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.