Breathwork

What is Pulsing Breath?

Pulsing Breath is a Middendorf Breathwork practice of noticing the subtle, living pulse and micro-variations within each breath, letting the breath move on its own rather than shaping it.

Limited Evidence

Last Updated

3 Jul 2026

We are still reviewing this page. Our research team checks every technique page for accuracy and evidence quality before final release. Details may change as that review completes. The evidence badge shows our current reading of the published research.

RECOMMENDED DOSE

How Much Pulsing Breath Should You Do?

No direct dose-response literature exists for this technique. This short, low-commitment starting range reflects general practice conventions for breathwork and lets newcomers build comfort with the pattern. No direct dose evidence; editorial synthesis.

No direct dose-response literature exists for this technique. This range represents a modest step up in session length and consistency once the basic pattern feels comfortable, based on general breathwork conventions. No direct dose evidence; editorial synthesis.

No direct dose-response literature exists for this technique. This maintenance-level range reflects a committed daily practice and should only be attempted after building tolerance at lower stages. No direct dose evidence; editorial synthesis.

Session length

Session length: 5–10 minutes

MIN

How long each individual practice session should last from start to finish.

Frequency

Frequency: 3–4 days

DAYS

The number of days per week to fit a session into your routine.

Session length

Session length: 10–20 minutes

MIN

How long each individual practice session should last from start to finish.

Frequency

Frequency: 5 days

DAYS

The number of days per week to fit a session into your routine.

Session length

Session length: 20–30 minutes

MIN

How long each individual practice session should last from start to finish.

Frequency

Frequency: 7 days

DAYS

The number of days per week to fit a session into your routine.

About this card. These recommendations are not a substitute for personalised guidance from a qualified practitioner. No direct dose-response literature was found for this technique, so all figures are conservative starting points based on general breathwork conventions.

Common questions about Pulsing Breath

Quick answers to what people most often ask. Each card links to the deeper section below.

evidence

What does the research say about Pulsing Breath?

No research has studied Pulsing Breath directly, so there are no evidence-backed benefit claims for this specific practice. Its proposed effects—steadier attention and a finer sense of the body—come from the Middendorf teaching tradition and broader work on focused attention and interoception, treated as possibilities to explore rather than proven outcomes.

good for

Who is Pulsing Breath good for?

Pulsing Breath suits people already familiar with gentler Middendorf breath practices who want to refine how finely they can sense the body and steady a busy mind. Because no studies have examined it, no benefit is established for any group, and it is not a substitute for care when anxiety, trauma, or a respiratory or cardiac condition is significant.

safety

Is Pulsing Breath safe?

Most healthy adults can practise Pulsing Breath safely, since it involves receptive noticing rather than forced or paced breathing. People living with trauma, panic disorder, health anxiety, or dissociation should approach with care and ideally a facilitator, because close attention to internal body signals can amplify breathlessness or detachment. No safety trials specific to this practice exist.

how it works

How does Pulsing Breath work?

Pulsing Breath is thought to work by giving attention one subtle thing to rest on—the fine pulse inside each breath—which can loosen the grip of looping, ruminative thoughts. Broader research on focused attention suggests anchoring attention this way reduces mind-wandering, while the Middendorf tradition holds that closely sensing the breath trains awareness of the body's internal signals.

For clinicians, researchers, and curious readers

What's in a session?

How does it work?

What does it do to the body?

What is it used for?

What does the research say?

Where does it come from?

Is it safe?Who should practise with care?How to practise safely?

How does it compare?

What does a Pulsing Breath session involve?

Pulsing Breath is a Middendorf Breathwork practice of resting attention on the subtle, living pulse and micro-variations in pressure, speed, and depth within each breath, without trying to control it.

You sit or lie quietly and rest attention on the fine pulse inside each breath, noticing tiny variations in pressure, speed, and depth rather than imposing a rhythm. The breath is allowed to come and go on its own while awareness stays receptive to its texture. It is one of the subtlest forms in the Middendorf tradition, usually introduced only after foundational practices such as Perceptible Breath and Breath Dialogue, so it is approached gradually and often with a teacher.

Pulsing Breath is not a paced or controlled breathing technique: nothing is counted, slowed, or forced, and it does not aim at a fixed physiological target. It differs from breathwork styles that drive strong sensations through fast or deep breathing, and from relaxation routines with a set rhythm. It is a refined, receptive noticing practice within Middendorf Breathwork, distinct from foundational Middendorf practices such as Perceptible Breath, and it is not a treatment for any medical or psychological condition.

Not to be confused with

Controlled breathwork (pranayama, box breathing, deep breathing exercises)

Those practices deliberately change the breath's pace or depth to produce an effect. Pulsing Breath does the opposite: it leaves the breath alone and only attends to the tiny variations already present, so it is noticing, not controlling.

Cathartic or high-intensity breathwork (holotropic, rebirthing)

Cathartic breathwork uses fast or forceful breathing to provoke strong emotional and physical release. Pulsing Breath is slow, subtle, and receptive, aimed at fine sensory attention rather than intensity or catharsis.

