Holding Your Breath: Benefits, Science and Training Guide

Holding your breath, known as apnea, triggers a series of physiological changes. Practiced correctly, breath hold training can strengthen the breathing muscles, help you stay calm with air hunger, and cause a short-term rise in EPO production.

The average person can hold their breath for 30 to 90 seconds. With training, this improves significantly. This article covers the benefits of breath holding, what happens in your body during a breath hold, how long you should aim for, and how to train safely.

What Happens When You Hold Your Breath

Normal breathing chemistry involves the exchange of oxygen (O2) and carbon dioxide (CO2). In simple terms, you breathe in to get oxygen, which your body needs for energy.

You breathe out to get rid of excess carbon dioxide and bring fresh oxygen into the lungs. Breathing is controlled by the brain, which responds to several inputs. CO2 is a powerful feedback signal, and during a breath hold, rising CO2 is an important contributor to the urge to breathe.

How strongly you react to that urge, and how you perceive it, can be trained. Breath holding exercises are one way to do this, giving you controlled exposure to air hunger.

The Oxygen Advantage® breath holding exercises disrupt blood gases to create hypoxia and hypercapnia. This provides a training stimulus that may lead to adaptations that support performance and make breathing feel easier.

Benefits of Holding Your Breath

Holding the breath until you feel a strong air hunger gives the diaphragm a workout and exposes the body to higher levels of carbon dioxide and lower levels of oxygen.

Over time, many people find they feel less breathless, their breathing is calmer, and they cope better with hard efforts.

The breath holding exercises to simulate altitude may have several benefits for sports performance. Research suggests breath hold training can help:

• Improve tolerance of fatigue during repeated hard efforts, according to some studies
• Improve repeated sprint ability for team sports such as rugby and football/soccer, particularly fatigue resistance across sprints
• Improve respiratory muscle strength, which can support breathing efficiency and endurance
• Support aerobic training
• Cause a short-term rise in EPO (erythropoietin) safely and legally
• Support running economy
• Support swimming performance
• Reduce oxidative stress after breath holding, as seen in trained breath-hold divers
• Build comfort with air hunger and composure under pressure

Results vary between individuals and between studies, and the evidence for some of these benefits is still developing.

How Long Can You Hold Your Breath?

The average person can hold their breath for around 30 to 90 seconds. People can hold longer after hyperventilating first, but this is dangerous and can cause blackout without warning. Never hyperventilate before a breath hold.

In March 2021, a 56-year-old free diver from Croatia, Budimir Šobat, set a Guinness World Record for the longest breath hold: 24 minutes 37.36 seconds. Records like this are set after breathing pure oxygen beforehand, which greatly extends breath hold time.

Previously the oxygen-assisted world record for holding the breath was held by Stig Severinsen. In 2012, Severinsen held his breath for 22 minutes.

Two years earlier, he had achieved another record-breaking breath-hold after swimming 72 meters under ice wearing only swimming trunks and goggles.

This was 14.5 meters further than Wim Hof's record of March 2000. In 2019, the Turkish athlete, Bilge Cingigiray, walked 86 meters underwater in one minute using a single breath.

These are elite, highly supervised feats. Breath holds should never be practiced in or under water.

How Long Should You Hold Your Breath?

Breath holding in the Oxygen Advantage® is not meant as a competitive sport or a test of willpower. While some people can learn to hold their breath after inhalation for a very long time, breath holding after exhalation is less influenced by lung volume and willpower. The BOLT score is measured after an exhalation, and it records how quickly you feel the first clear urge to breathe. It is influenced by several factors, including chemical sensitivity, breathing pattern, respiratory sensation and psychological factors.

When we use strong breath holds to simulate training at high altitude, we gauge the length of the breath hold by the strength of our air hunger.

If your BOLT score is low when you begin, it is important not to hold your breath for longer than half the BOLT score. With a BOLT score of 9, you might practice many small breath holds of 3 or 4 seconds.

But you wouldn't practice strong breath holding just yet. It is not advisable to practice strong breath holds until your BOLT score is 25 seconds or more. This protects your body from excessive stress that can slow down progress and exacerbate symptoms.

How to Hold Your Breath Longer

Swimming is known to help breath holding capacity. Research from 2021 concluded that young, trained swimmers had a reduced hypoxic ventilatory response and greater maximal voluntary apnea (breath hold) duration (after inhalation) [10].

However, the best way to increase breath hold time is to become more comfortable with air hunger, which is what Oxygen Advantage means by "CO2 tolerance." You can do this by practicing the Oxygen Advantage® breathing exercises.

What Happens If You Hold Your Breath Too Long?

