New research suggests that High Ventilation Breathwork (HVB) can induce profound effects on the central and autonomous nervous systems, which could potentially lead to the development of new ‘breathing’ treatment of psychiatric disorders.

HVB refers to practices employing specific volitional manipulation of breathing with increased ventilation, which have a long history of use to relieve various forms of psychological distress.

Researchers at BSMS, under the guidance of principal investigator Dr Alessandro Colasanti, MD, have led a review on the effects of HVB practices to inform their mechanism of therapeutic action, safety profiles and future clinical applications. The Colasanti Lab are conducting a research programme to test HVB mechanisms and develop interventions. 

Clinical observations and data from neurophysiological studies indicate that HVB is associated with extraordinary changes in subjective experience, as well as with profound effects on central and autonomic nervous systems functions through modulation of neurometabolic parameters and interoceptive sensory systems. 

This growing evidence base may guide how the phenomenological effects of HVB can be understood, and potentially harnessed in the context of such volitional perturbation of psychophysiological state. Reports of putative beneficial effects for trauma-related, affective and somatic disorders invite further research to obtain detailed mechanistic knowledge, and rigorous clinical testing of these potential therapeutic uses.

Co-first author, Guy Fincham, a PhD research fellow at Sussex Psychology and now a member of Colasantis Lab at BSMS, says: “Our research offers a consolidative insight into potential clinical application of HVB as a treatment of psychiatric disorders. This includes evidence that HVB may induce altered states of consciousness as well as having several beneficial effects reported anecdotally and some controlled trials in PTSD.” The team are very proud of the collaboration between the Medical and Psychology Schools at Sussex — “our group is at the forefront of such breathwork research” says Colasanti. 

Established autonomic and neurometabolic effects of hyperventilation clearly support the notion that HVB can induce profound modulatory effects at various levels of central and autonomous nervous systems, altering their functions and reciprocal interactions, and ultimately impacting high order metacognitive functions that might be relevant to HVBs therapeutic effects.  However, despite the huge potential in terms of the therapeutic applications of HVB, its popularity has not been matched by advances in research investigating its neurobiological mechanisms and clinical efficacy in rigorous, controlled studies. 

Fincham adds: “To advance the field of HVB research and practice, a roadmap of well-designed studies is needed. Rigorous pilot and feasibility studies are required to gauge both safety and tolerability as well as therapeutic potential. Moreover, regarding clinical efficacy, non-inferiority and superiority trials should use appropriate active control groups depending on the population being studied. Rigorous psychophysiological studies should also explore both brain and body physiological responses and phenomenological correlates to further uncover objective and subjective outcomes of HVB.”

The review, ‘High Ventilation Breathwork practices: An overview of their effects, mechanisms, and considerations for clinical applications,’ has been published in Neuroscience and Biobehavioral Reviews.

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