Heart rate variability (HRV) biofeedback

HRV biofeedback pairs paced breathing with a device that tracks physiological signals to train a target rhythm. Pulsing Breath uses no device and no target; the practitioner simply senses the natural micro-pulse within each breath.

How does Pulsing Breath work?

Pulsing Breath is thought to work by giving attention one subtle thing to rest on, the fine pulse inside each breath, which can loosen the grip of looping, ruminative thoughts. Research on focused attention broadly, not Pulsing Breath specifically, suggests that anchoring attention this way reduces mind-wandering. The Middendorf tradition adds that closely sensing the breath trains interoceptive awareness, the capacity to read your body's own internal signals. Both are best treated as plausible pathways rather than tested effects for this particular practice.

Possible Mechanisms

Interoceptive Awareness

Many people describe feeling more settled in the body and quicker to catch the first flickers of tension before they build. Attending to the tiny shifts in pressure, speed, and depth inside each breath is thought to train interoceptive awareness, the ability to read your body's own internal signals. Because no study has tested Pulsing Breath directly, treat this as a plausible pathway rather than a proven effect.

Attentional Anchoring

Racing, looping thoughts tend to lose their grip when attention has one clear thing to rest on. In Pulsing Breath, the fine pulse inside each breath becomes that anchor, giving a wandering mind a specific sensation to return to instead of the next worry. This is drawn from the Middendorf tradition and general research on focused attention rather than from studies of the practice itself, so treat it as a plausible way it may work.

What does Pulsing Breath do to the body?

No physiological changes have been measured for Pulsing Breath, so what follows is what practitioners tend to feel rather than what instruments have recorded. As attention settles onto the breath, many people notice the body growing quieter and steadier, breathing softening on its own, and a finer sense of small internal shifts, the flickers of tension or ease that usually pass unnoticed. Because attention stays receptive rather than controlling, the breath is allowed to find its own pace instead of being deliberately slowed.

What is Pulsing Breath used for?

Emerging evidence only. No clinical trial has tested Pulsing Breath, so there are no evidence-backed benefit claims for this specific practice. Within the Middendorf tradition it is taught to deepen presence, body awareness, and steadier focus, and general research on focused-attention and breath-awareness practices makes those directions plausible rather than confirmed. What is not yet supported: any controlled trial, effect-size estimate, or claim that it treats anxiety, sleep problems, or a diagnosed condition.

What does the research say about Pulsing Breath?

No research has studied Pulsing Breath directly. Its proposed benefits, steadier attention and a finer sense of the body, are drawn from the Middendorf teaching tradition and from broader work on focused attention and interoception, not from trials of this practice, its dose, or any population. The honest position is that these remain tradition-informed possibilities to explore, and the available description speaks to where the practice comes from and how it is taught rather than to any clinical effect.

The available material sets expectations from tradition, not measurement. Treat any reported benefit as general, individual experience rather than a promise about a single session, and not a replacement for clinical care.

Read the full reference list

Where does Pulsing Breath come from?

Pulsing Breath comes from Middendorf Breathwork, the tradition developed by Ilse Middendorf in mid-twentieth-century Germany, and from its concept of 'breath vitality,' the idea that each breath carries a living, dynamic quality perceptible only when attention is refined. It is considered one of the subtlest practices in that lineage, sequenced after foundational work such as Perceptible Breath and Breath Dialogue. These roots help explain the practice's form, its slow, non-directive attention to the breath's own movement, not any clinical effect.

Is Pulsing Breath safe?

Pulsing Breath is low-risk for most healthy adults, because it rests on gentle, receptive noticing of the breath rather than any forced or paced breathing. A few situations call for a slower, guided approach. Turning close attention inward to interoceptive signals, the subtle internal cues of pressure, movement, and tension within each breath, can make those sensations feel louder, settling for some people, but unsettling for others who are prone to panic or body-focused anxiety. These cautions are practice-informed and inferred from how the practice works, not drawn from safety trials, since no research specific to Pulsing Breath has been identified. They reflect reasonable care rather than evidence of harm, and the practice is not a substitute for treatment of any respiratory, cardiac, or mental-health condition.

Who should practise with care?

People living with trauma, panic disorder, health anxiety, or dissociative experiences should approach Pulsing Breath carefully, and ideally with a facilitator, because heightened attention to internal body signals can amplify a sense of threat, breathlessness, or detachment rather than easing it. This is a practice-informed concern inferred from the mechanism, not a measured risk. Because Pulsing Breath is one of the subtlest practices in the Middendorf tradition and is usually introduced only after foundational breath work, beginners attempting it alone may find it frustrating or over-focused. Anyone with a significant respiratory or cardiovascular condition should follow their usual medical guidance, since no data address safety in these groups.

Panic disorder or health anxiety

lowpractice-informed

Turning close attention inward to the subtle internal cues of pressure, movement, and tension within each breath can make those sensations feel louder. For people prone to panic or health anxiety, that heightened focus can amplify a sense of breathlessness or threat rather than easing it. Keep sessions short, widen your attention to the room or your contact with the floor or chair if fear rises, and let the breath return to normal. This caution is practice-informed, inferred from how the practice works rather than drawn from safety trials.

