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What this site is, what it is not, who should be careful, and when to stop.

Georges Rayess — writes and maintains Help Me Breathe. Not a clinician.

Last updated . Published by Georges Rayess, an individual.

If you need a person right now

A breathing timer is not a substitute for someone on the other end of a line. If you are thinking about suicide, if you have hurt yourself, or if you are frightened of what you might do next, contact one of these first. They are free, they are confidential, and trained people answer them.

  • Anywhere in the world — the International Association for Suicide Prevention keeps a page of crisis centres and helplines. It points to Find A Helpline, which it describes as a global directory that connects people to free and confidential support: choose your country at findahelpline.com and it lists the services that answer there.
  • United States — call or text 988, the 988 Suicide & Crisis Lifeline. Its own site states that The 988 Lifeline is available 24/7/365 and that Your conversations are free and confidential. 988lifeline.org
  • United Kingdom and Ireland — Samaritans on 116 123. In their words: Whatever you're going through, call us free any time, from any phone, on 116 123. samaritans.org
  • Australia — Lifeline on 13 11 14, described on their crisis support page as Free and confidential help for anyone in Australia who is feeling overwhelmed, in emotional distress, or thinking about suicide, available 24/7. lifeline.org.au
  • Lebanon — call 1564, which Embrace names The National Lifeline for Emotional Support and Suicide Prevention. Embrace runs it with the National Mental Health Programme and its page lists the line as free, confidential and answered 24/7. embracelebanon.org

If you or someone near you is in immediate physical danger, call your local emergency number instead of waiting.

Help Me Breathe is a breathing timer and a set of plain-language pages. It is not medical advice, it is not a medical device, and it does not treat, cure, diagnose, prevent or manage any condition. Nothing on this site is a substitute for care from a qualified professional who knows your history, and nothing here should ever be used to justify changing, delaying or stopping treatment that a clinician has prescribed.

The site is published by one individual, Georges Rayess, who is not a clinician and holds no medical qualification. No doctor, nurse, psychologist or therapist has reviewed these pages. The about page says so in more detail, along with the editorial rules the site follows.

This is general information, not advice about you

Everything here is written for a general audience. It cannot take account of your medical history, your medication, your pregnancy, your recent surgery or anything else a clinician would ask you about before recommending a practice. A timer on a web page does not know who is using it.

So: if you have any medical condition, if you are taking prescribed medication, if you are pregnant, or if you are simply unsure whether a breathing practice is a good idea for you, ask a doctor or another qualified professional before you start, and take their answer over anything written here. Do not delay seeking medical advice because of something you read on this site, and do not ignore advice you have already been given.

Where the site describes research, it describes it as research: what a study measured, in how many people, for how long, and what its authors said the limits were. That is on the science page. A measured physiological effect in a trial is not a promise about you, and no result on this site should be read as one.

Patterns with breath-holds or fast breathing: who should not use them

Slow, gentle breathing without holds is low risk for most people. Two other kinds of pattern are different, and both appear on this site: patterns that ask you to hold your breath, and patterns that ask you to breathe faster than usual.

Breathing faster than your body needs lowers the carbon dioxide in your blood. A StatPearls review of hypocarbia states that Decreased PaCO2 leads to respiratory alkalosis and cerebral vasoconstriction, which reduces cerebral blood flow and oxygen delivery, and that Neurologic manifestations such as lightheadedness, paresthesias, and syncope may occur in acute cases. In plain terms: fast breathing can make you dizzy, make your hands and face tingle, and in some people make you faint. None of that is a sign the practice is working. It is a sign to stop.

Do not practise breath-holds or fast breathing without asking a clinician first if any of these apply to you

