Breathing in virtual reality for promoting mental health: a scoping review

Breathing techniques have long been recognized as effective strategies for promoting mental health-related outcomes such as relaxation and emotional regulation. Virtual reality (VR), with its immersion and interactivity, offers the possibility to amplify the effectiveness of breathing techniques in promoting mental health. Recently, there has been an increasing use of VR to support breathing, although a formal summary of this integration is lacking. Following the PRISMA-ScR reporting guidelines, this scoping review aims to investigate the integration of breathing techniques and VR experiences and examine their potential effects on mental health-related outcomes. The synthesis of the reviewed studies (n = 18) reveals that different VR experiences can be used to strengthen breathing techniques. VR can, for example, reduce distractions and enhance focus during breathing exercises, provide direct, real-time feedback on the practice, and be used to create personalized environments, allowing users to train their breathing techniques in various contexts, from calming virtual nature settings to safe environments for practicing breathing skills that can be applied to real-life situations. Furthermore, this scoping review reveals the positive effects of VR-based breathing interventions on reducing clinical symptoms and increasing well-being and physical health outcomes. Overall, while acknowledging some methodological heterogeneity in the existing studies, the findings demonstrate the unique and promising potential of integrating breathing techniques with VR experiences. Future research is recommended to understand long-term effects, user experience, and the potential customization of interventions for diverse clinical and well-being contexts.