How does Pulsing Breath compare to similar techniques?

Technique	Best for	Use with care	Evidence strength	Distinction
Perceptible Breath (Middendorf foundational practice)	Beginners building basic breath awareness and a felt sense of where breath moves in the body.		emerging EVIDENCE	Perceptible Breath is the foundational Middendorf practice of letting the breath come and go on its own and noticing where it is felt in the body. Pulsing Breath works at a finer grain, resting attention on the micro-variations in pressure, speed, and depth inside a single breath, and is usually introduced only after Perceptible Breath feels familiar.
Breath Dialogue (Middendorf practice)	Practitioners exploring how attention and gentle prompts shape the breath in a more active, relational way.		emerging EVIDENCE	Breath Dialogue is a Middendorf practice of responsive, back-and-forth attention between the practitioner and the breath, often involving movement or touch cues. Pulsing Breath is quieter and more inward, staying with the subtle intra-breath pulse rather than the larger interplay of breath and body, and it typically follows Breath Dialogue in the learning sequence.

Glossary

Pulsing Breath

A Middendorf Breathwork practice of resting attention on the subtle, living pulse and the tiny variations in pressure, speed, and depth within each breath, without trying to change the breath itself.

Middendorf Breathwork

A tradition of breath practice founded by Ilse Middendorf that works with the unforced, natural breath as something to perceive and allow rather than to control or direct.

Breath vitality

The Middendorf idea that each breath has a living, dynamic quality that can be felt when attention becomes refined enough to notice its subtle inner movement. It is a way of framing the practice, not a measured physical property.

Micro-oscillations (intra-breath pulse)

The small moment-to-moment shifts in pressure, rate, and depth that occur within a single inhale or exhale, rather than between breaths. Sensing these fine changes is the focus of Pulsing Breath.

Interoceptive awareness

The ability to sense and interpret internal body signals such as breath movement, tension, and temperature. Strengthening it tends to feel like being more embodied and noticing rising stress earlier.

Interoception, or visceral afferent processing: the detection and interpretation of internal bodily states, associated with insular and somatosensory processing.

Attentional anchoring

Stabilizing attention on one clear target, here the fine pulse within the breath, so the mind stops repeatedly jumping to worries or distraction. It often feels like fewer spiraling thoughts and somewhere steady to return to.

Focused attention and attentional selection: sustaining focus on a chosen object while reducing mind-wandering and competing salient stimuli.

Full References

[1]other peer reviewed

Sun Feng, Tao Qiu-Shan, Zhan Si-Yan (2008). [Comparison of five different diagnostic criteria on metabolic syndrome applied during physical check-up programs among population aged 35-74, in Taiwan]..

Cited in: –

[2]other peer reviewed

RJ Windle, S. A. Wood, Stafford L. Lightman, C.D. Ingram (1998). The Pulsatile Characteristics of Hypothalamo-Pituitary-Adrenal Activity in Female Lewis and Fischer 344 Rats and Its Relationship to Differential Stress Responses*. https://doi.org/10.1210/endo.139.10.6238

DOI: 10.1210/endo.139.10.6238

Cited in: –

[3]other peer reviewed

Stafford L. Lightman, RJ Windle, María De Julián, Michael S. Harbuz, Nola Shanks, S. A. Wood (2000). Significance of Pulsatility in the HPA Axis. https://doi.org/10.1002/0470870796.ch14

History of trauma or dissociation

lowpractice-informed

Because Pulsing Breath trains attention to subtle internal body signals, that inward focus can amplify a sense of threat, breathlessness, or detachment for some people with a trauma history or dissociative experiences. Approach it gently and ideally with an experienced facilitator or mental-health professional; if distressing sensations arise, ease off and ground your attention in the room. This is a practice-informed concern inferred from the mechanism, not a measured risk, and it is not a substitute for trauma care.

New to Middendorf breath practice

lowpractice-informed

Pulsing Breath is one of the subtlest practices in the Middendorf tradition and is usually introduced only after foundational work such as Perceptible Breath and Breath Dialogue. Beginners attempting it alone may find it frustrating or over-focused. Build from gentler breath-awareness practices first, and keep early sessions short and unforced.

Significant respiratory or cardiovascular condition

lowpractice-informed

No data address the safety of Pulsing Breath in people with respiratory or cardiac conditions. Follow your usual medical guidance, treat the practice as a refinement exercise rather than a treatment, and continue any care you rely on. Pulsing Breath is not a substitute for treatment of any respiratory, cardiac, or mental-health condition.

How to practise safely?

Pulsing Breath is one of the subtlest practices in the Middendorf tradition, so it tends to land best once gentler breath-awareness work already feels familiar and you can turn attention inward without straining for it. A short, unforced session in a quiet spot is a sensible starting shape, resting on the breath's own fine movements rather than any rhythm you impose. If closely sensing internal signals feels activating rather than settling, it is worth easing off and, where a history of trauma, panic, or body-focused anxiety is in the picture, working alongside an experienced facilitator.

