Cyclic Sighing: How Breathwork Can Improve Mood and Stress
If you’ve ever sighed deeply after a long day and felt your body soften just a little—that wasn’t random.
That was your nervous system’s way of self-regulating. And now, science shows we can harness that reflex on purpose to reduce stress. And less stress in the body means less pain and inflammation and more healing—especially for women with endometriosis or chronic pelvic floor dysfunction.
What Is the Physiological Sigh?
The physiological sigh is a naturally occurring breathing pattern that involves:
Two inhales (a short second inhale stacked on top of a deeper first inhale)
Followed by a long, extended exhale
This breath pattern happens spontaneously during sleep and emotional relief. But when done intentionally—even for just 5 minutes a day—it can powerfully shift the nervous system from fight-or-flight into rest-and-restore.
In a 2023 randomized controlled study led by researchers at Stanford, participants who practiced cyclic sighing daily for one month had:
The greatest improvement in mood,
The greatest reduction in stress and anxiety, and
The greatest decrease in respiratory rate, compared to both other breathwork methods and mindfulness meditation (Balban et. al., 2023).
Why does that matter?
How Breath Influences the Nervous System and Pain
Breathing isn’t just about oxygen. It’s a direct line to your autonomic nervous system, which controls stress, digestion, hormone regulation, and—yes—pelvic floor tension.
When you're in a chronic state of stress (which is common for women living with endometriosis or persistent pain), your breath becomes shallow, your muscles brace—including your pelvic floor—and your pain sensitivity increases due to heightened sympathetic tone and central sensitization.
But long exhales, like those in the physiological sigh, increase vagal activity—the part of the nervous system responsible for calm, digestion, and repair. In the study, slower respiratory rates were strongly correlated with higher positive mood and lower physiological arousal.
This matters because:
“Voluntary control over breathing—especially with extended exhalation—can directly influence heart rate, vagal tone, and the emotional regulation centers of the brain, including the amygdala and insula” (Balban et al., 2023).
Why It Helps Women with Endometriosis and Pelvic Pain
For women with endometriosis, pelvic floor dysfunction often goes hand-in-hand with nervous system dysregulation:
Pain can increase pelvic muscle guarding
Guarding creates more pain signals
Pain signals elevate stress hormones
Stress suppresses the body’s natural anti-inflammatory and pain-relieving mechanisms
This creates a vicious loop of pain → tension → stress → more pain.
Practicing the physiological sigh offers a way to break that loop—gently, safely, and consistently.
It supports:
Downregulation of the nervous system (shifting from sympathetic to parasympathetic dominance)
Relaxation of pelvic floor muscles on the exhale
Improved interoceptive awareness, helping women tune into and reframe internal sensations
A sense of control over their body, which is often lost in chronic illness and trauma contexts
“Controlled breathing may provide more immediate relief than passive mindfulness by directly shifting physiology, especially in those who struggle with a sense of control—a hallmark of anxiety and chronic pain” (Balban et al., 2023).
How to Practice the Physiological Sigh
Try this at home, in bed, or anywhere you feel safe:
Inhale slowly through your nose until your lungs feel comfortably full
Take a second, shorter inhale to expand the upper lungs
Exhale slowly through your mouth with an audible long sigh
Repeat for 1–5 minutes (cyclic sighing)
Let your body soften on each exhale. Let your pelvic floor respond passively—no forcing.
Less Tension, More Ease
The path to pelvic healing doesn’t always start with exercise or internal work. Sometimes, it starts with the nervous system—with safety, softness, and small rituals that shift how we relate to our body.
The physiological sigh is one of those rituals. Backed by science. Free to practice. And gentle enough to meet you wherever you are on your journey.
If you’re navigating endometriosis, pelvic pain, or feeling disconnected from your body, this is one breath you can always come back to.
Need support?
At Occupelvic Health and Wellness, we specialize in helping women reconnect to their inner core, reduce pain, and restore confidence through integrated and holistic nervous system-focused pelvic health care. Reach out to explore virtual one-on-one support.
In Health,
Karla Ehlers, OTR/L, MOT, PCES, TIPHP
Owner, Occupelvic Health and Wellness
References
Balban MY, Neri E, Kogon MM, Weed L, Nouriani B, Jo B, Holl G, Zeitzer JM, Spiegel D, Huberman AD. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine, 4(1), 100895. https://doi.org/10.1016/j.xcrm.2022.100895
Want to learn other ways to tap into your nervous system to heal your pain from the inside out?
Check out our 30 minute masterclass “Living Well with Persistent Pain” created for women with endometriosis and other pelvic pain conditions to learn how science backed brain-based therapies can help break your pain cycle. Your pain isn’t all in your head. But pain does change your brain and can cause increased anxiety and depression which can further exacerbate your pain experience. Check out the masterclass below.
