4-7-8 호흡법
대체의학 분야의 권위자인 애리조나 대학의 앤드류 웨일 박사는 '4-7-8 호흡법'으로 불면증을 극복할 수 있다고 주장한다. 방법은 먼저 배를 부풀리며 4초간 코로 숨을 들이마신다. 7초간 숨을 참는다. 그다음 배를 당기며 8초간 입으로 숨을 내뱉으면 된다. 이것을 4회 반복한다. 이 호흡법은 폐에 더욱 많은 산소를 공급해 부교감신경계통을 안정시켜 수면에 도움을 주는 것으로 알려져 있다.
호흡하는 동안, 윗쪽 앞니 뒤편에 혀끝이 닿아 있어야 한다. 이어 다음과 같은 단계를 따른다.
-입으로 ‘쉬잇’ 소리를 내면서 완전히 숨을 내쉰다.
-입을 다물고 조용히 코로 숨을 들이마시면서 속으로 1에서 4까지 센다.
-1~7을 세는 동안 숨을 참는다.
-다시 입으로 ‘쉬잇’ 소리를 내면서 속으로 1~8을 세는 동안 입으로 숨을 내쉰다.
-이 호흡을 4번 되풀이하고, 같은 과정을 3세트 반복한다.
웨일 박사에 따르면 각 단계에서 보내는 시간보다 4-7-8의 비율을 지키는 것이 더 중요하다. 숨을 참는 것이 어렵다면 속도를 빠르게 하되, 단계의 비율을 일관되게 유지해야 한다. 연습을 통해 모든 단계를 느리게 진행할 수 있고, 숨을 점점 더 깊이 들이마시고 내쉬는 과정에 익숙해질 수 있다는 설명이다.
이완호흡의 효과과 주의할 점
다스굽타 교수는 “스트레스를 받으면 투쟁 혹은 도피 반응을 담당하는 교감신경계가 지나치게 활동적이 된다”고 말했다. 이렇게 되면 호흡이 빠르고 얕아질 뿐 아니라 빠른 심박수를 유발할 수 있다. 긴장을 풀고 잠으로 전환하기 힘들어진다는 것.
그는 “4-7-8 호흡 연습은 휴식과 소화를 담당하는 부교감 신경계를 활성화하는데 도움을 줄 수 있고, 이것이 교감 활동을 감소시켜 몸을 보다 편안한 수면으로 이끌 수 있다”고 덧붙였다. 부교감 시스템의 활성화는 불안한 뇌가 ‘왜 잠이 안올가?’라는 생각에서도 벗어나게 도와준다.
그러나 4-7-8 호흡과 수면 및 다른 건강상의 이점 사이에 더욱 명확한 연관성을 확립하기 위해서는 추가적 연구가 필요하다. 이 호흡의 전후를 비교하면 불안, 우울증, 불면증 증상을 줄이는 데 도움이 된다는 일부 증거가 있지만, 대규모 실험은 아직 이뤄지지 않았다.
다스굽타 교수는 “4-7-8 기술은 비교적 안전하지만 초보자라면 처음에는 약간 어지러움을 느낄 수 있다”고 말했다. 정상적 호흡은 산소를 들이마시는 것과 이산화탄소를 내쉬는 것 사이의 균형이다. 숨을 들이마신 것보다 더 많이 내쉬면서 이 균형을 깨뜨릴 때, 체내 이산화탄소의 급격한 감소를 부른다. 그는 “낮은 이산화탄소 수치로 인해 뇌에 혈액을 공급하는 혈관이 좁아지면서, 혈액 공급의 감소가 어지럼증 같은 증상으로 이어진다”고 설명했다. 따라서 그는 천천히 연습하고 완전히 익숙해질 때까지 한 세트 당 3~4회 호흡하는 것을 권장한다.
낮에 햇볕을 쬐며 30분 이상 산책하는 것이 좋다. 밝은 빛에 노출되는 시간이 길면, 몸에서 세로토닌이라는 호르몬이 분비돼 낮 동안 완전히 깨어 있게 된다. 그 결과, 밤에 수면유도 물질인 멜라토닌이 더 잘 분비되어 숙면을 취할 수 있게 된다.
저녁에 하는 가벼운 운동도 수면에 도움이 된다. 저녁 식사 후 산책이나 빨리 걷기는 수면 호르몬인 멜라토닌 분비를 촉진해 수면을 돕는다. 단, 운동은 잠을 깨우는 각성효과가 있어 신체가 안정을 찾기까지 1~2시간 정도가 걸리므로 잠들기 최소 2시간 전에 운동을 마치는 것이 좋다.
잠자리에 들기 전에는 체온을 약간만 떨어트리는 것이 좋다. 더위를 쫓기 위해 찬물로 샤워를 하면 중추신경이 활성화돼 시간이 지나면 오히려 체온이 올라간다. 때문에 미지근한 물로 샤워하거나 반신욕을 해 근육을 이완시키면 심리적으로도 안정이 된다. 이밖에 잠잘 때 수면안대와 귀마개를 착용하면 주변 환경에 영향을 덜 받아 숙면에 도움이 된다.
