Both 4-7-8 and extended exhale breathing use extended exhalation to activate the parasympathetic nervous system, but they do so with different mechanisms. The 4-7-8 pattern includes a 7-count breath hold that amplifies CO2 retention and creates a more sedating effect. Extended exhale breathing (typically inhale 4, exhale 8) flows continuously without holds, producing smooth parasympathetic activation without the intensity of breath retention.
For sleep onset, 4-7-8 is generally more effective because the breath hold creates additional sedation and mental occupation that prevents racing thoughts. For anxiety management during the day, extended exhale may be preferable because it provides calm without the drowsiness that the 4-7-8 hold can create. Both techniques are excellent for stress relief, with the choice depending on whether you need to remain alert afterward.
The practical difference often comes down to personal preference and comfort. Some people find the 7-count hold in 4-7-8 uncomfortably long, especially beginners. Extended exhale breathing has no hold component, making it more accessible. If you struggle with breath holds, start with extended exhale and progress to 4-7-8 as your CO2 tolerance develops.