When you practice exercises involving light/easy breath holds but extend your breath hold beyond half your BOLT score, you may experience uneven breathing when you take your next inhalation.

The aim is always to resume breathing with a normal breath in through your nose, not a big gasp of air through your open mouth. You may also experience a dry mouth and cold hands, or feelings of panic and suffocation. All these indicate you have pushed your body into a stress response.

If you push your body too far during a breath hold, you may feel an urgent need to pee when you resume breathing. You will feel your diaphragm begin to contract as your brain sends the signal to breathe in. Don't push yourself to hold beyond what feels bearable.

Some breathing methods use deliberate hyperventilation before breath holding to prolong the breath hold. They work by getting rid of carbon dioxide, delaying the urge to breathe.

People have passed out during these types of breath holds, and there have been cases of drowning because the practitioner blacked out while breath holding in water. This is why we strongly advise against breath holding in or near water.

Holding the breath after a normal exhalation, without hyperventilating first, is generally safe on dry land if you are healthy and have no contraindications. It is harder to push too far with willpower, and your body will let you know when it's time to breathe in.

Is Breath Holding Safe? Who Should Avoid It

Strong breath holding exercises are only suitable if you are in good health. If you have any concerns, consult your medical doctor before practicing the exercises.

You should never practice breath holds if you are in or near water, or if you are pregnant. The impact of breath holding on the unborn baby is not known.

You should not practice strong breath holds if you have:

• High or low blood pressure
• Epilepsy
• Diabetes
• Schizophrenia
• Uncontrolled hyperthyroidism
• Chest pains, heart problems or arrhythmias
• Pulmonary hypertension
• Sickle cell anemia
• Cancer
• Arterial aneurysm
• Kidney disease
• Panic disorder and/or anxiety
• Sleep apnea
• Cardiovascular issues
• A history of fainting, concussion or stroke
• Chronic fatigue syndrome, Long COVID, dysautonomia or POTS
• Uncontrolled asthma, severe COPD or an active respiratory infection
• An eating disorder
• A BOLT score under 12 seconds

Adults over 60 should only practice strong breath holds if cleared by their doctor.

Does Holding Your Breath Burn Calories?

When you lose weight, fat breaks down into carbon dioxide and water. The water leaves your body in urine, sweat and breath, while you get rid of CO2 via the lungs. In fact, 84% of the fat you lose leaves the body as exhaled carbon dioxide.

This helps explain why exercise supports weight loss: the more we move, the more energy we use and the more we breathe.

When breathing feels easier and more controlled, you may enjoy exercise more and be able to walk, run or cycle for longer. The more you move, the more calories you will burn.

The strong breath holding exercises in the Oxygen Advantage® method burn only a few calories themselves. Their bigger value is in helping you exercise more comfortably and consistently.

The Science Behind Breath Holding: Hypoxia and Hypercapnia

To understand why breath holding works, it helps to understand what happens to your blood gases during a hold.

What Is Hypoxia?

Hypoxia is a medical term that refers to a deficiency in the amount of oxygen reaching the tissues. There are many causes of hypoxia, but the most common is a lack of oxygen. When the body is deprived of oxygen for long periods, it can cause serious health problems. Hypoxia can affect any organ in the body, but it is most commonly seen in the brain, heart, and lungs.

What Is Hypercapnia?

Hypercapnia is a condition that results from too much carbon dioxide (CO2) in the blood. This can happen for several reasons, including:

• Breathing disorders such as sleep apnea
• Severe asthma attacks
• Chronic lung disease such as COPD
• Weakness of the breathing muscles
• Medications or drugs that suppress breathing

When hypercapnia occurs, the body tries to compensate by increasing the breathing rate (called tachypnea) and the heart rate (called tachycardia).

How Hypoxia and Hypercapnia Affect Athletes

Prolonged or severe hypoxia means the body cannot produce energy efficiently, leading to fatigue and performance decline. Hypercapnia, excess CO2 in the blood, triggers a cascade of responses the body must manage quickly. When experienced briefly, in a controlled training context, both provide a stimulus that may lead to useful adaptations.

The Benefits of Hypoxia and Hypercapnia Training

Research on hypoxic and hypercapnic training suggests it may support endurance, fatigue resistance during repeated sprints, and respiratory muscle strength. Results vary between studies, and the best protocols are still being researched.

• Hypoxia = low concentration of oxygen in the blood (below 90%)
• Hypercapnia = high levels of carbon dioxide in the blood
• Normal oxygen level = between 95 and 100%

What Research Shows About Breath Holding and Athletic Performance

A study by researchers at Nagoya University in Japan found that athletes had a lower breathing response to carbon dioxide than untrained individuals, both at rest and during exercise [1].

