Breathwork Safety: Dizziness and Overbreathing, Medical Conditions, Water and Driving, and When to Stop

If something feels wrong right now

Stop the exercise and go back to ordinary, unforced breathing. Call 911 (in the US) if you have chest pain or pressure, severe trouble breathing, blue or grey lips or skin, confusion, fainting that does not clear quickly, or a seizure. MedlinePlus says to call 911 for heart attack symptoms "even if you are not sure it is a heart attack," [1] and the NHS lists severe difficulty breathing, blue or grey lips or skin, and sudden confusion as emergencies. [2] MedlinePlus lists fainting that does not clear within a couple of minutes, and seizures, as reasons to call 911. [3] MedlinePlus also says rapid breathing that starts for the first time may be a medical emergency. [4] If you are in a mental health crisis in the US, call or text 988. [5] Someone motionless in water is an emergency; see the water section below.

The short version

Gentle, comfortable breathing is low risk for most healthy people. NCCIH says relaxation techniques are generally considered safe for healthy people, with occasional negative experiences such as increased anxiety, intrusive thoughts or fear of losing control. [6] Problems come mainly from forcing the breath, breathing very fast or very deep, holding the breath, practicing in the wrong place, or practicing with a health condition that needs a clinician's input. This page is information only. It is the overview for the safety pages in this library; the detailed ones are linked below.

Where each safety topic is covered

Dizziness and overbreathing

Overbreathing (hyperventilation) is rapid, deep breathing. MedlinePlus says it creates a low level of carbon dioxide in the blood, which causes many of its symptoms. [4] Those include feeling lightheaded, dizzy or weak, numbness and tingling in the arms or around the mouth, muscle spasms in the hands and feet, and chest pain or a fast, pounding heartbeat. [4] The same page says that when you are overbreathing you might not be aware you are breathing fast and deep. [4]

This is why the gentle technique on the NHS page tells you to let the breath flow "without forcing it." [7] If you feel lightheaded or tingly, stop, sit or lie down, and breathe normally. The NHS advice for dizziness is to lie down until it passes, then get up slowly. [8]

Medical conditions: check with a clinician first

Breathing practice is at most an add-on to care. It does not replace inhalers, blood pressure medicines, psychiatric medicines or therapy, and nothing here is a reason to change or stop a prescribed medicine. Talk with your clinician before starting if you have:

• Asthma, COPD or another lung condition. A Cochrane review of breathing exercises in adults with mild to moderate asthma found better quality of life at three months (moderate-certainty evidence), but did not count adverse effects as an outcome. [9] The NHS says that in an asthma attack you should sit up, try to stay calm and use your reliever inhaler if you have one. [10] More at breathing practices with lung conditions.
• High or low blood pressure, or a heart condition. A meta-analysis found slow breathing gave a modest reduction in blood pressure, in people at low cardiac risk. [11] Fainting can also come from heart problems. [12] See breathing practices with heart conditions.
• Epilepsy, a psychiatric condition, or a history of abuse or trauma. NCCIH reports rare cases where relaxation techniques might cause or worsen symptoms in these groups. [6] See epilepsy and seizure history.
• Panic or anxiety. Breathing practice may help some people but is not a substitute for assessment; see breathing practices with anxiety or panic history.
• Pregnancy. Ask your prenatal clinician; see therapies in pregnancy.

Water, driving and heights

Do not practice anything beyond ordinary breathing in or near water, including a bath, pool, lake or sea. The American Red Cross, YMCA of the USA and USA Swimming call hyperventilation before underwater swimming and extended breath-holding in the water "dangerous and potentially deadly." [13] A UK drowning-research group says hypoxic blackout can occur in any depth of water. [14] Details are on the breath-holding and shallow water blackout page.

For driving, machinery and heights, the NHS advises against anything dangerous while dizzy, such as driving, climbing a ladder or using heavy machinery. [8] Because overbreathing can cause lightheadedness, we advise practicing only seated or lying down. That is a precaution drawn from the symptom descriptions, not a rule from a study.

Intensive methods

Fast-breathing, breath-retention and holotropic-style methods are described, with their documented harms, on the intensive breathwork page. This site gives no instructions for them.

When to stop

Stop if you feel lightheaded, faint, tingling or numb, have chest pain or a pounding heartbeat, or feel anxious or out of control. [4][6] Return to normal breathing. If symptoms continue or you are unsure, get medical care. Our page on warning signs and when to stop goes through this in more detail. For gentler options, see relaxation techniques.