Build from the foundations first

Pulsing Breath is an advanced practice traditionally taught after Perceptible Breath and Breath Dialogue. Spend time with gentler breath-awareness practices before attending to the fine intra-breath pulse, so the subtle attention has somewhere familiar to rest.

Let the breath lead

Rest your attention on the natural micro-variations in pressure, speed, and depth within each breath rather than imposing any rhythm. There is nothing to control or correct; you are noticing the breath's own movement, not steering it.

Check how inward focus feels

If closely sensing internal body signals starts to heighten anxiety, breathlessness, or a feeling of detachment, ease off. Widen your attention to the room or to your physical contact with the floor or chair, and let the breath return to normal.

Keep sessions short and unforced

Start with a few minutes and stop while your attention still feels workable, rather than pushing for deeper or more sustained focus. The sense of settling tends to deepen with repetition rather than arriving in one long sitting.

Seek guidance where it helps

If you have a history of trauma, panic, or body-focused anxiety, or if the practice consistently feels activating, work with an experienced Middendorf facilitator or a mental-health professional rather than practising alone.

Keep it alongside, not instead of, care

Treat Pulsing Breath as a refinement practice, not a treatment. Continue any medical or psychological care you rely on for respiratory, cardiac, or mental-health conditions.

Medical Disclaimer

This information is educational and is not medical advice. This practice is not a substitute for professional care and should not replace prescribed medication or treatment for any medical or mental-health condition. If you are managing a health condition or taking medication, talk with a qualified health professional before changing your practice. If you are in distress or crisis, seek professional support.

Does Pulsing Breath actually work?

Not proven. No trials have tested Pulsing Breath, so there is no direct evidence it 'works' for any outcome or condition. It is a tradition-informed Middendorf practice with plausible attentional and body-awareness pathways drawn from broader research, not from studies of this practice.

Not proven. No clinical studies have examined Pulsing Breath itself, so no benefit, effect size, or claim that it treats anxiety, sleep, or any diagnosis can honestly be made for it. Within the Middendorf tradition it is taught to deepen presence, body awareness, and steadier focus, and general research on focused attention and interoception makes those directions plausible rather than established. A fair expectation is a gradual settling of attention you can explore, not a tested result.

Can Pulsing Breath help with anxiety or stress?

No study has tested Pulsing Breath for anxiety or stress, so it cannot be claimed to treat or reduce either. Within the Middendorf tradition some people find it settling and grounding, but it is not a substitute for care.

No study has tested this. Pulsing Breath is a Middendorf practice of noticing the subtle, living pulse within each breath, and no research has examined whether it eases anxiety or stress, so there is no effect size or population data behind a benefit claim. Taught as a tradition-informed practice, it may bring a gradual settling of attention that some people experience as grounding rather than symptom relief. If anxiety or stress is significant, treat it as an optional practice alongside, not instead of, appropriate care.

How does resting attention on the breath quiet a busy mind?

The proposed pathway is attentional anchoring: giving attention one subtle target, the fine pulse inside each breath, leaves less room for looping, worried thoughts, so the mind can feel quieter. This is a plausible mechanism drawn from general focused-attention research and the Middendorf tradition, not something tested for Pulsing Breath itself.

The proposed pathway is attentional anchoring, stabilising attention on one clear target so it stops jumping to worries. Resting on the intra-breath pulse gives the mind a single, absorbing thing to return to, and broader focused-attention research links this kind of anchoring to less mind-wandering. The Middendorf tradition adds that closely sensing the breath trains interoceptive awareness, the capacity to read the body's own internal signals. Both are best treated as proposed pathways rather than tested effects: no study has measured them for this specific practice and no physiological changes have been recorded, so this explains a plausible route to a quieter mind, not a proven or clinical outcome.

Why might Pulsing Breath make me feel more restless instead of calm?

Because turning attention inward can make subtle body sensations feel louder, which unsettles some people even as it soothes others. This is a common, normal variation, not a sign of harm. If restlessness rises, widen your attention, open your eyes, or shorten the session.

Restlessness is a common response, and both settling and unsettling reactions are normal. The likely reason comes from how the practice works rather than from any measurement of it: attending closely to the subtle internal signals of pressure, movement, and tension within each breath can amplify sensations you would usually not notice, which feels absorbing to some and activating to others. This is a plausible pathway drawn from how the practice is taught, not proven for Pulsing Breath and not a sign that anything is wrong. If it persists, ease off, ground your attention in the room or your contact with the chair, and let the breath return to normal.

Is Pulsing Breath safe if I have panic attacks or health anxiety?

Use care. For most healthy adults Pulsing Breath is low-risk, but closely attending to the body's internal cues of pressure, movement, and tension can make those sensations feel louder and may amplify panic or body-focused fear. If you live with panic attacks or health anxiety, approach it gently, ideally with a facilitator, and treat it as a support rather than a substitute for care.

Use care. No research specific to Pulsing Breath has been identified, so this is a practical, precautionary note rather than a finding from safety trials. The concern is straightforward: turning close attention inward to the subtle internal sensations of breath, pressure, and tension can heighten those cues, which unsettles some people prone to panic or health anxiety even as it soothes others. Keep sessions short, widen your attention to the room or your contact with the floor if fear rises, and work with an experienced facilitator or mental-health professional. The practice is not a substitute for treatment of any anxiety, respiratory, or cardiac condition.

