Cold Exposure Plus Breathwork Claims: Evidence and Risks

Urgent first

If someone has fainted or is unresponsive, in or out of water, call 911 in the US. MedlinePlus says to call if a person who fainted does not become alert within a couple of minutes. [1] Get a person who is motionless in the water out of it at once and call for help.

The clear rule

This site gives no routine that joins fast or forceful breathing with cold water, cold showers or ice. Never combine them, and never do any breathing exercise in or near water. This page describes the claims and the research only, and it is information, not a how-to.

What the claims are

Social media and some programs promote a package: a period of rapid, deep breathing, then cold exposure, with a mindset element. The best-known example is the Wim Hof Method, covered in its own pages: origins, claims and what studies found and drowning and blackout warnings. Claims include more energy, less stress and less inflammation. Here we ask what the research says about the combination, and why the two parts carry different risks.

Why the combination worries safety experts

Fast, deep breathing is called hyperventilation, and MedlinePlus says it lowers carbon dioxide in the blood, which causes many of its symptoms. [2] Those symptoms include numbness and tingling in the arms or around the mouth. [2]

Cold water causes its own breathing surge. The Met Office (UK) describes an involuntary gasp that can lead to inhaling water, a rapid rise in breathing rate and heart rate, and panic. [3] It adds that even strong swimmers can be overwhelmed. [3] A review of cold water immersion deaths says this cold shock response can kill through aspiration, reduced blood flow to the brain from low carbon dioxide, and heart rhythm disturbance, before the body has cooled. [4]

A review of repeated cold exposure notes that cold shock causes hyperventilation, raises the risk of heart rhythm problems and raises drowning risk by impairing safety behavior. [5] So the two practices push breathing in the same direction. This is a reasoned concern from physiology. We found no study that tested the combination for safety in a large group. Proper evidence not found for a safe combined protocol. What we checked: PubMed searches on Wim Hof Method, cold shock and hyperventilation, and the sources on this page.

What research found

Three cautions apply. First, none of these trials can hide the practice from participants, so expectation matters. In the depression trial, the control group thought its program was more credible. [7] Second, all six dropouts in that trial came from the Wim Hof group. [7] Third, the review included few trials. [6]

A brain-imaging report often cited for the method was a case study of a single practitioner. [9] It cannot show that others can copy his results safely.

What the trials do not tell us

These studies tested supervised or guided programs in volunteers. They do not show that the combination is safe when done alone, in a lake, in a bath or in a pool. Reports of deaths and injuries linked to the method exist in news coverage, but we did not read a peer-reviewed case series, so we give no counts. Proper evidence not found for the rate of harm.

Who must avoid it

People with heart conditions, high or low blood pressure, epilepsy, asthma or other lung disease, pregnancy, or a history of fainting, panic, bipolar disorder or psychosis should ask a clinician before any intensive breathing. Cold exposure raises its own risks; see hydrotherapy safety.

If you are curious

A cold shower on its own, with normal breathing, is a separate topic with its own cautions. For gentler choices, see gentle and intensive breathwork compared and breathwork safety.