It is assumed, but not well-studied, that the psychological effects of conscious connected breath directly or indirectly stem from hypoxia. Unfortunately, the mechanisms are not well known, mostly due to before-mentioned experimental limitations. Effect on different brain regions

Hypoxia disrupts the balance of both excitatory and inhibitory neurotransmitters (the bouncers of our neuron clubs), which has a very complex effect on different parts of the brain — some tend to be more excitable during hypoxia, some less.

The hippocampus (involved in memory formation) and reticular activating system (involved in maintaining consciousness) both initially get more excited as a response to hypoxia, even though prolonged hypoxia (way beyond the duration and intensity of common breathwork) can lead to cell damage and death in these regions.

While the exact mechanisms are unknown, this change in activity in some brain regions is known as an altered state of consciousness, modulating our awareness of both self, our thoughts and emotions and reality around us.

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Dopamine response

Animal studies have shown that hypoxia can lead to increased dopamine release, and decreased reuptake of dopamine. Dopamine is an important neurotransmitter that has been shown to play a crucial role in how we feel pleasure, plan, focus, and even find things interesting.

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Endorphin release

It is theorized that hypoxia triggers a release of β-endorphin, an endogenous opioid that binds to the same receptors as morphine and codeine. Like other opioids, endorphins can inhibit the transmission of pain signals and create a feeling of euphoria. It’s also released during intense prolonged exercise, where it’s known as “runner’s high”. Again, the bad news is that nobody knows the exact mechanism of either process.

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Subjective effects

Bahi et al., 2024 did one of the first neuropsychological studies specifically on conscious connected breath. Among other things, they compared the subjective effect of breathwork to the perceived effect of psilocybin using the well-established “11 Dimension Altered State of Consciousness Questionnaire”. Essentially, they asked subjects a number of questions after a breathwork session that map to eleven different “dimensions” of altered states. In the chart below you can compare the effect they found after conscious connected breath (red line) compared to a study of psilocybin (blue lines) by Hirschfeld et al., 2021. The latter study is a meta-analysis of a number of studies that have been done on the effects of psilocybin studies the effect of different doses on altered states of consciousness. You can use the slider below to see the results for different doses of psilocybin. As you can see, breathwork produced a similar subjective effect on eg. insightfulness, experience of unity as 400μg psilocybin per kg of body weight (which for a person weighing 70 kg works out to about 2.8g ± 0.6 of dried magic mushrooms, Psilocybe cubensis), while producing noticeably less visual imagery.

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Overview over known mechanisms