Is Pulsing Breath safe if I have a history of trauma or dissociation?

Approach it gently. No safety research on Pulsing Breath exists, but as a precaution, close inward attention can amplify a sense of threat, breathlessness, or detachment for some people with trauma or dissociation. Work with a facilitator where you can, and treat this as reasonable care, not evidence of harm.

Approach it gently. No safety study has examined Pulsing Breath or Middendorf breath awareness in people with trauma, panic, health anxiety, or dissociation, so this guidance is a practical, precautionary note rather than a safety finding. Because the practice trains interoceptive awareness, the capacity to sense subtle internal body signals like pressure, movement, and tension, that heightened inward focus can make those sensations feel louder, which unsettles some people even as it soothes others. If it stirs a sense of threat, breathlessness, or detachment, ease off, widen your attention to the room, and work with a qualified facilitator or mental-health professional. This is not a substitute for trauma care.

How do I start Pulsing Breath, and how long should a session be?

Start small and let the breath lead. Rest attention on the tiny natural variations in pressure, speed, and depth within each breath without controlling it, and keep early sessions to just a few minutes, stopping while attention still feels easy. These are practice-informed suggestions, not a tested dose.

Start by building from gentler Middendorf practices first, then rest attention on the subtle intra-breath pulse rather than imposing any rhythm; there is nothing to control or correct. Keep early sessions short, a few unforced minutes, and stop while focus still feels workable rather than pushing for depth. If turning attention inward begins to heighten anxiety, breathlessness, or detachment, widen your focus to the room and let the breath return to normal. No study has examined this practice, its dose, or session length, so treat these as practice-informed starting suggestions rather than an evidence-based prescription.

What's the difference between Pulsing Breath and paced breathing like box breathing?

The core difference is steering versus noticing. Box breathing sets a fixed rhythm, an even count in and out, to shape how the body feels, while Pulsing Breath imposes no rhythm at all and simply attends to the subtle, living pulse already inside each breath.

The core difference is steering versus noticing. Paced techniques like box breathing deliberately set a rhythm to guide the breath toward a target, whereas Pulsing Breath is a Middendorf practice of non-directive attention to the micro-variations in pressure, speed, and depth within a single inhale or exhale, leaving the breath free to find its own pace. This is a structural distinction drawn from how each practice is defined and taught, not a ranking: no direct trials of Pulsing Breath and no head-to-head comparison with paced breathing exist, so neither can be called more effective here.

[4]other peer reviewed

David Henley, Georgina Russell, J. A. Douthwaite, Susan A. Wood, Fiona Buchanan, Rosemary Gibson (2009). Hypothalamic-Pituitary-Adrenal Axis Activation in Obstructive Sleep Apnea: The Effect of Continuous Positive Airway Pressure Therapy. https://doi.org/10.1210/jc.2009-1174

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[5]other peer reviewed

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[6]other peer reviewed

Huang Li-Chung, Tsai Kuen-Jer, Wang Hao-Kuang, Sung Pi-Shan, Wu Ming-Hsiu, Hung Kuo-Wei (2014). Prevalence, incidence, and comorbidity of clinically diagnosed obsessive-compulsive disorder in Taiwan: a national population-based study.. https://doi.org/10.1016/j.psychres.2014.08.011

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[7]other peer reviewed

Lars Schwabe, Erno J. Hermans, Marian Joëls, Benno Roozendaal (2022). Mechanisms of memory under stress. https://doi.org/10.1016/j.neuron.2022.02.020

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[9]observational

Chen Jiunn-Horng, Chen Hsuan-Ju, Kao Chia-Hung, Tseng Chun-Hung, Tsai Chon-Haw (2018). Is Fibromyalgia Risk Higher Among Male and Young Inflammatory Bowel Disease Patients? Evidence from a Taiwan Cohort of One Million..

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[10]randomized controlled trial

McCrea J, Prueksaritanont T, Gertz B J, Carides A, Gillen L, Antonello S (1999). Concurrent administration of the erythromycin breath test (EBT) and oral midazolam as in vivo probes for CYP3A activity.. https://doi.org/10.1177/00912709922012015

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[11]observational

Tsung‐Ying Tsai, Pai‐Feng Hsu, Chung-Chi Lin, Yuan-Jen Wang, Yaw-Zon Ding, Teh-Ling Liou (2020). Factor analysis for the clustering of cardiometabolic risk factors and sedentary behavior, a cross-sectional study. https://doi.org/10.1371/journal.pone.0242365

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[12]randomized controlled trial

Tai Shu-Yu, Chien Chen-Yu, Wu Deng-Chyang, Lin Kun-Der, Ho Bo-Lin, Chang Yu-Han (2017). Risk of dementia from proton pump inhibitor use in Asian population: A nationwide cohort study in Taiwan.. https://doi.org/10.1371/journal.pone.0171006

