Controlled Hyperventilation

Controlled hyperventilation followed by breath retention cycles was popularized by a dutchman by the name of Wim Hof, some times also referred to as “the Iceman”. This is a breathwork practice that makes you feel very alert (1,2). So, if you feel tired, low on energy, have a tickle in your throat, or have a run down, this is a great breathwork exercise for you. 

Deliberate hyperventilation is a way of voluntarily changing the rhythm of your breath to trigger the stress response. In essence, you deliberately breathe really fast. This is typically done in bouts of 40 or so breaths, inhaling deeply through the nose and then passively exhaling, typically through the mouth (1,2)

Some like to combine deliberate hyperventilation with ice baths or cold showers (1-5). However, it is not necessary to get most of the benefits (4), although some effects are attenuated (6). Both, deliberate hyperventilation and cold exposure have more or less the same effect, of increasing adrenaline, which allows you to become more alert and may even combat certain infections since you activate the autonomic nervous system and the immune response (1-5). 

Benefits 

IMMEDIATE EFFECTS: 

  • Increased alertness (1,2,3) 

  • Reduced inflammation (3)

  • Improved immune function (1-5,7,8) 

  • Accelerated altitude acclimatization (9)

  • Reduced pain sensitivity (10)

EFFECTS FROM DAILY PRACTICE: 

  • Control over the autonomic nervous system (7) 

  • Reduce perceived stress (6) 

  • Reduced inflammation (5) 

  • Improved immune function (1,5) 

  • Reduced stress in extreme cold (11) 

  • Reduced symptoms of depression (11)

How it works

Deliberate hyperventilation makes you feel very alert, but why does it make you feel that way? Because that pattern of breathing, i.e. rapid movements of the diaphragm, is more than just a breathing technique — it's a gateway to enhancing the body's stress response. This method stimulates the adrenal glands to unleash adrenaline, sharpening alertness and fortifying the immune system against infections (1-5,7,12,13).  

Following up hyperventilation with breath retention adds a powerful twist, transitioning from stimulation to optimization of the body’s physiological functions. This sequence plunges the body into a dance between hyperoxia and hypoxia — first flooding it with oxygen, then stripping it away. This fluctuation not only sharpens the body’s mastery over oxygen and carbon dioxide but also triggers the Bohr effect, a phenomenon where shifts in blood pH optimize oxygen delivery to the tissues. Initially, low CO2 levels increase oxygen's affinity to hemoglobin, reducing its release. High CO2 levels during breath retention reverse this, enhancing oxygen flow to vital organs (14,15). 

The practice also fine-tunes the autonomic nervous system, switching from the adrenaline-fueled alertness of hyperventilation to the calm of breath retention. This dynamic shift not only bolsters physiological resilience but also improves mental focus and mood by regulating cerebral blood flow (1).  

Moreover, combining deliberate hyperventilation with cold exposure like ice baths or cold showers intensifies these effects. Cold acts as an additional stressor, prompting further adrenaline release, although its impact alone on certain inflammatory markers is minimal. This method offers a double dose of hormetic stress, which can significantly reduce inflammation and enhance immune function through adrenaline’s anti-inflammatory pathways (1,3,4,16-18). 

This breathing practice doesn’t just adjust physiological dials — it reshapes how we confront stress, enhancing mental resilience and a sense of control over our health. Controlled hyperventilation followed by breath retention is proving to be a promising strategy in lifestyle medicine, not only for reducing inflammation but also for boosting energy and improving overall well-being with minimal side effects. 

How it is done

This breathing technique combines hypoxic and hyperoxic phases. The exercise starts with 30-40 deep inhalations involving abdominal and thoracic breathing, and oral exhalation. The exhalation breath should be performed as “letting go” of the air, without forcefully pressing it out. After the last exhalation, the practitioner should hold its breath. For the context of beginners, we advice to set specific round limits of 60, 90, 120, and 150 seconds, respectively for the four rounds. For a regular practitioner, breath-holding time may be stretched out at will. Once this time has passed, the practitioner should take a deep breath and hold it for 15 seconds, before letting go. This step completes one round of the breathing exercise. One session commonly consists of a total of four rounds. 

    1. Almahayni O, Hammond L. Does the Wim Hof Method have a beneficial impact on physiological and psychological outcomes in healthy and non-healthy participants? A systematic review. PloS One [Internet]. 2024 Mar 13;19(3):e0286933. Available from: https://doi.org/10.1371/journal.pone.0286933

    2. Kox M, Van Eijk LT, Zwaag J, Van Den Wildenberg J, Sweep FCGJ, Van Der Hoeven JG, et al. Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans. Proceedings of the National Academy of Sciences of the United States of America [Internet]. 2014 May 5;111(20):7379–84. Available from: https://doi.org/10.1073/pnas.1322174111

    3. Zwaag J, Ter Horst R, Blaženović I, Stoessel D, Ratter JM, Worseck JM, et al. Involvement of lactate and pyruvate in the Anti-Inflammatory effects exerted by voluntary activation of the sympathetic nervous system. Metabolites [Internet]. 2020 Apr 10;10(4):148. Available from: https://doi.org/10.3390/metabo10040148

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    6. Kopplin CS, Rosenthal L. The positive effects of combined breathing techniques and cold exposure on perceived stress: a randomised trial. Current Psychology [Internet]. 2022 Oct 7; Available from: https://doi.org/10.1007/s12144-022-03739-y

    7. Muzik O, Reilly KT, Diwadkar VA. “Brain over body”–A study on the willful regulation of autonomic function during cold exposure. NeuroImage [Internet]. 2018 May 1;172:632–41. Available from: https://doi.org/10.1016/j.neuroimage.2018.01.067

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