Anuloma Viloma Timer
Mental Health Awareness Month closes tomorrow. I want to use this window to talk about a piece of research that has not received nearly enough attention in the breathwork space.
In September 2025, researchers at the University of Sussex and the University of Brighton published a study in PLOS One that captured something remarkable: using live brain imaging, they documented breathwork-induced altered states of consciousness and mapped the corresponding changes in brain blood flow. The finding was that breathwork shifts blood flow in the same brain regions associated with certain controlled substances. Just breath. No prescription, no clinical setting, no side effects.
The paper: “Breathwork can induce altered states of consciousness linked with changes in brain blood flow.” Source: EurekaAlert, University of Sussex broadcast.
What the study actually measured
This was the first neuroimaging study of its kind to specifically map breathwork-induced changes in cerebral blood flow against reported subjective experience. Participants who reported altered states during breathwork sessions showed measurable changes in regional blood flow that matched the phenomenology they described. The researchers were not claiming breathwork is equivalent to psychedelic substances in mechanism or effect. What they found is that the brain regions implicated in consciousness and self-perception respond to breath in a way that is physiologically measurable, not merely reported.
That distinction matters. It moves breathwork from the category of “relaxation technique” into a category that requires a more rigorous frame: a practice that directly modulates brain physiology.
The difference between activating breathwork and rhythmic pranayama
The technique studied was Conscious Connected Breathwork (CCB), a continuous circular breathing pattern that is deliberately activating, designed to produce altered states as part of a therapeutic or exploratory session. This is structurally different from the slow-paced, rhythmic alternating pattern of Anuloma Viloma.
CCB activates. Anuloma Viloma regulates.
Both work through the breath, but toward different ends. CCB uses sustained hyperventilation to shift CO2 levels and alter consciousness deliberately. Anuloma Viloma uses a 1:4:2 inhale-hold-exhale ratio through alternating nostrils to activate the parasympathetic nervous system, shift sympathovagal balance, and create a calm, clear physiological state without disorientation.
If CCB is the accelerator, Anuloma Viloma is the calibration. The Sussex study demonstrates that breath can reach the brain at the level of blood flow and regional activation. Anuloma Viloma is one of several breathing techniques that operate in that same neurological space, just through a different mechanism and toward a different outcome.
Why this matters for Mental Health Awareness Month
Forty percent of people globally report high anxiety on any given day, per the most recent Gallup data across 144 countries. Mental health care is still primarily pharmacological and talk-based, and access is still deeply uneven. The Sussex study adds to a growing body of evidence that breath-based practices reach the same physiological targets as interventions that require a prescription, a clinical setting, or both.
This is not a claim that breathwork replaces medication or therapy. It is a claim that breath deserves to sit in the same conversation, not as an alternative but as an adjunct with measurable neurophysiological action.
A separate 2026 randomised controlled trial (Journal of Affective Disorders, 107 adults, six weekly online sessions of Conscious Connected Breathwork) found an anxiety effect size of 1.44. Most pharmaceutical anxiety trials report 0.3 to 0.5. That number is not from a wellness blog. It is from a peer-reviewed RCT published in a clinical psychiatry journal.
Both studies point in the same direction: the breath is not a soft signal. It is a direct line to brain physiology.
The practice
Anuloma Viloma (Nadi Shodhana) is alternating-nostril breathing. Right thumb closes the right nostril for the inhale, right ring finger closes the left nostril for the hold and exhale, then the pattern alternates. The classical ratio is inhale 4 counts, hold 16 counts, exhale 8 counts, though any consistent ratio maintains the underlying mechanism.
The practice takes 5 to 15 minutes. You do not need a mat, a studio, or a subscription. The Apple Watch integration in the app shows real-time heart rate throughout the session.
After a single 15-minute session of Nadi Shuddhi Pranayama (the same practice), researchers at an Indian institution measured an immediate shift in sympathovagal balance via ECG in 40 healthy adults aged 20-40 who were completely naive to pranayama (PMC12331837, Applied Psychophysiology and Biofeedback, Springer, April 2025). Not after weeks of practice. After one session.
What to do with this
If Mental Health Awareness Month has brought you here looking for something that works through physiology rather than just mindset, Anuloma Viloma is worth five minutes of your time today.
The Sussex study shows the brain responds to breath at the level of blood flow. The CCB RCT shows breathwork produces effect sizes that clinical psychiatry would consider large. The HRV study shows the sympathovagal response does not wait for a 30-day streak to begin.
You do not need to wait for anything.
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