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[13]other peer reviewed

Andrew L. Masica, Gail Mayo, G. Wilkinson (2004). In vivo comparisons of constitutive cytochrome P450 3A activity assessed by alprazolam, triazolam, and midazolam. https://doi.org/10.1016/j.clpt.2004.07.003

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[14]other peer reviewed

Gu Y C, Liu Y, Xie C, Cao B S (2022). [Pituitary immune-related adverse events induced by programmed cell death protein 1 inhibitors in advanced lung cancer patients: A report of 3 cases].. https://doi.org/10.19723/j.issn.1671-167x.2022.02.027

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[15]other peer reviewed

Mohammad Bagher Shiran, M. S. Lennard, Mohammad‐Zafar Iqbal, O. Lagundoye, Nicholas Seivewright, Geoffrey T. Tucker (2008). Contribution of the activities of CYP3A, CYP2D6, CYP1A2 and other potential covariates to the disposition of methadone in patients undergoing methadone maintenance treatment. https://doi.org/10.1111/j.1365-2125.2008.03312.x

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[16]other peer reviewed

Diane Diorio, Victor Viau, MJ Meaney (1993). The role of the medial prefrontal cortex (cingulate gyrus) in the regulation of hypothalamic-pituitary-adrenal responses to stress. https://doi.org/10.1523/jneurosci.13-09-03839.1993

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[17]other peer reviewed

Huang Shiau-Shian, Huang Chia-Chang, Yang Ying-Ying, Wang Shuu-Jiun, Shulruf Boaz, Chen Chen-Huan (2019). Dreyfus scale-based feedback increases the medical student's satisfaction with the complex cluster part of the interviewing and physical examination course and skills' readiness in Taiwan.. https://doi.org/10.3352/jeehp.2019.16.30

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[18]randomized controlled trial

Kinirons M T, O'Shea D, Kim R B, Groopman J D, Thummel K E, Wood A J (1999). Failure of erythromycin breath test to correlate with midazolam clearance as a probe of cytochrome P4503A.. https://doi.org/10.1016/s0009-9236(99)70029-9

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[19]other peer reviewed

Kinirons M T, O'Shea D, Downing T E, Fitzwilliam A T, Joellenbeck L, Groopman J D (1993). Absence of correlations among three putative in vivo probes of human cytochrome P4503A activity in young healthy men.. https://doi.org/10.1038/clpt.1993.199

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[20]other peer reviewed

Rosario Pivonello, Chiara Simeoli, Maria Cristina De Martino, Alessia Cozzolino, Monica De Leo, Davide Iacuaniello (2015). Neuropsychiatric disorders in Cushing's syndrome. https://doi.org/10.3389/fnins.2015.00129

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[21]other peer reviewed

W. Stephen Nichols (2005). Clinical measurement of arterial stiffness obtained from noninvasive pressure waveforms. https://doi.org/10.1016/j.amjhyper.2004.10.009

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[22]other peer reviewed

Schmidt L E, Olsen A K, Stentoft K, Rasmussen A, Kirkegaard P, Dalhoff K (2001). Early postoperative erythromycin breath test correlates with hepatic cytochrome P4503A activity in liver transplant recipients..

Cited in: –

[23]other peer reviewed

Sekizaki Tomonori, Kameda Hiraku, Oba Chiho, Yong Cho Kyu, Nakamura Akinobu, Miyoshi Hideaki (2019). Nivolumab-induced hypophysitis causing secondary adrenal insufficiency after transient ACTH elevation.. https://doi.org/10.1507/endocrj.ej19-0076

DOI: 10.1507/endocrj.ej19-0076

Cited in: –

[24]other peer reviewed

Paine Mary F, Wagner David A, Hoffmaster Keith A, Watkins Paul B (2002). Cytochrome P450 3A4 and P-glycoprotein mediate the interaction between an oral erythromycin breath test and rifampin.. https://doi.org/10.1067/mcp.2002.128387

DOI: 10.1067/mcp.2002.128387

Cited in: –

[25]other peer reviewed

Grouthier Virginie, Lebrun-Vignes Bénédicte, Moey Melissa, Johnson Douglas B, Moslehi Javid J, Salem Joe-Elie (2020). Immune Checkpoint Inhibitor-Associated Primary Adrenal Insufficiency: WHO VigiBase Report Analysis.. https://doi.org/10.1634/theoncologist.2019-0555

DOI: 10.1634/theoncologist.2019-0555

Cited in: –

[26]other peer reviewed

Watkins P B, Turgeon D K, Guthrie S K, Remen A L, Grunhaus L (1993). P450IIIA (CYP3A) activity in severely depressed patients..

Cited in: –

[27]randomized controlled trial

Prueksaritanont T, Vega J M, Rogers J D, Gagliano K, Greenberg H E, Gillen L (2000). Simvastatin does not affect CYP3A activity, quantified by the erythromycin breath test and oral midazolam pharmacokinetics, in healthy male subjects..

