High Ventilation Breathwork (HVB)—volitional manipulation of breathing used historically for psychological distress—produces extraordinary changes in subjective experience and profound effects on central and autonomic nervous systems by modulating neurometabolic parameters and interoceptive sensory systems. Clinical observations and neurophysiological studies indicate these practices may have therapeutic potential for trauma-related, affective, and somatic disorders. The evidence base suggests that the phenomenological effects of HVB can be understood and potentially harnessed through volitional perturbation of psychophysiological state, but further research is needed for detailed mechanistic knowledge and rigorous clinical testing of these potential uses.
High Ventilation Breathwork (HVB), which involves deliberate manipulation of breathing, has a long history of use for psychological distress. This review examines its potential as a treatment for psychiatric disorders by analyzing its phenomenological and neurophysiological effects. Clinical observations and neurophysiological data show HVB produces extraordinary changes in subjective experience and profoundly affects central and autonomic nervous system functions by modulating neurometabolic parameters and interoceptive sensory systems. These effects may guide understanding and harnessing of HVB's volitional perturbation of psychophysiological states. Reports of beneficial effects for trauma-related, affective, and somatic disorders warrant further mechanistic research and rigorous clinical testing.
High ventilation breathwork (HVB), which involves rapid or deep breathing often accompanied by music, can produce altered states of consciousness (ASCs) similar to those caused by psychedelic substances, including euphoria, bliss, and perceptual changes. The neurobiological mechanisms behind these effects were largely unknown. In experienced practitioners, the intensity of ASCs from HVB was proportional to cardiovascular sympathetic activation and to changes in cerebral blood flow in the left operculum/posterior insula and right amygdala/anterior hippocampus—brain regions involved in sensing breathing and processing emotional memories. These brain changes may underlie the positive therapeutic outcomes associated with HVB.
A single session of high ventilation breathwork produced larger altered states of consciousness—including mystical experience, emotional breakthrough, and feelings of oneness—than body scan meditation in 24 healthy adults. One week later, breathwork was associated with greater psychological insight and self-reported behavioral change. Both groups showed improvements in stress, anxiety, depression, and well-being over time. These preliminary findings suggest breathwork can induce psychedelic-like effects and support further confirmatory research.