Decreased CO saturation during circular breathwork supports emergence of altered states of consciousness.

Altered states of consciousness (ASCs), induced e.g. during psychedelic-assisted therapy, show potential to treat prevalent mental health disorders like depression and posttraumatic stress disorder. However, access to such treatments is restricted by legal, medical, and financial barriers. Circular breathwork may present a non-pharmacological and hence more accessible alternative to engage similar therapeutic processes. Scientific studies of breathwork are only just emerging and its physiological and psychological mechanisms are largely unknown. Here, we track physiological and experiential dynamics throughout a breathwork session, comparing two forms of breathwork: Holotropic and Conscious-Connected breathwork. We show that a reduction in end-tidal CO pressure due to deliberate hyperventilation is significantly correlated to ASC onset (r = -0.46; p < 0.001). Based on standard questionnaires (MEQ-30 and 11-DASC), the ASCs evoked by breathwork resembled those produced by psychedelics across several experiential domains such as ego dissolution, and their depth predicted psychological and physiological follow-on effects, including improved well-being and reduced depressive symptoms. Further analysis showed that different breathwork approaches produced highly similar outcomes. Our findings identify physiological boundary conditions for ASCs to arise in a non-pharmacological context, shedding light on the functional mechanisms of breathwork as well as its potential as a psychotherapeutic tool.