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. 2025 Sep 30;20(9):e0333360. doi: 10.1371/journal.pone.0333360

Breathwork and holistic wellbeing: A protocol for a scoping review

Fern Eleanor Beauchamp 1, Emily Bispo 1, Iolanda Costa Galinha 1, Andrew H Kemp 2,*
Editor: Hidetaka Hamasaki3
PMCID: PMC12483246  PMID: 41026756

Abstract

Breathwork has great potential for supporting connections to self, others, and nature, laying the foundations for individual, collective, and planetary wellbeing. While reviews have summarised the impacts of a wide range of breathwork techniques on outcomes relating to individual wellbeing, past work has neglected broader contexts. Here we present a protocol for a scoping review to identify and summarise the available literature relating to a broader range of wellbeing domains, focused on connection to self (individual wellbeing), others (collective wellbeing), and nature (planetary wellbeing). In synthesising the literature, we will determine how and when holistic wellbeing might arise through breathing interventions. Guided by standardised guidelines for conducting scoping reviews, six electronic databases (PubMed, Scopus, Web of Science, APAPsycArticles, Psychology and Behavioural Sciences Collection and Cochrane), grey literature and reference lists of included literature will be searched. Using the Rayyan platform, two reviewers will independently screen title/abstracts after which the full texts of relevant articles will be reviewed based on predetermined criteria. Study details, breathing intervention type and wellbeing outcomes relevant to the research question(s) will be extracted. Numerical analysis of data items and descriptive qualitative analysis of data across the three domains will be reported. Preliminary results will be shared with breathwork facilitators, and their feedback will help highlight gaps not explored in the literature and to refine discussion of the findings in an applied context. We hope that results will inform subsequent research and encourage deeper reflection on the role of breathwork across wider contexts. This research will contribute to the growing evidence base for promoting the inner development of individuals and communities focused on major societal challenges.

Introduction

Can breathwork enhance connection to self, others, and nature, thereby supporting individual, collective, and planetary wellbeing? As past reviews have primarily focused on the individual, there is a need for a broader synthesis that considers these interconnected dimensions. Given today’s global challenges, often described as a ‘polycrisis’ [13], it is essential to explore the potential of breathing interventions to promote wellbeing relating to individuals, the collective, and planet. For instance, as we discuss below, breathing interventions may support the ‘inner’ development required to facilitate the ‘outer’ change needed to address the polycrisis and promote systemic change.

Encompassing a range of techniques, breathwork, such as prāṇāyāma (yogic breath control or extension), have been practiced for millennia [4]. Despite historical significance, scientific interest in the potential health and wellbeing benefits is relatively recent [5], with the number of studies referencing ‘breathing technique’ or ‘breathing intervention’ in Scopus more than doubling in the last decade (search date: 18th February 2025). So far, research interest has largely focused on individualised outcomes such as affect [6], physiological and psychological stress [7], blood pressure, heart rate [8], and heart rate variability (HRV) [9]. While existing reviews have focused on the effects of breathwork on outcomes aligned to hedonic (feeling good) and eudaimonic (functioning well) wellbeing perspectives [e.g., 10, 11], they typically neglect wider determinants. This individualistic focus reinforces neoliberal perspectives and isolates wellbeing from interconnected social and ecological systems [12], contributing to societal challenges such as loneliness [13] and the climate crisis [14], and undermining wellbeing [15,16]. Addressing these crises requires a shift away from individualistic models toward a more integrated, holistic understanding of wellbeing. This review therefore aims to synthesise existing literature on breathing interventions from a holistic perspective, considering their impact on self, others, and the natural world.

Breathwork

Breathwork, defined as “exercises, techniques, and therapies that involve manipulating the manner in which one breathes” [17], have deep cultural and spiritual roots often emphasising the interconnectedness of all living beings. Techniques such as qigong (Chinese breath, movement and mind practices to cultivate vital energy) [18], g-tummo (Tibetan practice to control inner energy) [19], prāṇāyāma [20], and shamanic breathing [21] originate from traditions that foster reverence for nature (e.g., Hinduism, Buddhism, Taoism, and Shamanism) [22]. For instance, prāṇāyāma, derived from yoga, conceptualises prāṇā as a fundamental life force, with yāma meaning control or extension [20]. In contemporary practice, breathwork is often integrated with nature-based approaches such as forest bathing (shinrin-yoku) [23] and cold-water exposure (Wim Hof Method; WHM) [24,25], further highlighting its potential role in promoting planetary wellbeing, a concept described later.

While breathwork is well-investigated for stress reduction [e.g., 7, 26], HRV enhancement [e.g., 9, 27], and increasingly hedonic and eudaimonic indicators of wellbeing [e.g., 10, 28], its effects may extend beyond individual benefits. For example, evidence suggests that prāṇāyāma strengthens social connectedness [29], and fosters a deeper relationship with the body through improved interoception and emotional regulation [28]. Body awareness, in turn, is a key predictor of nature connection [30]. Sudarshan Kriya Yoga (SKY), incorporating prāṇāyāma, has been associated with nature connection and climate change awareness [31], while WHM may promote holistic wellbeing through enhanced connection to self, others, and nature [25]. Similarly, holotropic breathwork has been linked to increased capacity to connect with others, sensitivity to one’s own needs, and greater awareness of one’s environment [32]. Despite these indications, no comprehensive review has considered a broader, holistic perspective of the wellbeing-related impacts of breathing interventions.

Defining wellbeing

Wellbeing is a contested concept, with definitions that are often contradictory, sometimes overlapping, and overly focused on the individual [3336]. Hedonic models emphasise subjective experiences of positive emotions and life satisfaction [37], while eudaimonic perspectives highlight meaning [38,39], purpose [40], autonomy [40,41], and social relationships [40,42] (Table 1). Models of flourishing have sought to integrate these perspectives [e.g., 38, 39, 45], although they sometimes contradict each other; for instance, the pursuit of meaning can come at the expense of positive emotion [66], highlighting the complexity of the construct of wellbeing [67]. Historically, wellbeing models have centred on individual experiences while neglecting broader social and environmental determinants [35,63]. However, newer conceptualisations acknowledge that individuals do not ‘feel good’ or ‘function well’ in isolation [34,36,56,64,68].

Table 1. Summary of theories, models and measures contributing to a holistic wellbeing definition.