Falling asleep or coming down from anxiety might never be as easy as 1-2-3, but some experts believe a different set of numbers — 4-7-8 — comes much closer to doing the trick.
The 4-7-8 technique is a relaxation exercise that involves breathing in for four counts, holding that breath for seven counts and exhaling for eight counts, said Dr. Raj Dasgupta, a clinical associate professor of medicine at the University of Southern California’s Keck School of Medicine, via email.
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Also known as the “relaxing breath,” 4-7-8 has ancient roots in pranayama, which is the yogic practice of breath regulation, but was popularized by integrative medicine specialist Dr. Andrew Weil in 2015.
“What a lot of sleep difficulties are all about is people who struggle to fall asleep because their mind is buzzing,” said Rebecca Robbins, an instructor in medicine at Harvard Medical School and associate scientist in the division of sleep and circadian disorders at Brigham and Women’s Hospital in Boston. “But exercises like the 4-7-8 technique give you the opportunity to practice being at peace. And that’s exactly what we need to do before we go to bed.”
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“It does not ‘put you to sleep,’ but rather it may reduce anxiety to increase likelihood of falling asleep,” said Joshua Tal, a New York state-based clinical psychologist.
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How 4-7-8 works
The 4-7-8 method doesn’t require any equipment or specific setting, but when you’re initially learning the exercise, you should sit with your back straight, according to Weil. Practicing in a calm, quiet place could help, said Robbins. Once you get the hang of it, you can use the technique while lying in bed.
During the entire practice, place the tip of your tongue against the ridge of tissue behind your upper front teeth, as you’ll be exhaling through your mouth around your tongue. Then follow these steps, according to Weil:
Completely exhale through your mouth, making a whoosh sound.
Close your mouth and quietly inhale through your nose to a mental count of four.
Hold your breath for a count of seven.
Exhale through your mouth, making a whoosh sound for a count of eight.
Repeat the process three more times for a total of four breath cycles.
Keeping to the ratio of four, then seven and then eight counts is more important than the time you spend on each phase, according to Weil.
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“If you have trouble holding your breath, speed the exercise up but keep the ratio (consistent) for the three phases. With practice you can slow it all down and get used to inhaling and exhaling more and more deeply,” his website advised.
What research shows
When you’re stressed out, your sympathetic nervous system — responsible for your fight-or-flight response — is overly active, which makes you feel overstimulated and not ready to relax and transition into sleep, Dasgupta said. “An active sympathetic nervous system can cause a fast heart rate as well as rapid and shallow breathing.”
The 4-7-8 breathing practice can help activate your parasympathetic nervous system — responsible for resting and digesting — which reduces sympathetic activity, he added, putting the body in a state more conducive to restful sleep. Activating the parasympathetic system also gives an anxious brain something to focus on besides “why am I not sleeping?” Tal said.
While proponents may swear by the method, more research is needed to establish clearer links between 4-7-8 and sleep and other health benefits, he added.
“There is some evidence that 4-7-8 breathing helps reduce anxious, depressive and insomniac symptoms when comparing pre- and post-intervention, however, there are no large randomized control trials specifically on 4-7-8 breathing to my knowledge,” Tal said. “The research on (the effect of) diaphragmatic breathing on these symptoms in general is spotty, with no clear connection due to the poor quality of the studies.”
A team of researchers based in Thailand studied the immediate effects of 4-7-8 breathing on heart rate and blood pressure among 43 healthy young adults. After participants had these health factors and their fasting blood glucose measured, they performed 4-7-8 breathing for six cycles per set for three sets, interspersed with one minute of normal breathing between each set. Researchers found the technique improved participants’ heart rate and blood pressure, according to a study published in July 2022.
When researchers have observed the effects of breathing techniques like 4-7-8 breathing, they have seen an increase in theta and delta brain waves, which indicate someone is in the parasympathetic state, Robbins said. “Slow breathing like the 4-7-8 technique reduces the risk of cardiovascular disease and type 2 diabetes and improves pulmonary function.”
What to expect
The 4-7-8 technique is relatively safe, but if you’re a beginner, you could feel a little lightheaded at first, Dasgupta said.
“Normal breathing is a balance between breathing in oxygen and breathing out carbon dioxide. When you upset this balance by exhaling more than you inhale, (it) causes a rapid reduction in carbon dioxide in the body,” he said. “Low carbon dioxide levels lead to narrowing of the blood vessels that supply blood to the brain. This reduction in blood supply to the brain leads to symptoms like lightheadedness. This is why it is often recommended to start slowly and practice three to four cycles at a time until you are comfortable with the technique.”
The more you practice the 4-7-8 technique, the better you’ll become, and the more your body and mind will incorporate it into your usual roster of tools for managing stress and anxiety, Dasgupta said. Some people combine this method with other relaxation practices such as progressive muscle relaxation, yoga, mindfulness or meditation.
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Unmanaged stress can rear its head in the form of sleep difficulties, Robbins said. “But when we can manage our stress over the course of the day (and) implement some of these breathing techniques, we can put ourselves in the driver’s seat instead of being victim to events that happen in our lives.”