Can a person with anxiety and insomnia try breathwork?

Question

Hello doctor,

I am 44 and struggle with anxiety and poor sleep. Many people recommend deep breathing, but sometimes focusing on my breathing makes me feel worse. My chest feels tight, and I become even more anxious. I would like to improve my sleep without relying on medication if possible, but I am worried about trying techniques that might backfire.

Is there a safer way to approach breathwork, or should I avoid it altogether?
Can someone with an anxiety disorder at 44 safely try breathwork without triggering panic?

My insomnia tends to worsen my anxiety, and the nights often feel long and lonely. I just want to be able to rest without feeling afraid. It is difficult to know what is genuinely helpful and what might be unhelpful when so much advice seems to take a one-size-fits-all approach.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

The condition you are experiencing makes a lot of sense, and it is actually quite common in people with anxiety disorders. Breath-focused techniques can sometimes backfire because directing attention inward, especially toward breathing, can unintentionally heighten body awareness and trigger a panic response.

So, the issue is not that you are doing it wrong; it is simply that this approach is not suitable for everyone in the same way.

You do not need to avoid all relaxation strategies, but it may help to move away from intense breath-focused exercises and instead use grounding techniques that keep your attention slightly external. Examples include noticing the feeling of your body against the bed, listening to a neutral sound, or gently identifying objects in the room.

If you would still like to try breathing exercises, a gentler approach may be more comfortable. Rather than trying to control, deepen, or slow your breathing, allow it to occur naturally while simply noticing it in the background. Effortful breathing exercises can sometimes increase anxiety in people who are sensitive to panic symptoms.

Many people with panic sensitivity find greater benefit from techniques that engage the senses or muscles rather than focusing on breathing alone. Examples include gentle progressive muscle relaxation or guided audio exercises that keep your attention moving rather than fixed on a single sensation.

For sleep, the goal is not to force relaxation but to reduce the struggle with being awake, as that struggle itself often fuels anxiety and insomnia. If insomnia and panic symptoms occur frequently, it may be worthwhile to discuss cognitive behavioral therapy for insomnia (CBT-I) with a mental health professional, as it is an effective non-medication treatment for chronic insomnia.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.