Theory, model or measure Included components Domain
Subjective Wellbeing [37] Subjective assessment of positive affect, negative affect, life satisfaction. Individual
Psychological Wellbeing Theory [40,43] Autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, self-acceptance. Individual, Collective
Flourishing [38,39] Positive emotions, engagement, relationships, meaning/mattering, accomplishment. Individual, Collective
Self-determination theory [44] Basic psychological need for autonomy, relatedness and competence. Individual, Collective
Social Wellbeing [42] Social coherence, social actualisation, social integration, social contribution, social acceptance. Individual, Collective
Flourishing [45] Emotional wellbeing, psychological wellbeing, social wellbeing. Individual, Collective
Flourishing [46] Competence, emotional stability, engagement, meaning, optimism, positive emotions, positive relationships, resilience, self-esteem, vitality. Individual, Collective
Eudaimonic Wellbeing [47] Self-discovery, perceived development of one’s best potentials, sense of purpose and meaning in life, intense involvement in activities, investment of significant effort, enjoyment of activities as personally expressive. Individual
Biophilia Hypothesis [48] An innate affinity to seek connection with nature and other forms of life. Individual, Planetary
Psycho-evolutionary theory [49] Exposure to nature can generate automatic positive affect. Individual, Planetary
Spiritual wellbeing [50] Personal wellbeing (e.g., self-awareness, joy), communal wellbeing (e.g., trust, respect others), transcendental wellbeing (e.g., relation with divine), environmental wellbeing (e.g., one with nature, value in nature). Individual, Collective, Planetary
Ecological wellbeing [51] Wellness of the ecological system, and more generally planet earth, encompassing the relationship between humans and their environment. Individual, Planetary
Sustainable wellbeing [52] Integrating wellbeing of individual, other members of society and natural environment. Individual, Collective, Planetary
Sustainable happiness and wellbeing [5355] Happiness that contributes to individual, community, and/or global wellbeing without exploiting other people, the environment, or future generations. Individual, Collective, Planetary
Sustainable wellbeing [56] All systems and wellbeing domains are in balance and harmony including the individual (physical, mental, social, spiritual dimensions), self-and-other, people-and-environment and over time. Individual, Collective, Planetary
Happy Planet Index [5762] Global index of sustainable wellbeing. Individual, Planetary
GENIAL framework [63,64,65] Genomics, Environment, vagus Nerve, social Interaction, Allostatic regulation, Longevity. Individual, Collective, Planetary

A systems perspective of wellbeing emphasises interconnectedness and interdependence [36,56,64,68,69] recognising that human wellbeing is inseparable from that of the planet [56,69,70]. Holistic wellbeing frameworks extend beyond the individual to incorporate social and environmental dimensions [e.g., 67, 56, 64, 65, 71]. Proponents of this approach call for more inclusive measures [e.g., 72], emphasising factors such as connection, vagal health [67,64,65], nature (e.g., biophilia), social trust and happiness [72], and societal harmony [56]. Emerging models such as the GENIAL framework [34,67,64,65] and the model of ‘sustainable wellbeing’ [56], span multiple domains (systems) within which wellbeing can arise (e.g., self, others, and nature), reinforcing the interconnectedness of individual, collective, and planetary domains of wellbeing.

Through this lens, individual wellbeing is defined as feeling good and functioning well [73], while collective wellbeing involves interdependently feeling good and functioning well [74]. Planetary wellbeing (also referred to as ecological wellbeing) highlights the reciprocal relationship between humans and the environment [51,70], and has been described as “the highest attainable standard of wellbeing for human and non-human beings and their social and natural systems” [75 p.4]. Measures of planetary wellbeing include pro-environmental behaviour [e.g., 76], nature connection [e.g., 77], and indices of ‘environmentally sustainable’ wellbeing [e.g., 5762, 78]. Importantly, interventions that enhance self-awareness [e.g., 79, 80], foster belonging [e.g., 81], and deepen nature connection [e.g., 82] may promote wellbeing across all three domains.

An urgent need for a more holistic perspective

The escalating global crises (e.g., climate change, war, political instability, and mental health challenges) [13,14,83,84] underscore the urgency of a more holistic approach to wellbeing. Despite policy efforts such as the United Nations Sustainable Development Goals, progress remains inadequate [85]. Dominant neoliberal ideologies, which emphasise individualism and economic growth, contribute to societal fragmentation and ecological degradation [8689]. Addressing these crises requires reflection on collective and planetary perspectives, with increasing recognition of the need to integrate ‘inner’ development with external solutions [89,90].

Current reviews of breathing interventions reinforce an individualistic outlook, overlooking their potential to foster connection across multiple domains. In this regard, breathwork may serve as a means of inner transformation, for example through strengthening mind-body awareness and re-establishing relationships with others and the environment [67,87,89]. A scoping review is a necessary next step to explore these possibilities, allowing for a more inclusive conceptualisation of wellbeing that accounts for individual, collective, and planetary dimensions. Furthermore, preliminary literature searches suggests an emerging research focus on the social and environmental impacts of breathwork [e.g., 25, 29, 31], highlighting the need for synthesis and identifying gaps in the existing knowledge base.

Methods

The scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) manual for scoping reviews [91] and will conform to the reporting standards published in the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) [92]. The current protocol has been registered on the Open Science Framework (osf.io/j7phg), and its development was guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P; S4 Table) [93]. The methodology for a scoping review was also guided by a six-stage framework described by Arksey and O’Malley [94] including: (1) the identification of a research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) collating, summarising, and reporting the results, and (6) consultation with breathwork facilitators. The optional sixth stage is conducted in parallel with earlier stages, and follows Buus et al. [95] recommendations for consultation exercises. The scoping review process began in April 2025 and is anticipated to take approximately twelve months to complete.

Stage 1: Identifying the research question

Research questions were developed in line with the JBI [91] recommended framework, including a focus on population, concept and context (Table 2). The primary research question is:

Table 2. The population, concept and context relating to the primary research question.

Population Concept Context
Individuals or groups of the general population exposed to a breathing intervention. Individual- or group-based breathing interventions intending to promote indicator(s) of wellbeing, broadly defined, spanning individual, collective and/or planetary domains. No restrictions will be placed on the context.

How do breathing interventions promote holistic wellbeing?

