Why does pneemo® use a 4-6 breathing rhythm?

Much research has been conducted into breathing rhythms, with many studies agreeing that longer exhalation is more beneficial. 

The vagus nerve is a cranial nerve complex that, among other things, functions to relay relaxation from the central nervous system to the body. Activity of the vagus nerve is modulated by breathing, which is suppressed during inhalation and activated during exhalation6. Prolonged exhalation therefore results in a signal of relaxation by the vagus nerve, which in turn leads to increased vagus nerve activity and further relaxation. 

That explains why exhalation is longer than inhalation, so why 4-6 specifically? 

The typical respiratory rate in normal adults is 12-15 breaths per minute5. Reducing this to just 6 breaths per minute via slow paced breathing (which is achieved with pneemo®’s 4-6 rhythm), has been shown to maximise heart rate variability (HRV). This is an important effect, as reduced HRV is closely associated with a number of stress-related disorders. 

How do I get into the rhythm of pneemo®?

The device starts vibrating and I start exhaling. When the vibration pauses, I start inhaling. Of course, the beginning is a bit difficult because you don't have a feeling for the length of time yet. You just have to try it. It's easier when there are two of you, i.e. when one person has already understood slow-paced breathing. Then you simply copy them: mimic their movements, the shape of their lips. That way, it's really easy to get into the rhythm. 

My phone/smartwatch has an app. Is that not the same?

No, not quite the same. 

Vibrations from a mobile phone are often received as an alert or alarm, which is counterintuitive to the calming effect of slow-paced breathing. Using pneemo® to regulate your breathing is the quickest and calmest way to regain control. 

Apps can help regulate your breathing, but pneemo® is more quickly and easily accessed during an emergency. Speed is imperative, particularly in attacks of anxiety, panic and fear. Because hyperventilation is often the precursor to these attacks, it’s important to be able to regain control as quickly as possible, and pneemo® is the fastest way to do so. 

Apps also have the disadvantage of being mostly visual. This requires a high level of concentration, especially if it's 5-15 minutes of uninterrupted looking. Additionally, incoming messages and notifications can pop up as a distraction, interrupting the calming effect of the exercise.

Smartphones and watches are also unreliable due to their short battery life.

Finally, many user groups find apps difficult to use. Many situations, such as in the hospital or on a plane, are no suitable for using a phone.


"In the clinical setting, pneemo® is the better way to go than smartphones".


Is it safe for my child to use?


Not only is it safe, but it’s encouraged for children with anxiety disorders, ADHD and behavioural issues. 

How long do I need to breathe alongside pneemo® for?

For as long as you need to feel in control. 

You know your body best, and once you’re acquainted with pneemo®, you’ll learn how much time you need to achieve calm. Research indicates that this is generally 3-10 minutes, but pneemo® will continue its rhythm for up to 15 minutes before automatically switching off (though you can stop this sooner if necessary). 

Can’t I just count?

In theory, yes. 

But your counting is unlikely to be as accurate as pneemo’s precisely programmed rhythm. Additionally, when you’re under stress or in a state of panic, having to rely on yourself to regulate your breathing is an added pressure and contradictory to the practice of slow paced breathing. 

Allow pneemo® to do the hard work for you so that you can focus solely on inhaling and exhaling to achieve calm and control. 

Why is hyperventilation harmful?

Hyperventilation is a condition in which a person breathes too quickly and shallowly, resulting in a decrease in the level of carbon dioxide in the blood. Hyperventilation can cause a number of symptoms, including lightheadedness, dizziness, tingling in the fingers and toes, and muscle cramps. Hyperventilation often occurs as a result of stress or a panic attack. If it occurs frequently, it can lead to suffocation and worsening of other symptoms of the disease.

Can I use pneemo® with an oxygen tank?

If you are using an oxygen tank , it is important that you follow the instructions of your healthcare provider or the manufacturer. Slow-paced breathing exercises can be helpful in managing symptoms and improving lung function, but it is important to use them in a way that complements your prescribed treatment plan.

In some cases, slow-paced breathing exercises may not be appropriate if you are using an oxygen tank. For example, if you have been prescribed a certain oxygen flow rate to meet your needs, it is important to maintain that flow rate as prescribed. Slow-paced breathing in this case may reduce the amount of oxygen you take in, which may not be desirable.

However, if you have been instructed to perform slow-paced breathing exercises as part of your treatment plan, it is important that you follow these instructions carefully. Your healthcare provider or respiratory therapist can explain how to safely and effectively perform slow-paced breathing exercises when using an oxygen tank.

How can I measure the efficacy of slow-paced breathing?

There are several ways to measure the efficacy if stress reduction:

Are there cases in which slow-paced breathing is not suitable?

Slow-paced breathing may require some practice for people with certain respiratory conditions such as chronic obstructive pulmonary disease (COPD) or asthma. Slow and deep breathing may be difficult to do. Also, people with certain neurological conditions such as Parkinson's disease may have difficulty coordinating their breathing with their movements. 

People who have recently had surgery or suffer from chronic pain may find it uncomfortable to breathe deeply. They should not practise breathing that hurts them. Breathing in and out with pneemo® Atemtakter should therefore be done gently and without force. 

If a person suffers from panic disorder, slow-paced breathing is a good way to relieve stress and regain control. If hyperventilation is one of the symptoms of panic disorder, slow-paced breathing is a good way to counteract it. However, one should not force oneself too much, as forcing can lead to additional stress. The effect of slow-paced breathing takes effect after 3-10 minutes (for 80% of people after 5 minutes). It is always better to consult a doctor to determine if slow-paced breathing is suitable and safe for you if you have a pre-existing condition or are recovering from an illness or injury.

Do you have a question that hasn't been answered? Contact us and we can help you.