Nervous System Regulation Exercises That Really Work
Nervous system regulation exercises are simple, practical techniques that are mostly built around breathing, movement, and attention. They can help you shift out of a stuck state and gradually train your body to settle more easily on its own. The trouble is that there is a lot of conflicting advice about nervous system exercises, so it can be hard to tell what could actually help in a moment of distress.
On this page, we explain, in clear terms, what exercises the evidence supports and walk you through the steps to practicing them. We explore:
- What regulating the nervous system actually means.
- Which nervous system exercises the science actually supports.
- Techniques people can use during moments of acute distress.
- How to build habits that last.
- What to do when exercises are not enough.
- Where to find professional support.
What Does “Self-Regulation” Mean?
Your autonomic nervous system is responsible for a range of functions like digestion, heart rate, pupil dilation, and breathing. Its two main branches, sympathetic and parasympathetic, work to mobilize you for action and return you to a calmer state, respectively.
However, if you are consistently faced with pressure, this system can get stuck in a loop of settling and mobilizing. This is a form of emotional dysregulation. Bruce McEwen (a neuroscientist at Rockefeller University) explained that there can be multiple forms of dysregulation, as some stress systems can fail to deactivate and others struggle to initiate in the first place.[1]
Emotional dysregulation is not a formal medical diagnosis, so it is unlikely to appear in your medical records. Your autonomic nervous system is outside of your conscious control. However, this doesn’t mean you can’t consciously work to make it more regulated.
“Self-regulation” is the phrase used to consciously monitor our emotional responses, including our thoughts, feelings, and behaviors, to reach a goal or endpoint. And nervous system regulation exercises are an excellent way of doing so.
To help you fully understand how these exercises work – and why – we’ll take a look at polyvagal theory.
Polyvagal Theory: An Overview
Polyvagal theory, proposed by Dr. Stephen Porges, a behavioral neuroscientist, offers a way of describing how the nervous system moves between feeling safe, mobilized for danger, or shut down.
Polyvagal theory has been influential in trauma therapy because it gives people accessible language for their internal states. It centers around the role of the vagus nerve, a long nerve that runs from your brain down through your gut, heart, and pelvis. This nerve essentially connects your brain to your heart, lungs, and digestive system.
The theory emphasizes that activating the vagus nerve through nervous system exercises should help you return to a state of calm if your go-to state is chronic activation – a process called “parasympathetic activation.”
It may be important to note that the theory has come under some criticism, as a 2023 review argued that its core premises are not supported enough by the available evidence.[2]
However, regardless of whether the evidence supports the theory’s claims, nervous system exercises have countless user testimonials regarding their benefits. So the practical takeaway is that the exercises we discuss next may help you achieve more calm in your day-to-day life. But it may just be the case that you need to practice a few to find the ones that work best for you.
Nervous System Exercises With the Strongest Evidence
You may have come across countless techniques in your search for nervous system exercises that work. Some of these techniques may have been legit, while others might have very little theoretical background or evidence for their efficacy. Below, we discuss three approaches with the most clinical evidence supporting them.
1. Cyclic Sighing
A study conducted at Stanford University compared three breathing exercises with mindfulness, with each exercise lasting five minutes a day for one month. One exercise in particular, cyclic sighing, with its long-exhale routine, improved mood significantly and reduced the respiratory rate compared with the others. In fact, it even outperformed meditation.[3]
The technique is simple: Inhale through the nose, wait a second, take a short sniff to fully inflate the lungs, then let out a long, slow exhale through the mouth. Repeat the routine for five minutes.
The second inhale is important as it is known to drive parasympathetic activation by reinflating collapsed air sacs and making the exhale more effective.
2. Slow, Paced Breathing
Nervous system regulation exercises typically focus on improving heart rate variability (HRV). For most people, heart rate variability (HRV) is high, at around six breaths per minute, demonstrating flexibility in the nervous system. But the more we stay stuck in states of activation, our HRV can drop, reducing flexibility. Slow, paced breathing can help regulate variability.
Like cyclic sighing, the routine is simple: Inhale for four seconds, exhale for six. Make sure your exhale is always longer than your inhale, as the exhale process is linked with the parasympathetic branch.
3. HRV Biofeedback
HRV biofeedback builds on the concept of improving heart rate variability (HRV). HRV biofeedback is a technique where a small sensor measures the natural variation in the time between your heartbeats and displays it on a screen or app while you breathe.
Because this variation reflects how balanced your nervous system is, seeing it in real time could help you adjust your breathing to gently steady your system and learn what a calmer state feels like.
A review that combined evidence from 24 studies found that this technique reduced self-reported anxiety and stress.[4] Further, another review of 58 randomized trials showed that HRV biofeedback significantly impacted anxiety, depression, and anger, with weaker impacts on sleep and PTSD.[5]
Other Exercises Supported by Evidence
Vagus nerve exercises are widely discussed, and the evidence behind them varies, so it can help to know which ones are well supported:
- Singing slowly, chanting, and humming are valid vagus nerve exercises for parasympathetic activation since they help slow down your breathing cycles and lengthen your exhale.
- Many people also find ear massage and gargling to be highly calming, but the evidence to support them is not well established. However, you can still try them as they are relatively harmless.
- Exposure to cold, such as cold water swimming, is also known to shift autonomic activity, although the immediate response is sympathetic. If you have a heart condition, consult your physician first.
Grounding Techniques for Acute Moments
Breathing exercises can be great for starting the process of self-regulation. However, grounding techniques can be more effective for helping people during moments of acute distress, such as panic attacks. The following are simple grounding techniques that you can access whenever you need them.
