Breathwork and Altered States: Claims, Mechanisms and Cautions

Urgent first

If you or someone else feels unsafe, in crisis or has thoughts of self-harm, call or text 988 in the US (Suicide and Crisis Lifeline). For fainting, a seizure, chest pain or difficulty breathing, call 911. MedlinePlus says to call 911 for a person who has fainted and does not become alert within a couple of minutes. [1]

The clear rule

This page describes claims and studies. It does not teach any fast, forceful or prolonged breathing method, and none is taught elsewhere on this site. Information only; this is not medical advice and not a substitute for care.

What the claim is

Some breathwork groups say that long sessions of continuous fast breathing, usually lying down with music, can produce an "altered state of consciousness," sometimes called a breathwork high or compared to a psychedelic experience. A 2023 review calls practices of this kind high ventilation breathwork. [2] It says they are associated with extraordinary changes in subjective experience. [2] The sessions are described on this site in holotropic breathwork and rebirthing and conscious connected breathing. An "altered state" is a self-reported change in perception, thinking or sense of self, not a measured brain state.

What the main study found

A 2025 study measured breathing and experience in 61 experienced practitioners who had done at least five immersive breathwork sessions. [3] Holotropic and conscious-connected sessions were compared, and 18 of 61 people were randomly assigned to a passive-breath control group that took part in the session but kept their everyday breathing. [3]

1. What changed physiologically?

   Unclear

   A lower end-tidal carbon dioxide level, due to deliberate hyperventilation, was linked to the onset of altered states (r = -0.46) [3]

   Physiological finding, exploratory

2. How did the states feel?

   Unclear

   Questionnaire scores resembled those from psychedelics in areas such as ego dissolution [3]

   Self-report

3. Did people feel better afterward?

   Unclear

   Depth of the state predicted improved well-being and reduced depressive symptoms in the authors' summary [3]

   Promising but limited

4. Did anyone feel worse?

   Unclear

   Some participants reported a decrease in well-being, and the authors say this suggests potential adverse effects in individual cases [3]

   Safety signal

Limits to keep in mind. The people were experienced, self-selected from breathwork communities, and screened. People with a history of psychosis, personality disorders, heart disease, chronic lung disease, pregnancy or epilepsy were excluded. [3] The results therefore say nothing about those groups. Follow-up questionnaires covered only a subset of participants. The authors who facilitate breathwork report this as a competing interest. [3] The study was not preregistered and was described by its authors as exploratory.

What other sources add

The 2023 review reports putative beneficial effects for trauma-related, affective and somatic disorders and says they invite further research. [2] One of its authors is a trained breathwork teacher. [2] An older paper in the field explicitly posed a hypothesis and said better methods were needed to confirm or refute it. [4] A small Danish study of 20 people referred by facilitators reported temperament changes followed by an increase in paranoid ideation, with no control group. [5] These do not establish benefit or safety.

What "psychedelic-like" does and does not mean

Resembling a psychedelic experience on a questionnaire does not mean the same effect, safety or mental health result as psychedelic-assisted therapy. Proper evidence not found for breathwork matching the clinical results of a psychedelic therapy. What we checked: PubMed searches on holotropic breathwork and altered states, and the studies above. See the natural psychedelics area, what are natural psychedelics and psychedelic adverse effects for that separate field.