Additional questions that will be answered in the scoping review will include:

  1. What types of breathing interventions have been used?

  2. How have they been delivered?

  3. What is the duration (number of minutes per session) and frequency (sessions per week) of practice?

  4. What are the reported outcomes relevant to holistic wellbeing (S3 Table)?

  5. What populations have been studied?

  6. What are the mediating and moderating effects of breathing interventions on holistic wellbeing?

Answering these questions will help inform further research, including the design and delivery of novel breathing interventions, which consider broader socio-ecological contexts and support wellbeing relating to self, others, and planet.

Stage 2: Identifying relevant studies

Search strategy.

The search strategy attended to established guidelines for conducting scoping reviews [91,94], and focused on identifying relevant quantitative and qualitative research in the published literature. The grey literature will also be reviewed for relevant studies. To ensure “in-depth and broad” retrieval of relevant literature [94, p.22], an extensive list of search terms was collated through several consultation exercises. Firstly, drawing on our knowledge of breathwork and wellbeing science and in collaboration with a skilled librarian from Universidade Católica Portuguesa, an initial search of PubMed and APAPsycArticles was conducted to identify articles related to the key themes of breathing interventions and wellbeing. Search terms relating to various breathing techniques and concepts relating to holistic wellbeing were selected (S3 Table). Relevant terms from publications’ titles, abstracts, and bibliographies were added to the list. Search terms were expanded following consultation of the APAPsycArticles thesaurus. Google Search and Google Scholar were then explored to capture the variety of references to breathing interventions, further developing the search term list. Terms which consistently returned studies outside of scope (e.g., ‘breathing’ returned multiple pulmonary-related studies) were removed or edited to be more specific. The full list of search strategy terms can be viewed in S3 Table.

The librarian was then consulted to help determine appropriate databases to search. The following databases were identified: PubMed, Scopus, Web of Science, APAPsycArticles, Psychology and Behavioural Sciences Collection and Cochrane. Grey literature sources will include PsyArXiv, ProQuest and Google Scholar. Reference lists will also be screened for additional studies relevant to breathing interventions and indicators of holistic wellbeing. The search strategy (S1 Appendix), including all identified keywords and index terms, will be adapted accordingly for each database and information source utilised (see S2 Table for examples of database-specific search strategies). No limits will be placed on language or date range. For identified non-English language evidence, translation services such as DeepL translator tool [96] will be used to determine whether inclusion criteria are met. Translations will be reviewed by individuals fluent in the relevant language. Any evidence that cannot be translated will be classified as “Studies awaiting classification” and reflected in the PRISMA flow diagram [97] in the full review [98]. Following the search, all identified citations will be collated and uploaded into Rayyan [99].

Eligibility criteria

Population.

The review will include studies of the general population which focus on the promotion of wellbeing, rather than reduction of ill-being. Therefore, specific sub-groups for which breathing interventions are delivered to manage symptoms as part of a healthcare treatment plan (e.g., for asthma or chronic obstructive pulmonary disease) will be excluded.

Concept.

Within the current scoping review, there are two main concepts of interest. The first is breathing interventions, or breathwork, as defined above, which must include interventions that deliberately manipulate the breath of the target population. This will include isolated breathing interventions (e.g., prāṇāyāma), and will not include studies that also test other complementary components (e.g., yoga asana), unless the breathing component is tested individually, or its effects can be isolated. This is because these additional components may influence the outcome measures. See S5 Table for a non-exhaustive selection of prominent breathing interventions, chosen based on the first author’s experience and as potential examples that may be identified in the search. The second concept is holistic wellbeing, informed by socio-ecological models of wellbeing such as the GENIAL framework [64,65]. Therefore, studies must also include outcome measures related to at least one of the domains within a broader conceptualisation of wellbeing spanning multiple domains (S3 Table). This conceptualisation spans the individual (e.g., positive affect, self-connection), community (e.g., perception of connectedness to others, social cohesion) and broader ecosystems (e.g., nature connection, pro-environmental attitudes).

Context.

We will not limit the context for the current scoping review. All studies (published or in the grey literature) will be included regardless of geographic location, specific settings, or time of publication.

Types of sources.

This review will consider all quantitative and qualitative, published, and unpublished primary research studies and evidence syntheses (e.g., systematic reviews, meta-analyses, other scoping reviews). Evidence syntheses will be included alongside original research in order to facilitate the identification of as many primary studies as possible. There will be no restrictions placed on study design or methodology. Where there are duplications due to inclusion of a synthesis and a primary source cited in that synthesis, the primary source will be excluded unless that data is missing [91]. The full text must be accessible by the authors. If full access is unavailable institutionally, the corresponding author will be contacted via email (from an institutional email) up to a maximum of three attempts. One month will be provided for authors to respond, with this date included in all email contacts. Two weeks after the initial attempt, a follow up email will be sent and subsequently after another week. Criteria for inclusion and exclusion are presented in Table 3.

Table 3. Types of sources eligibility criteria.
Criterion Inclusion Exclusion
Type of study Published and unpublished primary research studies and evidence syntheses reporting on wellbeing-based outcomes targeted by breathing interventions. This includes quasi-experimental designs, randomised controlled trials, interviews, focus groups and observations. Non-intervention based research.
Source Studies located in a peer-reviewed journal, available as an e-thesis or on a grey literature website. Studies not located in a peer-review journal, available as an e-thesis or on a grey literature website.
Availability Full text available. No full text available.
Study focus Use of at least one breathing intervention. Studies do not include at least one breathing intervention or are also testing other complementary components, unless the breathing component is tested individually, or its effects are isolated.

Stage 3: Study selection

After duplicate citations have been removed, the remaining titles and abstracts will subsequently be screened in a pilot exercise, as recommended by JBI guidelines [91,100]. This will allow for refinement within the review team and consist of reviewing a subset of potentially relevant titles and abstracts. A sample of 25 titles/abstracts will be selected randomly and reviewed by FEB and EB. These will be screened using the eligibility criteria and the reviewers will discuss the chosen papers and any required amendments to the criteria. Any revisions of the eligibility criteria, search terms or methodology will be reported in the final review. When 75% + agreement is achieved, full screening will commence. Full screening will consist of two reviewers, FEB and EB, independently assessing all titles and abstracts against the final eligibility criteria. Utilising the ‘blinding’ functionality in Rayyan, reviewers’ decisions will not be visible, and conflicts will be identified with opportunities to discuss decisions in real time. Any uncertainties or discrepancies will be discussed between the two reviewers, and a third reviewer called upon should they require assistance breaking a tie. Subsequently, following a similar screening process, the two reviewers will independently assess the full articles against eligibility criteria. The search may be altered and expanded during this process to account for potential new discoveries [101] due to the broad nature of scoping reviews, and focus on the two broad concepts. As recommended by Tricco et al. [92], results of the process and rationale for excluding studies will be reported using a Rayyan-generated PRISMA flow diagram [97] in the full review. Excluded full-text sources, along with reasons for exclusion, will be included in an appendix.