Older research has also suggested that endurance athletes and non-athletes differ in their breathing response to low oxygen (hypoxia) and higher carbon dioxide (hypercapnia) [2,3].

In a paper published in Medicine and Science in Sports, the authors found that breathing in non-athletes was heavier in response to exercise than in endurance athletes at equal workloads [3].

More recent research paints a more nuanced picture. A 2022 study found that endurance athletes and sedentary people had similar sensitivity to CO2, but athletes appeared to use additional strategies during exercise to reduce its influence on their breathing and perceptions [11]. How you perceive and respond to air hunger may matter as much as chemistry.

In another study, exercise physiologist Xavier Woorons notes that trained athletes breathe less than untrained men during exercise in low-oxygen conditions, which the authors suggest may reflect a weaker breathing response to carbon dioxide [4]. Training with reduced breathing frequency has also been studied as a way to change breathing responses during exercise [5,6,7].

During intense exercise, your body uses more oxygen and produces more carbon dioxide. Staying calm and in control as breathing demands rise is a valuable skill for athletes.

It is common for even elite athletes to have dysfunctional, inefficient breathing. Some start with a relatively low BOLT score. Physical training alone does not necessarily improve breathing pattern, which is why dedicated breathing training, such as the Oxygen Advantage® program, can be a useful addition.

How Breath Holding Simulates High Altitude Training

High altitude training has long been used by endurance athletes. If you train where atmospheric oxygen is low, you may gain an advantage when you return to sea level. Breath holding offers a practical way to create brief, altitude-like hypoxia at sea level, although it is not the same as living or training at altitude.

The Oxygen Advantage® method uses hypoxic/hypercapnic breath training, which we call simulation of high-altitude training. This type of training can involve the use of a training (elevation) mask.

Despite what many mask manufacturers will tell you, the mask itself does not simulate high altitude. Instead, it creates resistance to breathing, adding a load to the breathing muscles.

As you continue to breathe through your nose, the diaphragm becomes stronger. At the same time, the reduced airflow creates air hunger, giving you practice at staying calm as the urge to breathe builds.

Hypoxia is achieved with strong breath holds. The normal concentration of oxygen in blood is 95 to 100%, meaning that under normal circumstances, your blood is fully saturated with oxygen. But when you practice strong breath holding during physical movement, oxygen can drop to well below 90%.

When the breath is held, carbon dioxide cannot leave the body via the lungs. Instead, it builds up in the blood (hypercapnia).

Carbon dioxide has a special relationship with oxygen. Together with acidity, it helps red blood cells offload oxygen to the tissues, and it widens blood vessels, particularly in the brain.

During the hold, blood oxygen falls, which is the hypoxic stimulus the exercise is designed to create.

Researchers are also exploring whether controlled hypoxia can support recovery. Early animal research suggests hypoxia may influence muscle repair after injury [8] and muscle stem cells [9], but this has not been established in humans.

Breath Holding as a Natural Alternative to Blood Doping

Blood doping in sport is not going away. The number of detections, high profile reports and investigations suggests a self-fulfilling prophecy, one in which clean athletes succumb to the pressure of doping so they can compete on a level playing field. But as we at the Oxygen Advantage® know, there is a better way.

Doping improves oxygen carrying capacity and increases the delivery of oxygen to working muscles to increase VO2 max and performance. But it improves only one of the many parameters responsible for winning.

Running performance is based on many physiological parameters, including psychological preparedness and the ability to withstand fatigue. Or, as the great Finnish runner Paavo Nurmi said: "Mind is everything. Muscles; pieces of rubber."

The relationship between mind, body and exercise performance is at the heart of the "central governor" theory put forward by South African physiologist Dr. Tim Noakes. It is an influential but debated theory.

Noakes proposes that a "governor" located in the brain sets the limit on exercise intensity to protect the body from harm. When the brain senses that demands are becoming too great, it restrains the working muscles, and fatigue is experienced to slow down and preserve the athlete.

If the brain can be trained to cope with increased demands, athletes may be able to push themselves harder without the need to dope.

The Oxygen Advantage® method offers athletes a natural and legal alternative. The breath holding component is a departure from techniques used since the 1960s.

Instead of breath holding following an inhalation, the technique involves breath holding following a normal exhalation.

This causes a significant decrease in blood oxygen saturation and an increase in carbon dioxide, while simultaneously generating intense feelings of breathlessness, adding an extra load onto the athlete that would not otherwise be experienced during normal training.

This gives the brain repeated experience of lower oxygen, higher carbon dioxide and strong breathlessness, which may help athletes tolerate hard efforts and stay composed under fatigue.

