How to Hyperventilate Safely
You should not intentionally hyperventilate, as it is physiologically harmful and contraindicated in nearly all circumstances. 1, 2
Why Hyperventilation is Dangerous
Hyperventilation causes multiple harmful physiological effects that worsen outcomes:
- Reduces cardiac output by increasing intrathoracic pressure, which decreases venous return to the heart and diminishes perfusion to vital organs 1, 3
- Causes cerebral vasoconstriction through excessive hypocapnia (low CO2), which paradoxically worsens brain perfusion despite increased oxygen delivery 3, 2
- Increases mortality in trauma patients through decreased cardiac output and worsened outcomes in traumatic brain injury 2
- Worsens outcomes after cardiac arrest by reducing coronary and cerebral perfusion pressure 3
Absolute Contraindications to Hyperventilation
Never intentionally hyperventilate if you have: 2
- Recent stroke or intracranial hemorrhage
- Significant carotid stenosis
- Moyamoya disease
- Sickle cell disease or trait
If You Must Practice Controlled Breathing
If your goal is stress management or respiratory training (not hyperventilation), slow deep breathing at 6 breaths per minute is the safe and evidence-based approach: 4, 5, 6
Safe Breathing Technique Parameters:
- Rate: 6 breaths per minute (one breath every 10 seconds) 5, 6
- Duration: 2-15 minutes 5, 6
- Method: Breathe through your nose with normal tidal volumes, focusing attention on the breath 7
- Avoid: Shallow breathing (increases anxiety), mouth breathing with forced deep breaths, or any technique causing dizziness 1, 7
Physiological Benefits of Slow Breathing (Not Hyperventilation):
- Improves oxygen saturation at high altitude 6
- Increases vital capacity and ventilation efficiency 5
- Reduces blood pressure 6
- Increases respiratory stability 7
Critical Safety Points
Do not use paper bag rebreathing - this outdated technique is potentially dangerous and not recommended by the British Thoracic Society 1, 2
Monitor your oxygen saturation - if you have normal or high SpO2 (>94%), you do not need supplemental oxygen and should not be attempting any breathing manipulation 1, 2
Seek medical evaluation first - organic causes (hypoxemia, metabolic acidosis, pulmonary embolism, cardiac conditions, sepsis) must be excluded before attributing any breathing symptoms to psychogenic causes 2