Cited in: –

[28]observational

Nervo Alice, Gruosso Giovanni, Marino Marta, Migliore Enrica, Rubiolo Matteo, Vaccaro Elisa (2026). Adrenal Insufficiency During Treatment With Immune-Checkpoint Inhibitors: How to Simplify the Diagnostic Pathway?. https://doi.org/10.1111/cen.70023

DOI: 10.1111/cen.70023

Cited in: –

[29]other peer reviewed

David Martínez‐Gómez, Mengyun Luo, Yü Huang, Fernando Rodríguez‐Artalejo, Ulf Ekelund, Mercedes Sotos‐Prieto (2024). Physical Activity and All-Cause Mortality by Age in 4 Multinational Megacohorts. https://doi.org/10.1001/jamanetworkopen.2024.46802

DOI: 10.1001/jamanetworkopen.2024.46802

Cited in: –

[30]other peer reviewed

Ono Mayo, Fukuda Izumi, Nagao Mototsugu, Tomiyama Keiko, Okazaki-Hada Mikiko, Shuto Yuki (2022). HLA analysis of immune checkpoint inhibitor-induced and idiopathic isolated ACTH deficiency.. https://doi.org/10.1007/s11102-022-01231-1

DOI: 10.1007/s11102-022-01231-1

Cited in: –

[31]other peer reviewed

Cui Guo, Yiqian Zeng, Ly-yun Chang, Zengli Yu, Yacong Bo, Changqing Lin (2020). Independent and Opposing Associations of Habitual Exercise and Chronic PM <sub>2.5</sub> Exposures on Hypertension Incidence. https://doi.org/10.1161/circulationaha.120.045915

DOI: 10.1161/circulationaha.120.045915

Cited in: –

[32]other peer reviewed

Gharaibeh M N, Gillen L P, Osborne B, Schwartz J I, Waldman S A (1998). Effect of multiple doses of rifampin on the [14C N-methyl] erythromycin breath test in healthy male volunteers.. https://doi.org/10.1002/j.1552-4604.1998.tb05785.x

DOI: 10.1002/j.1552-4604.1998.tb05785.x

Cited in: –

[33]other peer reviewed

Milena Girotti, Sarah E. Bulin, Flavia Carreño (2024). Effects of chronic stress on cognitive function – From neurobiology to intervention. https://doi.org/10.1016/j.ynstr.2024.100670

DOI: 10.1016/j.ynstr.2024.100670

Cited in: –

[34]other peer reviewed

J. V. Seale, Stephen A. Wood, Helen C. Atkinson, Michael S. Harbuz, Stafford L. Lightman (2004). Postnatal masculinization alters the HPA axis phenotype in the adult female rat. https://doi.org/10.1113/jphysiol.2004.078212

DOI: 10.1113/jphysiol.2004.078212

Cited in: –

[35]other peer reviewed

James P. Herman, Nawshaba Nawreen, Marissa A. Smail, Evelin M. Cotella (2020). Brain mechanisms of HPA axis regulation: neurocircuitry and feedback in context Richard Kvetnansky lecture. https://doi.org/10.1080/10253890.2020.1859475

DOI: 10.1080/10253890.2020.1859475

Cited in: –

[36]other peer reviewed

Christine Y. Malati, Sarah Robertson, Jennifer D. Hunt, Cheryl Chairez, Raul M. Alfaro, Joseph A. Kovacs (2011). Influence of<i>Panax ginseng</i>on Cytochrome P450 (CYP)3A and P‐glycoprotein (P‐gp) Activity in Healthy Participants. https://doi.org/10.1177/0091270011407194

DOI: 10.1177/0091270011407194

Cited in: –

[37]other peer reviewed

Agnès Tran, Elisabeth Rey, Gérard Pons, Marina Rousseau, Philippe d’Athis, Georges Olive (1997). Influence of stiripentol on cytochrome P450-mediated metabolic pathways in humans: In vitro and in vivo comparison and calculation of in vivo inhibition constants*. https://doi.org/10.1016/s0009-9236(97)90044-8

DOI: 10.1016/s0009-9236(97)90044-8

Cited in: –

[38]other peer reviewed

Iesaka Hiroshi, Kameda Hiraku, Miya Aika, Nomoto Hiroshi, Cho Kyu Yong, Nakamura Akinobu (2023). Fulminant ACTH decrease following diabetic ketoacidosis induced by immune checkpoint inhibitor combination therapy with nivolumab and ipilimumab: A case report.. https://doi.org/10.1097/md.0000000000036664

DOI: 10.1097/md.0000000000036664

Cited in: –

[39]other peer reviewed

Morita Shuhei, Tsuji Tomoya, Kishimoto Shohei, Uraki Shinsuke, Takeshima Ken, Iwakura Hiroshi (2022). Isolated ACTH deficiency following immunization with the BNT162b2 SARS-CoV-2 vaccine: a case report.. https://doi.org/10.1186/s12902-022-01095-3

DOI: 10.1186/s12902-022-01095-3

Cited in: –

[40]other peer reviewed

Masanori KUBO, Toshiko Koue, Atsuhiro Inaba, Hiroshi Takeda, Hiromi Maune, Tsuyoshi Fukuda (2005). Influence of Itraconazole Co-administration and CYP2D6 Genotype on the Pharmacokinetics of the New Antipsychotic ARIPIPRAZOLE. https://doi.org/10.2133/dmpk.20.55