Orient
Turn your head around to scan the room slowly. Focus on and name what you can see in as much detail as possible. This process gives your brain real-time data about where you are.
Access the Five Senses
Name five things you can see, four you can hear, three you can touch, two you can smell, and one you can taste. This method is old but still very effective.
Change Temperature
Run cold water over your wrist and face or hold something cold. This forces your internal alarm to compete with physical sensation for attention.
Tap Into Movement
Move around. Push against the wall. Shake your hands out for 30 seconds. Anxiety is a form of hyperarousal. So making your body move around creates an outlet for it.
Name It Loudly
Identify your acute experience and name it loudly. For instance, you could say something like, “This is a panic response, and it peaks in about ten minutes.” By doing so, you’re engaging rational thought and reducing activity in the fear center of the brain.
Take your time to practice each of these techniques in a calm state. It takes a while to develop a new skill.
What the Science Says About Mindfulness Exercises
Mindfulness exercises are among the most researched nervous system regulation exercises. However, they may not be universally effective for managing different conditions and levels of activation.
The largest well-controlled review on the effectiveness of mindfulness pooled evidence from 47 trials covering 3,515 participants. Results showed that mindfulness meditation improved anxiety and depression, but found limited evidence for stress reduction and quality of life.[6]
This information is not to suggest that mindfulness is ineffective. It might just mean that the benefits vary from person to person depending on their unique experiences and symptoms. If being present in the here and now works for you, then great. However, if sitting still makes you feel worse, then approaches like exercise and behavioral therapy may be more suitable for your needs.
Mission Connection is here to help you or your loved one take the next steps towards an improved mental well-being.
A Selection of Exercises to Start With
There is no universal nervous system exercise routine that works for everyone. Your routine should reflect your:
- Symptoms.
- Experiences.
- Needs.
- Daily life.
For instance, if you experience background tension that never seems to leave, you could consider beginning with paced breathing. Practice for about five minutes every day for eight weeks.
However, if you also get sudden spikes of panic, such as during a meeting or in the middle of the night, you could follow paced breathing with acute calming exercises (which we cover shortly). For panic, routines should be easy to start within thirty seconds.
In contrast, if numbness and disconnection are issues you deal with regularly, start with gentle movement. For instance, incorporate walking, stretching, or anything rhythmic instead of stillness. Sitting with your eyes closed can make this worse.
If you’re not sure where you fall on the spectrum of regulation, or none of these experiences adequately reflect your own, start with daily breathing exercises. These nervous system regulation exercises have few to no negative effects.
Further, it’s important to note that while nervous system exercises could improve states of calm, they will not outperform chronic sleep deprivation or a mental health condition. Healthy routines around sleep can improve rest, but if persistent sleep disturbances or a mental health condition is present, speaking to a mental health professional is advised.
Building Habits
With all the information discussed in mind, it may be worth noting that nervous system exercises are not a switch but a skill. In the early stages, progress is slow, making many people quit prematurely.
It’s important to invest more in consistency than in duration. Five minutes every day could give you more results than one hour every week. Also, you could couple your practice with something you already love doing, as this can help promote habit building.
It’s also good to bear in mind that the early stages of nervous system exercises can be difficult for some people. Slowing down to reflect on your internal processes could raise awareness of the issues you might have been trying to avoid. If this sounds like you, perhaps enlist the help of a therapist.
Many therapists are trained in trauma-informed approaches, meaning they can help you understand and process triggering emotions and thoughts. They can also pace the exercises according to your needs, potentially starting small and doing shorter exercises to build up your resilience.
Remember: self-regulation is a skill that takes time to master. While consistent nervous system regulation exercises can build emotional resilience, you may need to give it six to eight weeks before evaluating progress.
You might make a few mistakes in the beginning, such as flitting too much between exercises, only practicing your routine during a crisis, holding your breath too tightly, or forcing a deeper inhale than you should. Practice makes perfect, so do not let mistakes hold you back.
When Exercise Is Not Enough
There is a limit to what breathing or nervous system exercises can do, and pretending otherwise can do people real harm.
If your symptoms are severe, persist despite months of consistent practice, trauma memories are intruding on daily life, or if you cannot function at work or at home, you may need more than anxiety coping skills.
Trauma recovery in particular usually requires processing the distressing experiences that led to the response:
- Eye Movement Desensitization and Reprocessing (EMDR) and trauma-focused therapy do work that no daily exercise can substitute for.
- Cognitive behavioral therapy (CBT) targets the thinking that keeps arousal high.
- Dialectical behavior therapy (DBT) teaches emotional regulation skills in a structured sequence with someone tracking your progress.
Nervous system regulation exercises work best as part of treatment. On their own, for serious symptoms, they are usually not enough.
Find Nervous System Regulation Support With Mission Connection
If you have been trying to breathe your way out of something bigger than breathing can reach, this is not a discipline problem.
At Mission Connection, our team of licensed mental health professionals goes beyond traditional treatment and provides life-changing care. We offer several options for effective outpatient treatment, including in-person programs at our locations in California, Virginia, and Washington, virtual telehealth, and a hybrid program that combines in-person and virtual care.
We create a structured care plan for every patient that consists of evidence-based therapies and medication management when appropriate. Mission Connection accepts most major insurance providers, so that your recovery is not hindered due to financial issues.
Reach out to us online or call us at 866-833-1822 to find out how we can support your long-term recovery.
