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Breath play: Difference between revisions
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'''Breath | {{Infobox kink | ||
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| health_risk = High | |||
| legal_risk = Moderate | |||
}}'''Breath play''' (also called '''breath control''') is the intentional interference with the natural oxygen-based gas exchange of the human body for the purposes of sexual gratification. When performed specifically to restrict oxygen to the brain, this is called '''erotic asphyxiation''' (or when performed alone, '''autoerotic asphyxiation)'''. Breath control is a high-risk [[kink]] and a common cause of fatalities in kink-related incidents. | |||
== Background == | == Background == | ||
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Human lungs exchange oxygen for carbon dioxide and store additional oxygen, which allows for brief periods of apnea (pauses in breathing) without harm. The amount of gas stored in the lungs at a given time is described by "[[wikipedia:Lung_volumes|lung volumes]]", and varies depending on what the person is doing. If breathing is paused, adequate oxygenation will be provided to the body until the remaining oxygen stored in the lungs is consumed, after which the person's oxygen saturation will rapidly decrease followed shortly by loss of consciousness. | Human lungs exchange oxygen for carbon dioxide and store additional oxygen, which allows for brief periods of apnea (pauses in breathing) without harm. The amount of gas stored in the lungs at a given time is described by "[[wikipedia:Lung_volumes|lung volumes]]", and varies depending on what the person is doing. If breathing is paused, adequate oxygenation will be provided to the body until the remaining oxygen stored in the lungs is consumed, after which the person's oxygen saturation will rapidly decrease followed shortly by loss of consciousness. | ||
Importantly, the body's sense of urgency to breathe is almost entirely driven by the ability to exhale carbon dioxide rather than the level of oxygen in the blood. This means that in certain circumstances (e.g. inhaling breaths of nitrous oxide continuously), the person will never feel short of breath despite low oxygen levels which can rapidly lead to unconsciousness. | Importantly, the body's sense of urgency to breathe is almost entirely driven by the ability to exhale carbon dioxide rather than the level of oxygen in the blood. This means that in certain circumstances (e.g. inhaling breaths of [[nitrous oxide]] continuously), the person will never feel short of breath despite low oxygen levels which can rapidly lead to unconsciousness. | ||
The following table demonstrates how much gas remains in the lungs and how long that gas can supply enough oxygen to the body for a number of different circumstances for an average adult. Note that while the average volumes of gas vary greatly between individuals based upon their [[wikipedia:Lean_body_mass|lean body weight]], there is a reciprocal change in the rate of oxygen consumption meaning that the calculated times until desaturation occurs remain roughly the same. | The following table demonstrates how much gas remains in the lungs and how long that gas can supply enough oxygen to the body for a number of different circumstances for an average adult. Note that while the average volumes of gas vary greatly between individuals based upon their [[wikipedia:Lean_body_mass|lean body weight]], there is a reciprocal change in the rate of oxygen consumption meaning that the calculated times until desaturation occurs remain roughly the same. | ||
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=== Hypoxia (Low oxygen) === | === Hypoxia (Low oxygen) === | ||
Hypoxia is the term used to describe inadequate oxygen delivery to the body. When oxygen is completely depleted: | Hypoxia is the term used to describe inadequate oxygen delivery to the body at the tissue level<ref>https://my.clevelandclinic.org/health/diseases/23063-hypoxia</ref>. When oxygen is completely depleted: | ||
* Consciousness is lost within seconds | * Consciousness is lost within seconds | ||
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** This may delay or prevent assistance being provided, leading to further injury or death | ** This may delay or prevent assistance being provided, leading to further injury or death | ||