DOI: 10.2133/dmpk.20.55

Cited in: –

[41]other peer reviewed

Pierrard Julien, Petit Bénédicte, Lejeune Sarah, Seront Emmanuel (2019). Isolated adrenocorticotropic hormone (ACTH) deficiency and Guillain-Barré syndrome occurring in a patient treated with nivolumab.. https://doi.org/10.1136/bcr-2019-230848

DOI: 10.1136/bcr-2019-230848

Cited in: –

[42]randomized controlled trial

Turgeon D K, Leichtman A B, Blake D S, Schmouder R L, Lown K S, Annesley T M (1994). Prediction of interpatient and intrapatient variation in OG 37-325 dosing requirements by the erythromycin breath test. A prospective study in renal transplant recipients..

Cited in: –

[43]other peer reviewed

Young‐Jin Park, Jongwon Shim, Suyeon Jeong, Gi‐Ra Yi, Heeyeop Chae, Jong Wook Bae (2017). Microtopography‐Guided Conductive Patterns of Liquid‐Driven Graphene Nanoplatelet Networks for Stretchable and Skin‐Conformal Sensor Array. https://doi.org/10.1002/adma.201606453

DOI: 10.1002/adma.201606453

Cited in: –

[44]other peer reviewed

Daniel S. Streetman, Joseph Bertino, A N Nafziger (2000). Phenotyping of drug-metabolizing enzymes in adults: a review of in-vivo cytochrome P450 phenotyping probes. https://doi.org/10.1097/00008571-200004000-00001

DOI: 10.1097/00008571-200004000-00001

Cited in: –

[45]other peer reviewed

Yang Xing-hua, Tao Qiu-shan, Sun Feng, Cao Chun-keng, Zhan Si-yan (2013). [Setting up a risk prediction model on metabolic syndrome among 35-74 year-olds based on the Taiwan MJ Health-checkup Database]..

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[46]other peer reviewed

Jonghwa Park, Jinyoung Kim, Jaehyung Hong, Hochan Lee, Youngoh Lee, Seungse Cho (2018). Tailoring force sensitivity and selectivity by microstructure engineering of multidirectional electronic skins. https://doi.org/10.1038/s41427-018-0031-8

DOI: 10.1038/s41427-018-0031-8

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[47]other peer reviewed

Verónica Cabanas‐Sánchez, Enrique G. Artero, Carl J. Lavie, Sara Higueras‐Fresnillo, Esther García‐Esquinas, Kabir P. Sadarangani (2020). Prediction of cardiovascular health by non-exercise estimated cardiorespiratory fitness. https://doi.org/10.1136/heartjnl-2020-316871

DOI: 10.1136/heartjnl-2020-316871

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[48]other peer reviewed

Takeno Ayumu, Yamamoto Masahiro, Morita Miwa, Tanaka Sayuri, Kanazawa Ippei, Yamauchi Mika (2019). Late-onset isolated adrenocorticotropic hormone deficiency caused by nivolumab: a case report.. https://doi.org/10.1186/s12902-019-0335-x

DOI: 10.1186/s12902-019-0335-x

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[49]other peer reviewed

Lin Si-Hong, Zhang Ao, Li Lu-Zhen, Zhao Liang-Chen, Wu Le-Xia, Fang Can-Tu (2022). Isolated adrenocorticotropic hormone deficiency associated with sintilimab therapy in a patient with advanced lung adenocarcinoma: a case report and literature review.. https://doi.org/10.1186/s12902-022-01151-y

DOI: 10.1186/s12902-022-01151-y

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[50]other peer reviewed

Micuda S, Hodac M, Parízek P, Pleskot M, Sispera L, Cerman J (2000). Influence of CYP3A metabolizer status on the pharmacokinetics and pharmacodynamics of amiodarone..

Cited in: –

More Pulsing Breath in Insight Timer

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Pulsing Breath effort level

How hard is Pulsing Breath?

Hard

You feel for the tiny pulses and ripples living inside a single breath, a fine-grained sensing that takes real focus to reach.

Mental Effort

4 / 4

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Emotional Depth

2 / 4

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Physical Intensity

2 / 4

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4 / 4

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Pulsing Breath

Middendorf Breathwork

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Micro-oscillations (intra-breath pulse)

Interoceptive awareness

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Full References

Pulsing Breath Tracks & Video

Breathwork For Stuck Energy | 9 Minutes

Breathwork For Sleep: Fall Asleep Quickly

History of trauma or dissociation

New to Middendorf breath practice

Significant respiratory or cardiovascular condition

How to practise safely?

Build from the foundations first

Let the breath lead

Check how inward focus feels

Keep sessions short and unforced

Seek guidance where it helps

Keep it alongside, not instead of, care

Medical Disclaimer

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More Pulsing Breath in Insight Timer

Breathwork For Stuck Energy | 9 Minutes

Breathwork For Sleep: Fall Asleep Quickly

Explore Pulsing Breath

Breathwork For Stuck Energy | 9 Minutes

Pulsing Breath effort level

Hard