An exploratory study of breathwork-induced altered states of consciousness in experienced practitioners: the airways to alteration (A2A) trial

BACKGROUND: Breathwork that increases ventilatory rate or depth represents an accessible non-pharmacological modality for potentially inducing altered states of consciousness (ASCs). Despite gaining traction as a potential therapeutic tool, empirical controlled research on breathwork and ASCs remains limited. METHODS: We examined the effects of a single session of high ventilation breathwork, compared to body scan meditation, in 24 healthy adults with primary outcomes of acute ASCs including mystical experience and emotional breakthrough. Sub-acute secondary outcomes were collected 1 week later. RESULTS: Breathwork was associated with larger effects on oceanic boundlessness (p = 0.007, r = 0.63), visionary restructuralisation (p = 0.018, r = 0.60), total mystical experience (p = 0.007, r = 0.66), oneness (p = 0.018, r = 0.60), positive mood (p = 0.007, r = 0.66), ineffability (p = 0.038, r = 0.55), and emotional breakthrough (p = 0.028, r = 0.45). At follow-up, breathwork was associated with substantially greater psychological insight (p = 0.002, r = 0.67) and behavioral change (p = 0.008, r = 0.60) relative to body scan meditation. Stress, anxiety, depression and wellbeing improved in both groups over time. DISCUSSION: Results from this preliminary experimental study indicate that breathwork is associated with larger acute psychedelic-like effects than meditation, alongside greater emotional breakthrough, insight, and self-reported behavioral change. These exploratory relationships and preliminary observations provide greater context around breathwork-induced ASCs, and support the feasibility of ASC-focused breathwork research for future confirmatory trials.