Oxa Podcast. Episode #3. Sarah Silverman: Managing Insomnia with Breathwork

In this episode, we dive into a discussion with Dr. Sarah Silverman on the topic of insomnia, distinguishing it from other sleep-related issues such as sleep deprivation and various sleep disorders, along with exploring effective breathing exercises to combat insomnia and enhance sleep quality.

Dr. Silverman, a holistic sleep specialist with training from Stanford, is an authority on insomnia and a wellness consultant with a deep commitment to promoting sleep health. Adopting a bespoke, mindfulness-based strategy, she aims to ameliorate sleep challenges, utilizing cognitive behavioral therapy and breathwork as primary, non-pharmacological solutions for adults experiencing persistent insomnia.

Throughout this dialogue, Dr. Silverman shares insights on immediate sleep solutions, sleep aids, and the utilization of specific breathing techniques, such as diaphragmatic breathing and box breathing (also referred to as four square breathing), to activate the parasympathetic nervous system, encourage a state of calm, and enhance the quality of sleep.

She discusses the benefits of box breathing exercises for achieving a relaxed state, the optimal times for practice during the day, and the duration before observing significant improvements in sleep quality.

By the conclusion of this episode, listeners will gain knowledge on enhancing sleep quality through effective and straightforward breathing techniques that can be incorporated into everyday routines.


  • Insomnia is a primary sleep disorder involving difficulty falling asleep, staying asleep, waking up too early, nonrestorative sleep, and daytime fatigue.
  • Insomnia can be caused by stress, worry, and medical conditions.
  • Insomnia can increase the risk of high blood pressure, anxiety, and depression.

Breathing and Insomnia Management

  • Diaphragmatic breathing stimulates the parasympathetic nervous system, promoting relaxation and improving sleep quality.
  • Box-breathing is a simple breathing technique that can help achieve a relaxed state.
  • Regular practice of breathing exercises can significantly improve sleep quality over time.
  • Nasal breathing is generally recommended for promoting sleep.

Read more about: How Oxa Improves Your Daily Stress Management

Cognitive Behavioral Therapy (CBT) for Insomnia

  • CBT is the first-line treatment for chronic insomnia in adults.
  • Relaxation training, including diaphragmatic breathing, is a key component of CBT for insomnia.
  • Diaphragmatic breathing activates the vagus nerve, which helps to promote a state of rest and digestion.
  • Breathing exercises should be done for relaxation, not to force sleep.
  • Practicing breathing during the day can help to reduce stress and improve sleep quality.

Time to Recover from Insomnia

  • The time it takes to recover from insomnia varies and depends on the individual.
  • Some people may see improvements in as little as 2-3 weeks, while others may take 3-6 months to notice significant changes.

Breathing Techniques for Insomnia

  • Simple breathing techniques like the 4-4-4-4 boxed breathing and the 4-7-8 technique can be effective in promoting relaxation and reducing insomnia.
  • Progressive muscle relaxation (PMR) combines breathing with physical tensing and releasing of muscle groups to teach the nervous system the difference between tension and relaxation.
  • The key is to find a breathing pattern that is comfortable and works for you, and to practice it regularly for the best results.
  • Sarah Silverman recommends the box-breathing technique as her favorite breathing practice for relaxation and starting the day.
  • Box-breathing involves inhaling for 4 seconds, holding for 4 seconds, exhaling for 4 seconds, and holding for 4 seconds, and it is recommended to maintain this pattern rather than extending the duration of each phase.

Also read about: From Stress to Sleep: How Breathing Techniques Can Improve Sleep Quality


Today's episode is sponsored by Oxa, the innovative wearable technology that provides live biofeedback for breathing, acting as your personal mentor for improved sleep and stress management. Oxa continuously monitors essential indicators such as your heart rate and breath rate, designing tailored breathing routines that aid in stress reduction and promote restful sleep. 

Dr. Sarah Silverman
June 20, 2024

PsyD, a holistic sleep specialist and insomnia expert, is revolutionizing the way we approach sleep health. With an impressive academic background from the University of Miami and Nova Southeastern University, coupled with specialized training at the Stanford Sleep Medicine Center, Dr. Silverman brings a wealth of knowledge and experience to her practice. Her commitment to enhancing sleep wellness and her holistic, evidence-based strategies have made her a beacon of hope for those struggling to find restorative sleep, embodying her belief that everyone deserves to feel well-rested every day.

Ready to begin?

Get the Oxa Sensor and your choice of garment - lounge-wear shirt, bra, or adjustable chest strap. Your purchase includes access to the Oxa app which gives personalized data summaries and insights, as well as access to breathing exercises to teach you how to harness the power of your own breath.