[[File:Posturing.jpg|thumb|Examples of decorticate and decerebrate posturing.]] | [[File:Posturing.jpg|thumb|Examples of decorticate and decerebrate posturing.]] | ||
[[File:Posturing.webm|frame|right|An example of rapid loss of consciousness and onset of posturing due to bilateral carotid compression.<br/>0:11 - Consciousness is lost<br/>0:14 - Decorticate posturing begins<br/>0:21 - Posturing transitions toward a decerebrate pattern. Note the right arm attempting to extend outward blocked by legs.<br/>0:32 - Decerebrate posturing more apparent when body allowed to fully extend | [[File:Posturing.webm|frame|right|An example of rapid loss of consciousness and onset of posturing due to bilateral carotid compression.<br/>0:11 - Consciousness is lost<br/>0:14 - Decorticate posturing begins<br/>0:21 - Posturing transitions toward a decerebrate pattern. Note the right arm attempting to extend outward blocked by legs.<br/>0:32 - Decerebrate posturing more apparent when body allowed to fully extend<br/>0:35 - Posturing ceases, consciousness returns]] | ||
=== Hypercarbia (high carbon dioxide) === | === Hypercarbia (high carbon dioxide) === | ||
Hypercarbia is the term used to describe the inability to eliminate carbon dioxide from the body by exhalation. When carbon dioxide cannot be eliminated, an increasingly urgent sensation to breathe develops. If airflow is not restricted, the rate and depth of breathing reflexively increase. At very high levels of carbon dioxide, a person can become unresponsive and the pH of the blood can become dangerously acidic. | Hypercarbia is the term used to describe the inability to eliminate carbon dioxide from the body by exhalation. When carbon dioxide cannot be eliminated, an increasingly urgent sensation to breathe develops. If airflow is not restricted, the rate and depth of breathing reflexively increase. At very high levels of carbon dioxide, a person can become unresponsive and the pH of the blood can become dangerously acidic. | ||
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== Appeal<!-- Describe the reasons why people participate in this kink. --> == | == Appeal<!-- Describe the reasons why people participate in this kink. --> == | ||
== Risks | === Euphoria === | ||
Hypoxia with or without hypercarbia commonly causes a sense of euphoria. The causal relationship of this is not clear; it may be related to a release of endogenic endorphins, alteration to the balance of neurotransmitters in the brain, or to cerebral vasodilation. The euphoric effect can enhance sexual pleasure. | |||
=== Loss of control === | |||
Especially when combined with [[bondage]], breath control can cause an elevated level of helplessness or panic. This may be a desired goal in a BDSM scene. As breathing is an integral component to staying alive, ceding control of it to another person can be a significant symbol of submission. | |||
== Methods<!-- Describe the techniques and approaches for how this kink is typically performed. --> == | |||
=== Mouth and/or nose occlusion === | |||
The blocking of air from reaching the mouth and nose. | |||
For example: | |||
* Hand/Glove over mouth (HOM/GOM) | |||
* Gas masks (Hand over intake, valves, restrictors) | |||
* Swimcap over face/head | |||
* Dedicated breath control hoods | |||
=== Rebreathing === | |||
Rebreathing is the act of breathing in air that has already been exhaled. This is mostly done by means of an air bladder connected to a gas mask or a dedicated breath control mask/hood. | |||
=== Neck compression === | |||
Where pressure is added to the neck to halt breathing or restrict bloodflow to the brain. | |||
For example: | |||
* Choking | |||
* Ligature strangulation | |||
* Hanging | |||
==== Carotid compression ==== | |||
Carotid compression in isolation does not involve restricting airflow, so it technically isn't breath control in the traditional sense. However, it does involve acutely depriving the brain of oxygen which has significant overlap in the appeal and risks of breath control. See [[Carotid compression|carotid compression]]. | |||
=== Inhalants / gas displacement === | |||
==== Nitrous oxide ==== | |||
See main article at [[nitrous oxide]]. | |||
==== Co2 gas addition ==== | |||
== Risks <!-- Describe the risks of this kink. -->== | |||
Breath control is an extremely high-risk form of play. The specific risks depend on the details of the scene, but can include: | Breath control is an extremely high-risk form of play. The specific risks depend on the details of the scene, but can include: | ||