Stage 4: Charting the data

The data extraction form (Table 4) will be pilot tested by FEB and EB on a random selection of 10 papers [102]. This process will assess consistency and reliability in extraction as well as form functionality [103]. Subsequently, both reviewers will convene to discuss any refinement required of the form. The full data extraction process will involve regular discussion between the two independent reviewers and utilise the finalised form. Extracted data will include general study details as well as population, concept, and context information relevant to the current research question. Breathing interventions will be categorised into slow- and fast-paced techniques (S5 Table). In the eventuality that any information is missing or unclear, as with the full text sourcing process, the corresponding author will be contacted via email a maximum of three times requesting clarity or the absent information. If information is not recovered, it will be coded as “Not reported” or if it remains unclear it will be coded as “Unclear” and reported in the full review. In cases of multiple reports of the same study or ‘friend studies’, these will be treated on a case-by-case basis and the most appropriate strategy employed accordingly. All strategies employed will be detailed when reporting the full review. Data extraction is expected to increase in speed as familiarity in the process grows. The two reviewers will engage in regular discussion throughout the process to highlight any issues. A third reviewer will be on hand to resolve disagreement. Any alterations made during the process will be disclosed in the final review.

Table 4. Data extraction form.

Study Details Population Breathing Intervention Description Wellbeing Outcomes Results Notes
Author(s)
Title
Publication year
Aim(s)
Study design
Recruitment method
Field of study, first author
Country
Target population
Participant characteristics:
• Sample size
• Age range
• Mean age
• Sex
• Gender identity
• Ethnicity
• Race
Control
Other population notes
For each intervention: Breathing technique name
Technique description/components
Categorisation of intervention (fast/slow)
Method of delivery
Provider of delivery
Frequency
Duration
Location of delivery
Total number of intervention groups
Contraindication(s) (where applicable)
Comparison group(s) (presence/absence and type)
For each wellbeing outcome of interest:
Wellbeing-related outcome
Measures used
Timeline of measures
Categorisation of outcomes by wellbeing domain
Description of key findings Limitations of study as identified by authors
Relevant quotes (qualitative)

Stage 5: Collating, summarising and reporting the results

Once data has been extracted, all authors will convene to discuss the data, plan analysis and reporting. We intend to present a quantitative analysis of the extent, nature, and distribution of the studies included in the review using tables and charts, as well as a narrative synthesis. Using the multiple wellbeing domains presented in the GENIAL framework [64,65] as a guide, from the charted data (Table 4) we will produce tables, charts, and visualisations presenting the distribution of evidence by grouping outcomes relating to these domains. Primary outcomes of interest will be focused on any wellbeing measure that could be defined holistically (e.g., Happy Planet Index [62] or Gallup World Poll [e.g., 72]). Secondary outcomes will be focused on measures that can be categorised within the domains of individual, collective, and planetary wellbeing. Further, due to the volume of techniques and potential homogeneity of outcomes in relation to speed (e.g., slow-paced techniques can produce relaxation-based outcomes [e.g., 11], while fast-paced can energise [e.g., 104]), we will also organise breathing interventions by pace (e.g., slow- and fast-paced) similar to existing literature [e.g., 5, 11]. To answer the research questions, we will summarise (1) the types and characteristics of breathing interventions studied, (2) wellbeing outcomes and their direction (beneficial, adverse, mixed, no difference/unchanged) reported within each domain, (3) wellbeing-related measures used, (4) populations studied, (5) methodological approaches employed, and (6) the key conclusions drawn from evidence syntheses. Quantitative analysis will comprise of producing tables and charts showing the frequencies of studies based on this data (e.g., breathing intervention studies by wellbeing domain, as exemplified in Table 5 and Fig 1), aiming to highlight key areas of interest and illuminate gaps in the literature for future research.

Table 5. Illustrative, hypothetical example of a results table, reporting frequency of breathing intervention studies by pace, wellbeing domain and direction of outcome.

Wellbeing Domain
Individual Collective Planetary
+ +/- O + +/- O + +/- O
Breathing technique by pace Slow-paced [Total n studies]
Breathing intervention 1 (e.g., Nadi Shodhana)
...
Fast-paced
Breathing intervention 5 (e.g., Conscious Connected Breathing)
...
Both (slow- and fast-paced)
Breathing intervention 9 (e.g., g-tummo)
...

Key: + = beneficial effect, - = adverse effect, + /- mixed results, O = no difference/unchanged.

Fig 1. Illustrative, hypothetical example of a visualisation reporting on frequency of breathing intervention by wellbeing outcome.

Fig 1

We will also conduct a narrative synthesis to understand the effectiveness of breathing interventions in relation to the presented broader conceptualisation of wellbeing, why and how this might occur, and the degree to which existing breathing intervention research utilises this conceptualisation. Data analysis and presentation details will be reported fully in the final review.

Stage 6: Consultation

A consultation exercise will be conducted utilising the optional sixth stage [94]. Initial findings from Stage 5 will be shared with breathwork facilitators with two main aims (1) to identify gaps not explored in the literature and (2) seek feedback on how to discuss the findings and implications of the review in an applied context. Potential implications will include three elements (a) opportunities to promote holistic wellbeing outcomes in existing practices, (b) considerations required for this, and (c) recommendations for future research. Breathing interventions have a long, diverse, applied, and largely non-scientific history, suggesting there may be knowledge gaps in the existing literature. It is therefore anticipated that consulting breathwork facilitators will enable additional meaningful and applied perspectives, aligning to Buus et al. [95] and Mak and Thomas [105] critique and recommendations for consultation exercises. Facilitators of a variety of breathing intervention doctrines will be contacted via email and asked whether they would like to consult in the research. We will provide detailed information about the research and what to expect should they wish to assist. The consultation process, associated outcomes, and how they opposed (or not) conventional viewpoints will be included in the full review [95].

