Breathing Techniques for Chronic Fatigue Syndrome and Fibromyalgia

Breathing Techniques for Chronic Fatigue Syndrome and Fibromyalgia


Something has gone wrong with the breathing in chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM). Many people with these disorders report they find it difficult to take deep breaths and that they regularly experience shallow breathing.

Studies suggest that chemically induced hyperventilation caused by blood pressure problems when standing or during exercise may be present in many people with ME/CFS/FM and/or postural orthostatic tachycardia syndrome (POTS). Dr. David Systrom, a pulmonologist who employs invasive exercise testing, has reported that hyperventilation commonly occurs during exercise in ME/CFS/FM and POTS patients.

Dr. Charles Lapp has reported that the hunched over posture seen in many ME/CFS/FM patients also increases the difficulty of taking the deep relaxing breathes so important.

The breathing issues found and the need rebalance an autonomic nervous system which many studies indicate is tilted toward the ("fight or flight") sympathetic nervous system make breathing techniques a natural for these disorders.

The autonomic nervous system is one of the few systems in the body we have control over. Employing breathing techniques over time may allow it to reset improving calmness, sleep, and even cognition and reducing pain.

One of the first techniques Staci Stevens, an exercise physiologist with ME/CFS, employs with ME/CFS/FM clients is to have them take deeper breaths.

Breathe To Heal

To get started you might want to check out a popular Tedd Talk by Max Strom called "Breathe to Heal"

Waiting To Exhale...

The exhalation (or relaxation) phase of the breath tends to be inhibited in ME/CFS/FM. Simply by lengthening one's exhalations while breathing through one's nose (or if that doesn't work one's mouth) can induce a state of calm and reduce pain and tension.

Several of the techniques on this page focus on the exhalation phase of the breath. Even if you don't do the techniques on this page, pausing every now and then to do long exhales can be helpful.


Dr. Friedberg, a clinical psychologist with chronic fatigue syndrome (ME/CFS), uses breathing techniques in his “Seven Steps to Less Pain and More Energy” book for ME/CFS and fibromyalgia (FM) patients.

He recommends that people with ME/CFS/FM begin with 10 minutes of focused breathing/meditative techniques in the morning and evening and work up to as much as an hour a day. Friedberg has found that these practices can greatly help ME/CFS/FM patient reduce insomnia and enter in deeper sleep more quickly.
"While sitting in a comfortable chair or lying down and breathing through your nose say silently to yourself ‘reee’ as you inhale and ‘laaaxxx’ as you exhale."

The Buteyko Breathing Method

The Buteyko breathing method has been recommended for ME/CFS/FM.

  1. Take 2 normal breaths, then breathe out for as long as you can.
  2. While keep your mouth shut take shallow breaths for your nose for 5 minutes. Then take two normal breaths and then breathe out as long as you can.
  3. Do these two steps several times in a row (for now more than 25 minutes) at least once a day.

Dr. Weil’s Regulated 4-7-8 Breath Holding Technique

Dr. Cheney recommends using Dr. Weil's breathing technique which also uses an extended exhalation phase. Dr. Cheney believes that when done consistently, Weil's technique can increase blood oxygen levels.
  1. Inhale through your nose for four seconds
  2. Hold your breath for seven seconds
  3. Exhale through tightly pursed lips, creating “back pressure,” for eight seconds
  4. Do this eight times, twice a day, everyday

Alternate Nostril Breathing

Alternate nostril breathing is believe to induce the ‘rest and digest’ response and reduce the ‘flight or fight response’ - just what is needed in ME/CFS/FM. It is often used to calm the mind down at the beginning of meditation sessions.

Ashok Gupta, the creator of the Amygdala Retraining Program (and a former ME/CFS/FM patients) recommends using alternate nostril breathing as a calming mechanism.

More Breathing Techniques

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When I tried Wim Hof techniques it was extremely painful, which shouldn't be a symptom. After blood clot resolution (multiple PE), I did this yoga thing where I wrapped my elbows around a straight object like a broom handle and breathed. It was more comfortable and I still do that. It can be found in the Iyengar book which is probably my favorite yoga book. (It's a big heavy textbook type of book, and not very user friendly but it has great stuff in it). Thanks for pulling together all these methods in one place. Very helpful!

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