Maximal breath holds can also cause a short-term rise in EPO (erythropoietin). Whether this leads to lasting increases in red blood cells is less clear: one controlled study of six weeks of static breath holds found no change in hemoglobin mass [12]. Breath holding is not a like-for-like replacement for doping, but it is a legal way to add a hypoxic training stimulus.

Doping risks not only the health of the athlete, but the very future of their sport. Oxygen Advantage® offers a natural and legal alternative.

Learn the Right Technique and Apply It

Breath holding after exhalation is one of the most potent tools in functional breathwork, and one of the least understood. Research suggests that, done correctly, it can cause a short-term rise in EPO, strengthen the breathing muscles, build comfort with air hunger, and improve fatigue resistance during repeated sprints. Done incorrectly, it can be dangerous.

Learn the right technique from the source. Patrick McKeown's online breathing course includes step-by-step video instruction on breath hold exercises, how to perform them, how to progress them safely, and how to integrate them into your training.

If you are interested in trying the OA method for yourself, why not try our online course, download the free OA Breathing App or find an Oxygen Advantage® instructor near you.

FAQS

Q: What are the health benefits of holding your breath?
A: Breath hold training can strengthen the breathing muscles, build comfort with air hunger, and trigger the spleen to release stored red blood cells during the hold. In athletes, some studies show improved fatigue resistance during repeated sprints. Results vary, and strong breath holds are not suitable for everyone.

Q: Does breath holding stimulate EPO production?
A: Yes, intense breath holds that cause a large drop in blood oxygen can trigger a short-term increase in EPO, which returns to baseline within hours. Whether regular breath holding leads to lasting increases in red blood cells or aerobic performance is still uncertain.

Q: How long should I hold my breath for health benefits?
A: It depends on your BOLT score and goals. Gentle 2 to 5-second holds suit relaxation and nasal clearing. Longer, stronger holds are used by healthy athletes to create an altitude-like training stimulus, and are best learned with guidance.

Q: Is holding your breath dangerous?
A: Yes, if practised incorrectly. Strong breath holds are strictly prohibited in or near water due to blackout risk, during pregnancy, and for anyone with serious medical conditions or severe panic disorders. Never hyperventilate before a breath hold.

Q: What happens in the body during a breath hold?
A: CO2 accumulates, blood oxygen drops, nitric oxide pools in the nasal cavity, the spleen contracts to release stored red blood cells, and the diving response activates to slow heart rate and conserve oxygen.

References

1. Miyamura M, Yamashina T, Honda Y. Ventilatory responses to CO2 rebreathing at rest and during exercise in untrained subjects and athletes. The Japanese Journal of Physiology 1976; 26: 245-54
2. Scoggin CH, Doekel RD, Kryger MH, Zwillich CW, Weil JV. Familial aspects of decreased hypoxic drive in endurance athletes. Journal Applied Physiology 1978;(Mar;44(3)):464-8
3. Martin BJ, Sparks KE, Zwillich CW, Weil JV. Low exercise ventilation in endurance athletes. Med Sci Sports.1979;(Summer;11(2)):181-5
4. Woorons X, Mollard P, Pichon A, Lamberto C, Duvallet A, Richalet JP. Moderate exercise in hypoxia induces a greater arterial desaturation in trained than untrained men. Scand J Med Sci Sports 2007: 17: 431-436
5. Jakovljevic DG, McConnell AK. Influence of different breathing frequencies on the severity of inspiratory muscle fatigue induced by high-intensity front crawl swimming. J Strength Cond Res, 2009; 23, 1169-1174
6. Kapus J, Kapus V, Strumbelj B, Usaj A. Can high intensity workloads be simulated at moderate intensities by reduced breathing frequency? Biol Sport, 2010a; 27, 163-168
7. Kapus J, Usaj A, Lomax M. Adaptation of endurance training with a reduced breathing frequency. J Sports Sci Med, 2013;12(4), 744-752
8. Ferreira IR. Effect of intermittent hypobaric hypoxia on induced muscle injury repair in laboratory rats. Master's thesis, 2012
9. Jash S, Adhya S. Effects of transient hypoxia versus prolonged hypoxia on satellite cell proliferation and differentiation in vivo. Stem Cells International 2015
10. Arce-Alvarez A, et al. Hypoxic Respiratory Chemoreflex Control in Young Trained Swimmers. Frontiers in Physiology 12 (2021): 215
11. Harrison OK, Russell BR, Pattinson KTS. Perceptual and ventilatory responses to hypercapnia in athletes and sedentary individuals. Frontiers in Physiology 2022; 13: 820307
12. Bouten J, Debusschere J, Lootens L, et al. Six weeks of static apnea training does not affect Hbmass and exercise performance. J Appl Physiol 2022; 132(3): 673-681