Ethics and dissemination

Ethical approval will not be required as this will be a review of previously published data. Additionally, the consultation made with breathing intervention facilitators is intended to only inform research findings and thus the research carried out ‘with’ them, rather than ‘about’ them. As their contribution is therefore deemed as public involvement, ethical approval will not be required [106]. The full scoping review will be published in peer-reviewed journals and study findings may be shared at scientific conferences and with those taking part, as defined in Stage 6 of the scoping review.

Conclusion

Results of this scoping review will comprehensively report on what is known from the existing literature about how breathing interventions might promote holistic wellbeing. A holistic wellbeing framework will be utilised to help understand how such interventions may enhance wellbeing within each of these domains. In doing so, this scoping review aims to provide an urgently needed overview which looks both at and beyond the individual, also considering the impact of these cost-free, accessible, and sustainable interventions on broader social and environmental outcomes. This will enable a better understanding of how such interventions might be leveraged in support of inner development and rapidly evolving global challenges facing humanity.

Supporting information

S1 Appendix. Search strategy.

(DOCX)

pone.0333360.s001.docx (13.3KB, docx)
S2 Table. Database-specific search strategies.

(DOCX)

pone.0333360.s002.docx (32.8KB, docx)
S3 Table. Study concepts and associated search terms.

(DOCX)

pone.0333360.s003.docx (18.2KB, docx)
S4 Table. PRISMA-P 2015 Checklist.

(DOCX)

pone.0333360.s004.docx (37KB, docx)
S5 Table. Non-exhaustive selection of potential breathing interventions.

(DOCX)

pone.0333360.s005.docx (20.6KB, docx)

Acknowledgments

The search strategies and databases selected for the current scoping review were developed with the valuable advice of an experienced librarian from Universidade Católica Portuguesa. Accordingly, the authors would like to extend our appreciation to Maria Perdigão for her comprehensive support and guidance in database-specific search strategies.

Data Availability

No datasets were generated or analysed during the current study. All relevant data from this study will be made available upon study completion.

Funding Statement

The author(s) received no specific funding for this work.

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Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #2: Yes

**********

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

Reviewer #1: The protocol is well written but it will benefit from a few amendments

1: The registration number obtained when the protocol was registered in open science framework must be stated in the manuscript

2: I wonder if a meta-analysis will be done after the scoping review, if so then perhaps a subgroup analysis and sensitivity analysis must be done and must be stated in the protocol.

Reviewer #2: I found the topic to be highly relevant and timely, and your protocol is generally well-structured and comprehensive. The detailed approach you propose for your scoping review suggests a thorough and systematic investigation into breathwork and its impact on holistic wellbeing. I appreciate the effort put into developing such a detailed plan.

My comments are provided below, starting with the more overarching and methodological points, followed by more specific suggestions to further enhance the clarity, rigor, and conciseness of your protocol.

Major Comments

1. Introduction Length and Focus: For a protocol, the Introduction section appears quite extensive. While providing context is crucial, some of the more detailed background information and extensive justification for the review's necessity might be more suitable for the full scoping review manuscript itself. I suggest considering a more concise and direct approach for the protocol's introduction, focusing primarily on setting the stage for why this protocol is needed.

2. Search Strategy and Disease-Specific Terms: I noted that your search strategy includes specific disease terms (e.g., "cancer[Title] OR patient*[Title] OR diabetes[Title] OR COPD[Title] OR asthma[Title] OR disease*[Title] OR cystic fibrosis[Title] OR myocardial infarction[Title] OR hypertension[Title] OR treatment[Title]"). Given that the title of your review is "Breathwork and holistic wellbeing," which suggests a broad exploration of the topic, the specific inclusion of these diseases in the search terms requires further clarification and justification within the protocol. It is not clear why these specific conditions have been chosen over others, or if this implies a narrower scope than initially suggested by the title.

Please clarify the rationale: Are these diseases chosen because breathwork interventions are predominantly studied in these populations, or do they represent an intentional limitation of your review's scope?

Implications for Scope: If your intention is to focus solely on these conditions, this should be explicitly stated in the protocol's eligibility criteria, and potentially even reflected in the title to align expectations.

Risk of Omission: Without a clear justification, there's a risk of inadvertently excluding relevant studies on breathwork in other health conditions or general populations, thereby limiting the comprehensiveness typically associated with a scoping review. This point is crucial for ensuring the transparency and rigor of your chosen search methodology.

3. Clarification on "Evidence Syntheses" and Inclusion Criteria:

In lines 269-270, you state that the review "will consider all quantitative and qualitative, published and unpublished primary research studies and evidence syntheses." It would be highly beneficial to explicitly define what you mean by "evidence syntheses" in this context. Is this referring to other types of reviews (e.g., systematic reviews, meta-analyses, or other scoping reviews)?

Furthermore, if "evidence syntheses" refer to other reviews, it's important to clarify your rationale for including them alongside primary studies. While existing reviews can be valuable for identifying primary studies or for comparison, relying on their data synthesis or interpretations might introduce bias if their methodologies or eligibility criteria do not perfectly align with your own. Please clarify if you intend to extract data from these "syntheses" or primarily use them to identify primary studies. A clear justification for this approach, particularly regarding how potential biases from secondary data selection/interpretation will be mitigated, would strengthen the protocol.

4. Explicitly Stating Outcomes of Interest: While you mention following the GENIAL framework (Stage 5), it would significantly enhance the clarity and reduce potential bias during the review process if you could provide more detail regarding the specific types of outcomes you anticipate identifying and extracting from the included articles. Outlining the primary and secondary outcomes of interest within the protocol would provide a clearer roadmap for the subsequent review.

5. Rationale for Fixed Pilot Test Sample Sizes: In line 289, you specify a pilot test of 25 titles, and in line 309, a pilot data extraction from 10 articles. Could you clarify the rationale for these fixed numbers? It might be more robust to define a percentage of the total number of identified titles/abstracts or articles, as the absolute numbers might vary significantly depending on the initial literature search yield.

