Side Effects of High Ventilation Breathwork: A Naturalistic Online Survey on Prevalence, Time Course, and Predictors

High ventilation breathwork (HVB) can reliably induce altered states of consciousness similar to those produced by psychedelics and has shown positive effects on mental health, yet its safety profile remains poorly characterized. This project will conduct a longitudinal online survey in which participants report on a recent HVB session (within nine days), including side effects, subjective experiences, contextual factors, and demographic and risk-related variables. Side effects are classified as acute (during or directly after the breathing phase), subacute (within 48 hours), and delayed (48 hours to three weeks). Prevalence rates will be estimated as percentages, and hierarchical multiple regression will predict side effect severity. The goal is to inform evidence-based guidelines for responsible HVB use.

Study at a glance

Abstract

This project investigates the safety profile of high ventilation breathwork (HVB). HVB has been shown to reliably induce altered states of consciousness (ASCs) comparable to psychedelics and has demonstrated multiple positive effects on mental health in clinical and non-clinical populations. Although HVB is regarded as generally safe when considering contraindications, intense somatic, cognitive and affective reactions may occur during and after HVB sessions. Despite growing efforts to systematically assess side effects in psychedelic research, the safety profile of HVB remains largely uncharacterized. This project aims to systematically investigate the prevalence, time course and potential predictors (i.e., pre-state, environment, dose; see Carhart-Harris et al., 2018) of side effects associated with HVB. To this end, we will conduct a longitudinal online survey in which participants report on a recent HVB session (max. nine days ago), including side effects, subjective breathwork experiences, contextual factors of the session, as well as demographic and risk-related variables. We will further examine long-lasting side effects exploratively two to three weeks after the HVB session. Side effects will be classified as acute (during or directly after the HVB breathing phase), subacute (within 48 hours post-session), and delayed (between 48 hours and three weeks after the session; also exploratively assessed in the follow-up; see Hinkle et al., 2024). Prevalence rates will be estimated as percentages and transience of side effects will be examined using Friedman-test for repeated measures. Finally, hierarchical multiple regression analyses will be conducted to predict side effect severity. By systematically characterizing the range of reactions to breathwork and identifying potential predictors that shape these experiences, this research aims to contribute to a more comprehensive understanding of HVB safety and to support the development of evidence-based guidelines for its responsible and effective use.