Neurobiological substrates of altered states of consciousness induced by high ventilation breathwork accompanied by music
Amy Kartar, Toru Horinouchi, Balázs Örzsik, Brittany L. Anderson, Lottie Hall, Duncan Bailey, Sarah Samuel, Nohra E. Beltran-vargas, Samira Bouyagoub, Chris Racey, Yoko Nagai, Iris Asllani, Hugo Critchley, Alessandro Colasanti
PLoS ONE August 27, 2025 Peer reviewed DOI: 10.1371/journal.pone.0329411 via OpenAlex
Summary
High ventilation breathwork (HVB) can induce altered states of consciousness similar to those caused by psychedelics, characterized by feelings of euphoria and perceptual changes. This study found that the intensity of these states is linked to increased cardiovascular sympathetic activation and changes in blood flow in specific brain regions, including the left operculum/posterior insula and right amygdala/anterior hippocampus, which are important for emotional processing and interoception. These findings suggest that HVB may have significant therapeutic effects.
Study at a glance
| Population | experienced practitioners of high ventilation breathwork |
|---|---|
| Key finding | The intensity of altered states of consciousness induced by high ventilation breathwork correlates with cardiovascular sympathetic activation and changes in cerebral perfusion in specific brain regions. |
Abstract
The popularity of breathwork as a therapeutic tool for psychological distress is rapidly expanding. Breathwork practices that increase ventilatory rate or depth, facilitated by music, can evoke subjective experiential states analogous to altered states of consciousness (ASCs) evoked by psychedelic substances. These states include components such as euphoria, bliss, and perceptual differences. However, the neurobiological mechanisms underlying the profound subjective effects of high ventilation breathwork (HVB) remain largely unknown and unexplored. In this study, we investigated the neurobiological substrates of ASCs induced by HVB in experienced practitioners. We demonstrate that the intensity of ASCs evoked by HVB was proportional to cardiovascular sympathetic activation and to haemodynamic alterations in cerebral perfusion within clusters spanning the left operculum/posterior insula and right amygdala/anterior hippocampus; regions implicated in respiratory interoceptive representation and the processing of emotional memories, respectively. These observed regional cerebral effects may underlie pivotal mental experiences that mediate positive therapeutic outcomes of HVB.