6. Relevance and Placement of Tables:

Table 2 (Timeline): The inclusion of a detailed timeline for the project (Table 2) does not appear to add significant methodological value to the protocol itself. It might be more appropriate for project management documentation rather than a scientific protocol.

Table 4 & Table 5: Given their size and detailed nature, I suggest considering moving Table 4 and Table 5 to supplementary materials. This would enhance the readability and flow of the main protocol document while still making the detailed information accessible to readers.

Table 6: This table seems largely redundant, as the information presented is already clearly outlined in the text. You could consider removing it entirely or, alternatively, condensing the surrounding text and presenting the information exclusively within the table.

Specific Points and Minor Suggestions

• Introduction References: There are instances in the Introduction (e.g., lines 62-64) where concepts are presented without corresponding references. I recommend a thorough review of the Introduction to ensure all claims and conceptual foundations are adequately supported by citations.

• Sub-title Rephrasing (Line 105): At line 105, the section title is presented as a question; I suggest rewording to be more objective and declarative.

• Use of Dashes: Throughout the manuscript, consider replacing long dashes used to interject phrases with commas. This can often improve textual clarity and objectivity.

• Reference Management: The sequencing of references in lines 164-166 (reference 93 immediately after 91) and then reference Buus et al. also identified as 93, in line 171 suggests that a reference management software (such as Zotero, Mendeley, or EndNote) might not be consistently used. I highly recommend utilizing such a tool to prevent these types of discrepancies and to ensure consistent style and accurate numbering, especially given the anticipated large number of references for both this protocol and the eventual scoping review.

• Table References in Text: When referring to tables in the text, it is not necessary to include the word "see" (e.g., "Table 1" is sufficient instead of "see Table 1").

• Table 5 Details: For Table 5, if it's not exhaustive, it would be helpful to briefly explain the rationale behind selecting these specific examples over others. Additionally, it would be beneficial to include references for the different techniques presented and their descriptions within the table itself.

• Table 7 (Data Extraction Fields):

Population Characteristics: Regarding the "Population" section, please clarify the reason/relevance of distinguishing between "sex" and "gender identity" for data extraction. Also, while "nationality" is listed, extracting the "country/location where the study was conducted" (which you already have) might be more straightforward and consistently available than participants' nationalities. When referring to "ethnicity," please also include "race," as these are distinct concepts.

Control Group Data: It's unclear whether you intend to collect the same level of detailed demographic and intervention-related data for the control groups or simply note their presence/absence. Please clarify this for the "Comparison group(s)" column within the "Breathing Intervention Description" section.

• Clarity on "Homogeneity of Outcomes" (Lines 336-337): In lines 336-337, you state, "Further, due to the volume of techniques and potential homogeneity of outcomes in relation to speed…" Could you please clarify if "homogeneity of outcomes" is an expected characteristic or if this might be a typographical error? If homogeneity is expected, a brief explanation would be useful.

• Figure 1 and Table 8 (Illustrative Formats):

While you aptly present Figure 1 and Table 8 "as exemplified" to illustrate potential reporting formats for your results, please ensure that Figure 1 is clearly cited if it is adapted from an existing source. If it is an original, hypothetical example created for this protocol, it would be beneficial to state this explicitly. For a protocol, whose primary purpose is to outline the methodology, committing to an exact visual format for presenting findings can sometimes be premature. The optimal presentation strategy often evolves during the data synthesis phase of a scoping review, especially given the potential heterogeneity of the included literature. You might consider adding a brief note to reinforce that these are illustrative examples or potential formats, allowing for flexibility in the final representation of results.

I trust these comments will assist you in refining your protocol.

**********

what does this mean? ). If published, this will include your full peer review and any attached files.

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Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy

Reviewer #1: Yes:  Irene Boateng

Reviewer #2: No

**********

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PLoS One. 2025 Sep 30;20(9):e0333360. doi: 10.1371/journal.pone.0333360.r002

Author response to Decision Letter 1


11 Aug 2025

Reviewer #1

Opening comment

Feedback: The protocol is well written but it will benefit from a few amendments.

Response: We are grateful to the reviewer for their review of the manuscript and their kind comments.

Point 1

Feedback: The registration number obtained when the protocol was registered in open science framework must be stated in the manuscript.

Response: Thank you for this suggestion, we have added the DOI to the manuscript obtained when the protocol was registered in Open Science Framework (line 164).

Point 2

Feedback: I wonder if a meta-analysis will be done after the scoping review, if so then perhaps a subgroup analysis and sensitivity analysis must be done and must be stated in the protocol.

Response: A meta-analysis is not currently part of the scoping review. However, the scoping review will determine our next steps and a decision will be made at a later date, on completion of the scoping review.

Reviewer #2

Opening comment

Feedback: I found the topic to be highly relevant and timely, and your protocol is generally well-structured and comprehensive. The detailed approach you propose for your scoping review suggests a thorough and systematic investigation into breathwork and its impact on holistic wellbeing. I appreciate the effort put into developing such a detailed plan.

My comments are provided below, starting with the more overarching and methodological points, followed by more specific suggestions to further enhance the clarity, rigor, and conciseness of your protocol.

Response: We would like to thank the reviewer for their thoughtful and encouraging feedback and appreciate the recognition of our work’s relevance and comprehension. We believe their valuable suggestions have helped improve the manuscript’s clarity and conciseness and further enhanced the quality and rigour of our protocol.

Point 1. Introduction Length and Focus

Feedback: For a protocol, the Introduction section appears quite extensive. While providing context is crucial, some of the more detailed background information and extensive justification for the review's necessity might be more suitable for the full scoping review manuscript itself. I suggest considering a more concise and direct approach for the protocol's introduction, focusing primarily on setting the stage for why this protocol is needed.

Response: We appreciate this helpful suggestion. After careful consideration of the reviewers’ feedback, we have revised the introduction to improve its clarity, focus and length. However, given the emerging nature of the wellbeing perspective underpinning this review, we have taken a measured approach to reducing its length to ensure that sufficient background remains to justify the rationale and significance of our approach. We believe that the revised version strikes a clearer balance between brevity and the necessary context for these novel concepts.

