Breathing Practices With Epilepsy or Seizure History: Why Overbreathing Matters

Urgent help first

MedlinePlus says it is a medical emergency if seizures last longer than 5 minutes.[1] The NHS (United Kingdom) adds that anyone should get emergency help if it is their first seizure, if a seizure is longer than usual for them (or over 5 minutes when you do not know their usual), or if they do not recover as usual.[2] In the US, call 911. If a seizure happens during a breathing practice, that is a reason to stop and follow the person's seizure care plan, if they have one.

Who this page is for

This page is for people with epilepsy or any history of seizures, and for those who live with or support them. It is information only. Whether a breathing practice is right for you is a question for your neurologist or epilepsy nurse, who knows your seizure type, triggers and medicines. The main treatment for epilepsy is medicine to prevent seizures,[2] and nothing here replaces it. Do not stop or change anti-seizure medicine because of a breathing practice.

Why overbreathing matters

Breathing fast and deep for a while (hyperventilation, also called overbreathing) lowers the carbon dioxide level in the blood.[3] It can affect brain activity, and it is used on purpose in some brain tests.[4] The NHS says that during an EEG (a test of the brain's electrical activity, mainly used for epilepsy) you may be asked to do tasks such as opening and closing your eyes, breathing deeply for a few minutes, or looking at a flashing light.[5]

What studies of those tests found:

1. Does overbreathing provoke abnormal brain activity?

   Physiological finding in test settings

   A review describes it as an activation method that provokes slowing of brain rhythms, discharges and seizures, especially in generalized idiopathic epilepsies.[4]

2. Childhood absence epilepsy

   Strong in this specific syndrome

   A 2024 review reports that overbreathing produces abnormal EEG discharges in more than 90% of children with this condition and provokes absence seizures, brief loss of consciousness, typically within 90 seconds.[6]

3. Focal epilepsy under video-EEG monitoring

   Varies by person

   In 97 people with hard-to-treat focal epilepsy, 24 had a seizure provoked and 73 did not.[4]

4. Everyone with proven epilepsy

   Mixed; depends on epilepsy type

   In 433 people who did 5 minutes of voluntary overbreathing during EEG, a clinical seizure was linked to it in two (0.46%), and discharges increased in 4.4%.[7] The authors concluded it is rarely associated with seizures.[7]

These findings were gathered under hospital monitoring, by staff who can respond. They show that the effect differs between people and epilepsy types, which is why a general "it is probably fine" cannot be given for home practice. Because of this, this library describes no fast, deep or forceful breathing instructions. The intensive styles, such as hyperventilation-based breathwork, are covered critically on intensive breathwork and on who should not do intensive breathwork.

What about gentle, calming breathing?

Stress, tiredness and poor sleep are commonly reported triggers. The Epilepsy Society lists lack of sleep and stress among common triggers, and notes that triggers do not cause epilepsy but can make seizures more likely.[8] Epilepsy Action says many people with epilepsy report that tiredness or poor sleep, and stress, can trigger seizures.[9] The NHS suggests keeping a diary to help spot triggers such as tiredness and stress.[2] It is therefore natural to wonder whether relaxation helps.

• Slow, relaxed breathing and seizure frequency: Proper evidence not found. We searched PubMed for breathing exercises with seizures and epilepsy and found no randomized trial of gentle breathing practice reducing epileptic seizures.
• Yoga: A Cochrane review found two small unblinded trials (50 people with hard-to-treat epilepsy) and concluded that no reliable conclusions can be drawn about yoga for uncontrolled epilepsy, citing few studies, few participants and lack of blinding.[10] Evidence: insufficient.
• Relaxation techniques in general: NCCIH says they are generally considered safe for healthy people, but there have been rare reports that certain relaxation techniques might cause or worsen symptoms in people with epilepsy.[11]
• Non-epileptic (functional) seizures: A small open-label pilot trial gave an hour of breathing control training from a respiratory physiotherapist to people with functional seizures, partly because of an association between hyperventilation and these seizures.[12] Eighteen people were recruited and 10 completed follow-up; no adverse events were reported, and the authors said a randomized trial is needed.[12] Functional seizures are a different condition from epilepsy and need a specialist diagnosis. Evidence: preliminary.

If you and your clinician decide to try a gentle practice

These are general safety points, not a prescription:

• Choose a slow, comfortable, effortless style. Never force or exaggerate the breath, and do not hold it.
• Practice sitting or lying somewhere safe, with someone nearby if your clinician advises. Never practice in or near water, in a bath, while driving or at heights.
• Stop and return to normal breathing if you feel dizzy, tingling, strange sensations or your usual warning signs, or get unusually anxious.
• Keep sleeping, eating and taking your medicine on schedule: not taking medicine as prescribed is a listed trigger.[8]
• Write down what you tried and what happened, and share it with your care team. See telling your doctor about your breathing practice.

For causes of dizziness and tingling, see overbreathing and hyperventilation.