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* Lung injury | * Lung injury | ||
Many forms of breath play cannot be made completely risk-free, so full consent is | == Risk mitigation <!-- Describe the risk mitigation for this kink. --> == | ||
Many forms of breath play cannot be made completely risk-free, so full consent is incomplete without an understanding and acceptance of risk. Risk mitigation involves careful planning of a scene to ensure any method to restrict airflow or blood flow is [[fail-safe]]. | |||
Some important specifics to consider include: | Some important specifics to consider include: | ||
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** Could the mouth or nose become blocked? | ** Could the mouth or nose become blocked? | ||
* What is the risk that vomiting or aspiration (inhaling of vomit or saliva) could occur? | * What is the risk that vomiting or aspiration (inhaling of vomit or saliva) could occur? | ||
** Concurrent [[intoxication]] '''tremendously''' increases the risk of vomiting and aspiration | ** Concurrent [[Intoxication play|intoxication]] '''tremendously''' increases the risk of vomiting and aspiration | ||
** Is the mouth covered or the head positioned in such a way that fluid in the mouth would be inhaled rather than fall away from the body? | ** Is the mouth covered or the head positioned in such a way that fluid in the mouth would be inhaled rather than fall away from the body? | ||
** In scenes with heavy bondage or sensory deprivation | ** In scenes with heavy bondage or sensory deprivation | ||
*** Would an episode of vomiting be noticed by others? | *** Would an episode of vomiting be noticed by others? | ||
*** Could the head be quickly released, turned to the side, and any obstruction in front of the mouth immediately removed? | *** Could the head be quickly released, turned to the side, and any obstruction in front of the mouth immediately removed? | ||
* Are any other drugs/inhalants also being used? | |||
** Each drug will have its own unique risks that must be carefully considered in the context of the scene | |||
Breath control is risky for anyone to practice. In healthy people with proper safety practices, some sources of risk can be diminished. <u>'''However, for people with certain health conditions, the risks of breath control cannot be meaningfully mitigated and should be avoided entirely.'''</u> | Breath control is risky for anyone to practice. In healthy people with proper safety practices, some sources of risk can be diminished. <u>'''However, for people with certain health conditions, the risks of breath control cannot be meaningfully mitigated and should be avoided entirely.'''</u> | ||
Many types of heart or lung disease can make any form of breath control unmanageably dangerous (especially severe disease). If airflow or blood flow is restricted in these individuals, a cascade of life-threatening physiologic derangements can be initiated that cannot be easily reversed, even after restoring normal flow. | Many types of heart or lung disease can make any form of breath control unmanageably dangerous (especially severe disease). If airflow or blood flow is restricted in these individuals, a cascade of life-threatening physiologic derangements can be initiated that cannot be easily reversed, even after restoring normal flow. Additionally, breath control should not be practiced by individuals with neurovascular conditions such as carotid stenosis, Moyamoya disease, cerebral aneurysms or vascular malformations due to greatly increased risk of stroke. | ||
== Known incidents<!-- Provide a list of links to articles describing incidents involving this kink. --> == | |||
== | === Medical case reports === | ||
There have been many cases within the kink community of accidental deaths related to breath control, primarily solo breath control. In the Western countries, the incidence of these deaths is of approximately 0.5 deaths per million inhabitants per year. <ref>{{Cite journal |last=Sauvageau |first=Anny |date=2013-12-01 |title=Current Reports on Autoerotic Deaths—Five Persistent Myths |url=https://doi.org/10.1007/s11920-013-0430-z |journal=Current Psychiatry Reports |language=en |volume=16 |issue=1 |pages=430 |doi=10.1007/s11920-013-0430-z |issn=1535-1645}}</ref> | |||
=== RACKWiki incident reports === | |||
[[Incident:IR-202308-1:_Fatality_from_nitrous_oxide-induced_hypoxia|IR-202308-1: Fatality from nitrous oxide-induced hypoxia]] | |||
== | |||
== References == | == References == | ||
<references /> | |||