Point 2. Search Strategy and Disease-Specific Terms

Feedback: I noted that your search strategy includes specific disease terms (e.g., "cancer[Title] OR patient*[Title] OR diabetes[Title] OR COPD[Title] OR asthma[Title] OR disease*[Title] OR cystic fibrosis[Title] OR myocardial infarction[Title] OR hypertension[Title] OR treatment[Title]"). Given that the title of your review is "Breathwork and holistic wellbeing," which suggests a broad exploration of the topic, the specific inclusion of these diseases in the search terms requires further clarification and justification within the protocol. It is not clear why these specific conditions have been chosen over others, or if this implies a narrower scope than initially suggested by the title.

Please clarify the rationale: Are these diseases chosen because breathwork interventions are predominantly studied in these populations, or do they represent an intentional limitation of your review's scope?

Implications for Scope: If your intention is to focus solely on these conditions, this should be explicitly stated in the protocol's eligibility criteria, and potentially even reflected in the title to align expectations.

Risk of Omission: Without a clear justification, there's a risk of inadvertently excluding relevant studies on breathwork in other health conditions or general populations, thereby limiting the comprehensiveness typically associated with a scoping review. This point is crucial for ensuring the transparency and rigor of your chosen search methodology.

Response: We thank the reviewer for their comments on this point. For clarification, the disease-specific terms used in the search strategy are for exclusion purposes only. We are using these terms as an automated means to filter out and reduce the number of hits. We added these terms as exclusions because our initial literature searches were returning many studies which included participants with these specific diseases, which were irrelevant to the research question.

Point 3. Clarification on "Evidence Syntheses" and Inclusion Criteria

Feedback: In lines 269-270, you state that the review "will consider all quantitative and qualitative, published and unpublished primary research studies and evidence syntheses." It would be highly beneficial to explicitly define what you mean by "evidence syntheses" in this context. Is this referring to other types of reviews (e.g., systematic reviews, meta-analyses, or other scoping reviews)? Furthermore, if "evidence syntheses" refer to other reviews, it's important to clarify your rationale for including them alongside primary studies. While existing reviews can be valuable for identifying primary studies or for comparison, relying on their data synthesis or interpretations might introduce bias if their methodologies or eligibility criteria do not perfectly align with your own. Please clarify if you intend to extract data from these "syntheses" or primarily use them to identify primary studies. A clear justification for this approach, particularly regarding how potential biases from secondary data selection/interpretation will be mitigated, would strengthen the protocol.

Response: We appreciate the reviewer’s comments and have responded by providing examples of what we mean by “evidence syntheses” (systematic reviews, meta-analyses, other scoping reviews) to lines 263-264. Our rationale for including evidence syntheses alongside primary studies is to help us to locate as many relevant primary studies as possible. We will not be focused on their interpretation or data synthesis and have amended the manuscript (lines 264-265) to include this rationale. In addition, we will include a descriptive summary of the key conclusions drawn from the evidence syntheses we locate, focused on answering our research questions. We have amended the manuscript at lines 336-340 to reflect these changes. We thank the reviewer for their feedback and stimulating further reflection, we believe this has helped strengthen the protocol and the comprehension of the review.

Point 4. Explicitly Stating Outcomes of Interest

Feedback: While you mention following the GENIAL framework (Stage 5), it would significantly enhance the clarity and reduce potential bias during the review process if you could provide more detail regarding the specific types of outcomes you anticipate identifying and extracting from the included articles. Outlining the primary and secondary outcomes of interest within the protocol would provide a clearer roadmap for the subsequent review.

Response: We appreciate the reviewer’s suggestion and have elaborated on the specific types of outcomes that we anticipate identifying and extracting from the included articles. Our primary outcomes of interest will be focused on any wellbeing measure that could be defined more holistically, such as Happy Planet Index [1] or Gallup World Poll [2]). Secondary outcomes will be focused on measures that can be categorised within the domains of individual, collective and planetary wellbeing. We have amended the manuscript accordingly in lines 329-332.

1. Wellbeing Economy Alliance. Happy Planet Index [Internet]. Happy Planet Index. 2021 [cited 2025 Apr 26]. Available from: https://happyplanetindex.org/

2. Lambert L, Lomas T, Weijer MP van de, Passmore HA, Joshanloo M, Harter J, et al. Towards a greater global understanding of wellbeing: A proposal for a more inclusive measure. International Journal of Wellbeing. 2020 May 31;10(2).

Point 5. Rationale for Fixed Pilot Test Sample Sizes

Feedback: In line 289, you specify a pilot test of 25 titles, and in line 309, a pilot data extraction from 10 articles. Could you clarify the rationale for these fixed numbers? It might be more robust to define a percentage of the total number of identified titles/abstracts or articles, as the absolute numbers might vary significantly depending on the initial literature search yield.

Response: We acknowledge the reviewer’s suggestion of defining a percentage of the total number of identified titles/abstracts or articles for piloting. However, our rationale for specifying a pilot test of 25 titles (now line 282) was guided by JBI methodology [3]. Regarding our rationale for specifying a pilot data extraction from 10 articles (now line 301-302), JBI methodology recommends trialling on two to three sources [3,4]. However, we decided to take a more cautious approach to ensure the accuracy of data extraction, as per other institutional recommendations [5].

3. Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. JBI; 2024 [cited 2025 Jul 31]. Available from: https://synthesismanual.jbi.global/

4. Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020 Oct;18(10):2119–26.

5. Western Libraries. Research Guides: Knowledge Synthesis: Systematic & Scoping Reviews: 6. Data Extraction [Internet]. Western University. 2025 [cited 2025 Jul 31]. Available from: https://guides.lib.uwo.ca/knowledgesynthesis/dataextraction

Point 6. Relevance and Placement of Tables

Feedback: Table 2 (Timeline): The inclusion of a detailed timeline for the project (Table 2) does not appear to add significant methodological value to the protocol itself. It might be more appropriate for project management documentation rather than a scientific protocol.

Response: We acknowledge and appreciate the reviewer’s comments of the inclusion of our proposed timeline (Table 2). Accordingly, we have removed this from the manuscript.

Feedback: Table 4 & Table 5: Given their size and detailed nature, I suggest considering moving Table 4 and Table 5 to supplementary materials. This would enhance the readability and flow of the main protocol document while still making the detailed information accessible to readers.

Response: We acknowledge that the manuscript’s readability and flow would be enhanced by moving Table 4 and Table 5 to the supplementary materials (S3 Table and S5 Table, respectively). We have updated the manuscript to reflect these amendments.

