Breathing Exercises for Autism: Enhancing Well-Being and Reducing Stress

Breathing is something we do automatically, so it might seem strange that it’s something we need to learn. 

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While breathing won’t solve all your problems, learning how to breathe intentionally can change how you respond to them, and that can make a big difference. Breathing exercises offer autistic adults a powerful, science-backed tool for navigating nervous system dysregulation, sensory overwhelm and emotional intensity. 

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These practices don’t need to be rigid or perfect to be effective; rather, they can be tailored to sensory preferences, embedded in daily routines and paired with mindful movement or imagery. Ultimately, breath is more than a survival mechanism—it becomes a means of self-connection, regulation and empowerment.

There’s solid science behind why deep breathing practices can be helpful, particularly for autistic adults whose nervous systems often lean toward dysregulation. 

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The autonomic nervous system has two main branches:

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• The sympathetic nervous system, which handles the fight, flight or freeze responses
• The parasympathetic nervous system, which supports the rest, digest and recovery responses. 

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These systems are meant to work in balance. When one is activated, the other quiets down. For many autistic people, this balance can be harder to maintain, leading to chronic hyperarousal or shutdown states. Plus, many autistic people experience heightened autonomic nervous system dysregulation. Breathwork helps combat this. 

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Slow, intentional deep breathing sends safety signals to the brain, which can lower heart rate, blood pressure and cortisol levels, calming both the body and mind.

Breathing exercises offer many benefits for autistic individuals, including support for nervous system regulation, sensory modulation and emotional regulation.

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Intentional breathing doesn’t erase stressors, but it gives us more control over how we respond to them. Even just pausing to notice your breath can start to shift your state, one breath at a time.

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Autism is often accompanied by hypersensitivity or hyposensitivity to sensory input, which can lead to sensory overload. Breathing can serve as a grounding tool, helping to anchor attention and bodily awareness in a way that reduces overwhelm. It can also support the development of interoception—the awareness of these internal body signals—to promote self-care. 

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Emotional regulation challenges are common among autistic individuals, particularly under stress. Breathing exercises can help manage escalating emotions before they lead to shutdowns or meltdowns. 

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Of course, not all breathing techniques are comfortable or effective for everyone. But for many, breathwork offers a science-backed, empowering tool that can be adapted to meet individual needs.

These simple, sensory-considerate breathing exercises support nervous system regulation, sensory grounding and emotional regulation. They can be adapted or combined to suit individual needs and preferences.

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Just paying attention

How to do it:

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1. Inhale gently through the nose
2. Exhale slowly through the mouth
3. Breathe at a comfortable pace that feels right for your body

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What it does: Even just paying attention to our breath helps to regulate us. It’s a gentle way to begin breath awareness without rules or counting. 

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How it works: Engaging conscious awareness of breath activates the prefrontal cortex and helps shift attention away from sensory overwhelm or intrusive thoughts.

Belly breathing (AKA diaphragmatic breathing)

How to do it:

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1. Place one hand on your chest and one on your belly
2. Breathe so your belly rises and falls (not your chest)
3. You can also place a stuffed animal on your belly to watch it move

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What it does: Belly breathing promotes calm and anchors attention gently to the body.

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How it works: It encourages vagus nerve activation and lowers sympathetic nervous system arousal by increasing oxygen exchange and reducing shallow chest breathing.

Square breathing (AKA box breathing) 

How to do it:

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1. Inhale for 4 seconds
2. Hold for 4 seconds
3. Exhale for 4 seconds
4. Hold for 4 seconds
5. Repeat 3–5 times

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What it does: It’s structured and rhythmic, helpful for transitions or emotional overwhelm. The predictability may feel soothing.

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How it works: Box breathing can activate the parasympathetic nervous system, aiding stress reduction.

Breathing with hand tracing

How to do it:

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1. Spread out one hand with your fingers wide
2. With one finger on your other hand, slowly trace up one finger while you inhale, and trace down the finger while you exhale
3. Repeat across all fingers

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What it does: It combines tactile feedback with breath pacing, which supports sensory grounding. 

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How it works: Combining tactile input with breathing may reduce arousal and improve interoceptive awareness.

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Pursed lip breathing

How to do it:

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1. Inhale through the nose
2. Exhale through pursed lips (as if blowing out a candle)

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What it does: Exhaling through pursed lips naturally slows breathing and reduces effort, which is useful during anxiety spikes.

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How it works: It increases back-pressure in the airways and slows exhalation, which improves carbon dioxide regulation.

Equal (resonant or coherent) breathing 

How to do it:

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1. Inhale for a count of 5
2. Exhale for a count of 5
3. Aim for ~5–6 breaths per minute

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What it does: It supports calm by keeping your inhales and exhales balanced.

