to your videos and pod cast, I learn so much! I was wondering if you would be interested in translating some of these knowledge into Spanish to reach a wider audience.
    I am originally from Chile so I speak both languages very well, I have been working here in the USA translating and interpreting for many years. I been living here in Virginia for more than 25 years,
    I know there is a huge interest in the Spanish community to learn this knowledge. And I would love to make this happen.
    Thank you for all you do and the generous knowledge that you give.
    Ximena Stroubakis

    • Hi Ximena,

      Thanks so much for reaching out about this. Dr. John will have our management reach out to you at their earliest opportunity to discuss this further with you.

      LifeSpa Staff

  2. What about the alternate nostril breathing, is that stimulating or calming? I have read that it is balancing for the 2 brain hemispheres but not sure about other effects.

    • Hi Marsha,

      With alternate nostril breathing, there are small pauses on both the inhale and exhale. If you wanted specific benefits, you could choose to extend your breath hold on either the inhale or exhale to get the benefits described in this article.

      LifeSpa Staff

  3. Curious, do you know if just lengthening the duration of the exhale (rather than holding the breath) would have the same physiological effect? (e.g. on blood O2/CO2 levels, sedating, etc.)
    Meaning, instead of Inhale 10 seconds/Exhale 10s/Hold 10s,
    just Inhale 10 seconds then Exhale 20 seconds.

    • Hi Van,

      Yes, lengthening the exhale as compared to the inhale is a classic pranayama technique that should happen naturally over time. As long as you are adjusting to levels of air hunger, you are building CO2 tolerance.

      Be Well,
      Dr. John

      • Thank you, sir! Is it the same effect then – holding vs just lengthening – or different purposes for both?
        Side bar – I practiced Wim Hof method for a while & got up to about 3 1/2 mins breath hold including 50 pushups. (I’m 66.)
        Then started Buteyko & was astounded that I could only hold comfortably for about 8 seconds after exhale. 8 seconds!!
        Switched to Buteyko ;-))
        Hoff was stimulating and fun but Buteyko seems to be improving my resp capacity more. And is certainly more calming. (Fits Antah/Bahih perfectly, huh?)
        2nd Side Bar – Did a couple workshops with you in Portland decades ago. Nasal & ujjayi have been indispensable components of my teaching ever since. EVERYONE should read ‘Mind Body Sport’.

        • Thanks for the note, Van.

          As you know, in Ayurveda there are a variety of different pranayama techniques each with a unique effect on the physiological.

          Wim Hof and Buteko offer two types, one based on boosting the sympathetic nervous system and the other parasympathetic. Both have value for different reasons.

          In Ayurveda, there are so many more than just these two most popular, which is why I have been writing articles on many of the different pranayama techniques and their effects.

          Hope that helps. I love both by the way!

          Be Well,
          Dr. John

  4. I studied Pranayama in India at the Kdhama Institute and I studied the Yoga Sutras at an ashram where I lived for 25 years.
    You are not supposed to hold the breath when you are not pure enough. You need to have a clean Yoga practice of all levels, moral, physical, etc. If you do not then holding the breath is really not all that healthy.
    I don’t care anything about the CO2/ O2 levels for what is being described in this article. I know that the West has taken the substance of the East and really modified it in many ways.
    But really this article is missing important information..
    One just does not start at the beginning if not being purer on all levels to hold the breath.

    • Most practices are adaptable and fluid. The strict rules you adhere to are not exclusive
      Or fixed. Become open, fluid and receptive to adaptation.

  5. This brings up a concern about people who have to wear masks all day. Inhaling all that CO2 can’t be good. Can you comment? Lyn

  6. Hi Dr John–
    I took a workshop from you about 1993-4 at the Pacific Palisades TM Center. Started doing pranayama –mostly SRF based after. I found out years later I had OSA, CVID and posterior tongue tie. I wrote an article about George Catlin and “Shut Your Mouth and Save Your Life” for the Weston A Price Foundations’ Wise Traditions Journal in 2009. About that time, I came upon a breathing diagnostic method and devised a technique for breathing which has resulted in 4 Pulmonary Function tests in 10 years of around 130%. This last Feb was 132% and I am 65. I know I am doing something right. And, I am on a CPAP and have a 1 mm airway. I am a success story and have overcome many odds– even going thru 4 minor surgeries w/ no sedation and 3 other procedures which normally would require sedation, but I needed none. I have more to share that I think can help others, but want to talk with you or someone who is an SRF Kriyaban and medical expert to discuss details.
    Thanks for all of your work DrJohn! Much needed right now.


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