Airways to Alteration (A2A): a randomised-controlled trial exploring effects of breathwork on conscious state

Breathwork which increases ventilatory rate or depth represents an accessible nonpharmacological modality for potentially inducing altered states of consciousness (ASCs). Despite gaining traction as a therapeutic tool, empirical research remains limited, hence we conducted the first randomised-controlled trial (NCT06916312) on breathwork and ASCs. 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 one week later. Breathwork was associated with considerable 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 induced substantially greater psychological insight ( p = 0.002, r = 0.67) and behavioural change ( p = 0.008, r = 0.60). Stress, anxiety, depression and wellbeing improved in both groups over time. Results from this trial indicate that breathwork induces greater acute psychedelic-like effects than meditation, paired with substantial effects on emotional breakthrough, insight, and behaviour. These novel findings are relevant for future characterisation of breathwork’s potential in therapeutic contexts.