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How it works: By maintaining balance between inhalation and exhalation phases, you optimize heart rate variability (HRV), which is linked to emotional regulation and cognitive flexibility.

4-7-8 breathing 

How to do it:

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1. Inhale through your nose for 4 seconds
2. Hold for 7 seconds
3. Exhale through your mouth for 8 seconds

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What it does: It helps settle the nervous system, and it’s often used to support sleep or reduce sensory overload.

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How it works: Extending the exhale phase activates the parasympathetic system, aiding in recovery from sensory and emotional stress.

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Breathing exercises can also be paired with sensory tools or elements to enhance accessibility and effectiveness. Here are five examples.

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Using imagery

There are various ways you can incorporate imagery into your breathwork. Two examples are:

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• Color breathing: Inhale while imagining a calming color (like blue) entering your body, and then exhale while you visualize stress leaving as another color (like gray or red).
• Balloon visualization: Imagine inflating a balloon with each breath in and deflating it with each breath out. (Note: if you have aphantasia and struggle to create mental images, you can use your hands to mimic the shape of the balloon).

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What it does: It engages imagination and visual thinking, especially for those who think in images.

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How it works: Imagery is widely used in therapeutic and meditative practices, but limited empirical evidence shows that specific imagery has measurable physiological effects. 

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Nature-paced breathing

How to do it:

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• Breathe in and out along with the rhythm of natural sounds like ocean waves, rain or birdsong. You can do this in person, through audio recordings, or via an app like Noisli.

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What it does: Natural pacing can support sensory modulation and feel less clinical than timers or counting.

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How it works: Natural sounds are scientifically proven to reduce stress.

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Pairing 5-4-3-2-1 grounding with breathing

How to do it:

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1. Name 5 things you can see: Take a slow, deep inhale through your nose as you begin scanning your surroundings. With each exhale, name one thing you see. Repeat this for five breath cycles.
2. Name 4 things you can feel or touch: On your inhale, bring awareness to the part of your body making contact. With each exhale, name one sensation. Repeat this for four breath cycles.
3. Name 3 things you can hear: Inhale and notice ambient sounds. On each exhale, name one sound. Repeat this for two breath cycles.
4. Name 2 things you can smell: Tune into any scents with your inhale. On each exhale, name what you notice. Repeat this for two breath cycles..
5. Name 1 thing you can taste: Take a mindful inhale, and note the taste with your exhale.

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What it does: It combines mindfulness and sensory grounding, which is great during shutdowns or dissociation.

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How it works: Combining breath with sensory scanning activates brain regions that interrupt shutdown or dissociation patterns.

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Linking movement and breath

How to do it:

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• Walk and match breath to steps (inhale for four steps; exhale for four steps, and adjust based on comfort) 
• Use dynamic stretches or gentle rocking to cue breath rhythm (inhale as you expand a stretch; exhale as you contract, or inhale as you gently rock to one side, and exhale as you gently rock to the other) 

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What it does: Linking breath to movement can reduce perceived stress and support autonomic regulation.

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How it works: It promotes emotional regulation, reduces physical tension and supports nervous system balance.

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Progressive muscle relaxation

How to do it:

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• Gently tense one muscle group at a time as you inhale, hold for a few seconds, then slowly release the tension as you exhale. Move progressively from head to toe (or vice versa), noticing the contrast between tension and relaxation.

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What it does: It integrates body awareness with relaxation and regulation.

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How it works: It reduces somatic tension in the body while reducing anxiety.

Various tools are available to help learn and practice breathing exercises. Guided apps include:

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• Breathe+ (iOS): A visual breathing pacer with a customizable timer. Minimalist and sensory-friendly—no sound or talking.
• Breathwrk (iOS/Android): Offers short breathing routines for stress relief, energy and focus. Visual and audio guidance can be turned off or customized.
• Insight Timer: A free meditation and breathing app with thousands of guided sessions. 
• Smiling Mind: Designed by psychologists, this free app offers structured mindfulness and breath programs. Includes adult and neurodivergent options.

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You can also use printable and offline tools such as:

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• Designing your own chart to include when, where and how long to practice breathing exercises. You can create your own on Canva or with icons from Flaticon. 
• Browsing Therapist Aid for breathing worksheets, interactive activities and videos.

Ready to breathe easier? Whether you’re navigating autistic burnout, anxiety or simply looking for ways to feel more grounded, Prosper Health is here to help. We’re not here to “fix” you, we’re here to affirm, support and collaborate with you on your terms. 

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From adult autism assessments to neurodiversity-affirming therapy, Prosper Health provides the care you need. Plus, therapy is a great place to learn and practice breathing exercises and other coping strategies. Take the next step by scheduling your evaluation or therapy intake today.