Feedback: Table 6: This table seems largely redundant, as the information presented is already clearly outlined in the text. You could consider removing it entirely or, alternatively, condensing the surrounding text and presenting the information exclusively within the table.

Response: We believe structuring the types of sources in tabular form allows for easy reference of the inclusion/exclusion criteria. However, we acknowledge that some elements of the table are redundant as the information is already presented in the text. We have therefore condensed the surrounding text and opted to keep the table (now Table 3) in the main body of the manuscript.

Specific Points and Minor Suggestions

Introduction References

Feedback: There are instances in the Introduction (e.g., lines 62-64) where concepts are presented without corresponding references. I recommend a thorough review of the Introduction to ensure all claims and conceptual foundations are adequately supported by citations.

Response: We have thoroughly reviewed the Introduction to ensure all claims and conceptual foundations are adequately supported by citations. As a result, citations have been added to lines 61, 62 and 156.

Feedback: Sub-title Rephrasing (Line 105): At line 105, the section title is presented as a question; I suggest rewording to be more objective and declarative.

Response: We thank the reviewer for their suggestion and have reworded the section title accordingly.

Feedback: Use of Dashes: Throughout the manuscript, consider replacing long dashes used to interject phrases with commas. This can often improve textual clarity and objectivity.

Response: We thank the reviewer for their suggestion and have replaced long dashes with commas to improve textual clarity and objectivity.

Reference Management

Feedback: The sequencing of references in lines 164-166 (reference 93 immediately after 91) and then reference Buus et al. also identified as 93, in line 171 suggests that a reference management software (such as Zotero, Mendeley, or EndNote) might not be consistently used. I highly recommend utilizing such a tool to prevent these types of discrepancies and to ensure consistent style and accurate numbering, especially given the anticipated large number of references for both this protocol and the eventual scoping review.

Response: We appreciate the diligence in spotting these referencing errors in lines 164-166 and 171. We consistently use Zotero and have ensured that the referencing process has been refreshed and updated.

Table References in Text

Feedback: When referring to tables in the text, it is not necessary to include the word "see" (e.g., "Table 1" is sufficient instead of "see Table 1").

Response: We have amended the manuscript to remove all instances of “see” alongside table references in brackets.

Table 5 Details

Feedback: For Table 5, if it's not exhaustive, it would be helpful to briefly explain the rationale behind selecting these specific examples over others. Additionally, it would be beneficial to include references for the different techniques presented and their descriptions within the table itself.

Response: We acknowledge that a brief explanation of the rationale for selecting the specific breathing interventions and inclusion of references would be helpful. Accordingly, we have included the rationale in the manuscript (lines 246-248) and amended the table (now S5 Table).

Table 7 (Data Extraction Fields)

Feedback: Population Characteristics: Regarding the "Population" section, please clarify the reason/relevance of distinguishing between "sex" and "gender identity" for data extraction.

Response: Our intention to distinguish between "sex" and "gender identity" during data extraction is important because these constructs represent different aspects of identity and may yield different findings. We believe structuring data collection in this way also ensures greater inclusivity and accuracy in analysis.

Feedback: Also, while "nationality" is listed, extracting the "country/location where the study was conducted" (which you already have) might be more straightforward and consistently available than participants' nationalities.

Response: We acknowledge that extracting the “country/location” where the study was conducted might be more straightforward and consistently available, therefore have removed the field “nationality”.

Feedback: When referring to "ethnicity," please also include "race," as these are distinct concepts.

Response: We appreciate the reviewer’s suggestion and have revised the manuscript to include “race” in addition to “ethnicity”, ensuring they are distinct constructs, consistent with APA guidelines. We have amended the data extraction table accordingly (now Table 4).

Control Group Data

Feedback: It's unclear whether you intend to collect the same level of detailed demographic and intervention-related data for the control groups or simply note their presence/absence. Please clarify this for the "Comparison group(s)" column within the "Breathing Intervention Description" section.

Response: We thank the reviewer for their suggestion regarding control group

Attachment

Submitted filename: Response to Reviewers.pdf

pone.0333360.s006.pdf (308.9KB, pdf)

Decision Letter 1

Hidetaka Hamasaki

14 Sep 2025

Breathwork and holistic wellbeing: A protocol for a scoping review.

PONE-D-25-29701R1

Dear Dr. Kemp,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Hidetaka Hamasaki

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewer #2:

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

Reviewer #2: Yes

**********

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses??>

Reviewer #2: Yes

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable??>

Reviewer #2: Yes

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete??>

The PLOS Data policy

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #2: Yes

**********

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

Reviewer #2: Thank you for submitting the revised version of your manuscript PONE-D-25-29701; Breathwork and holistic wellbeing: A protocol for a scoping review.

I would like to acknowledge and commend your diligent work in responding to the suggestions and comments raised during the previous review round. Your thoughtful revisions have significantly enhanced the clarity, rigor, and overall quality of the article, making it a much stronger contribution.

I appreciate your efforts in addressing all points so thoroughly.

Best regards,

**********

what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy

Reviewer #2: No

**********

Acceptance letter

Hidetaka Hamasaki

PONE-D-25-29701R1

PLOS ONE

Dear Dr. Kemp,

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team.

At this stage, our production department will prepare your paper for publication. This includes ensuring the following:

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PLOS ONE

Associated Data

    This section collects any data citations, data availability statements, or supplementary materials included in this article.

    Supplementary Materials

    S1 Appendix. Search strategy.

    (DOCX)

    pone.0333360.s001.docx (13.3KB, docx)
    S2 Table. Database-specific search strategies.

    (DOCX)

    pone.0333360.s002.docx (32.8KB, docx)
    S3 Table. Study concepts and associated search terms.

    (DOCX)

    pone.0333360.s003.docx (18.2KB, docx)
    S4 Table. PRISMA-P 2015 Checklist.

    (DOCX)

    pone.0333360.s004.docx (37KB, docx)
    S5 Table. Non-exhaustive selection of potential breathing interventions.

    (DOCX)

    pone.0333360.s005.docx (20.6KB, docx)
    Attachment

    Submitted filename: Response to Reviewers.pdf

    pone.0333360.s006.pdf (308.9KB, pdf)

    Data Availability Statement

    No datasets were generated or analysed during the current study. All relevant data from this study will be made available upon study completion.


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