  • Pregnancy. Breath-holds and deliberate over-breathing change your blood gases, and pregnancy is not the time to experiment with that. Stay with gentle, unforced slow breathing unless your midwife or obstetrician tells you otherwise.
  • Cardiovascular conditions — heart disease, arrhythmia, a history of heart attack or stroke, an aneurysm, or an implanted cardiac device.
  • Uncontrolled high blood pressure. Breathing practices are not a treatment for hypertension and are never a reason to change or stop blood pressure medication.
  • Epilepsy or any seizure disorder. Deliberate hyperventilation is used clinically to provoke seizure activity during EEG testing: a StatPearls review of absence seizures notes that If hyperventilation is done successfully, the patient may develop seizures that can be seen clinically or on EEG. That is reason enough not to do it casually at home.
  • Respiratory conditions such as asthma, COPD or any condition that already makes breathing hard. Breath-holds and forced breathing can trigger symptoms rather than settle them.
  • Recent surgery, recent injury, or a hernia — anything where raised pressure in the chest or abdomen would be a problem. Ask your surgeon when it is safe to resume.
  • Glaucoma or raised eye pressure. Straining or bearing down raises pressure inside the eye. In a study of 63 healthy volunteers without glaucoma, The resting-state IOP significantly increased during the standardized Valsalva maneuver, from 13.2 ± 2.9 mmHg to 18.6 ± 5.2 mmHg (P < 0.001). Read the limits with the number: those were healthy eyes, not glaucomatous ones, and a relaxed breath-hold is not the same thing as bearing down. What was measured was a forced Valsalva manoeuvre, not the relaxed hold this site asks for, which is exactly why the answer here is to ask your ophthalmologist rather than to guess.
  • Panic disorder, for breath-holds specifically. For some people a held breath is one of the sensations that starts an attack. If that is you, skip the holds entirely; the long, slow exhale patterns need none of them.
  • Children should only use these patterns with an adult present who has read this page.

The energizing pattern on this site is the fastest one and asks you to confirm you have read its safety note before it will start. That confirmation is not a legal formality — it exists because that pattern is the one most likely to make someone light-headed.

Stop if you feel dizzy

This is the single most important line on the page. If at any point you feel dizzy, faint, light-headed, sick, or you notice tingling in your hands, feet or around your mouth, or your vision narrows or dims, stop straight away.

Then: sit or lie down where you cannot fall. Let your breathing go back to whatever it does on its own — do not try to correct it. Wait until you feel normal before you stand up. Do not push through it, do not try to finish the session, and do not treat the sensation as a sign that the practice is working.

Breathing exercises should feel comfortable. If a pattern is uncomfortable, shorten the counts, drop the holds, or use a gentler pattern. Discomfort is a reason to stop, not something to breathe through. If you faint, if symptoms do not settle within a few minutes, if you have chest pain, or if this keeps happening, contact a doctor.

Never in water, never while driving

Two rules on this page have no exceptions.

Never practise breath-holds in or near water

Not in a pool, not in the sea, not in a bath, not in the shower, and not while lying at the water's edge. Holding your breath after breathing quickly is the mechanism behind shallow water blackout. The StatPearls chapter on it records that the American Red Cross, the YMCA and USA Swimming have renamed the condition hypoxic blackout and describe it as the loss of consciousness in the underwater swimmer or diver, during an apnea submersion preceded by hyperventilation, where alternative causes of unconsciousness have been excluded.

The reason it kills people who feel fine is that the warning signal is switched off. A review of drowning cases in New York State, published in the CDC's Morbidity and Mortality Weekly Report, explains that Hyperventilation or breath-holding before diving or swimming decreases the body's stores of CO2 and partial pressure of carbon dioxide (PCO2), delaying the cerebral response to come to the surface to breathe. You do not feel the urge to breathe, and then you are unconscious, without any struggle that a lifeguard could see.

Never use this site while driving or operating machinery

Do not use the timer while driving, cycling, riding, operating machinery, working at height, near traffic, on stairs, or anywhere that becoming light-headed or closing your eyes would put you or anyone else in danger. Pull over and park first. The same applies to any place where a faint would mean a fall.

When to stop reading and get help

Breathing exercises are not for emergencies. Call your local emergency number, or go to an emergency department, if you have sudden shortness of breath, chest pain or pressure, a suspected asthma attack that is not responding to your inhaler, weakness on one side, confusion, or if you cannot catch your breath at rest.

If breathlessness is new, getting worse, waking you at night, or happening at rest, that is a reason to see a doctor rather than a reason to practise. Breathing that has changed on its own is a symptom, and symptoms deserve a diagnosis.

If you are in emotional crisis, please use the numbers at the top of this page rather than the timer.

No professional relationship, and the limits of what is promised

Using this site, subscribing or emailing the address below does not create a doctor-patient or any other professional relationship. It is a tool for your own use, and nothing more.

The site is provided as it is, without any warranty. Information here may be incomplete, may become out of date, and may be corrected without notice. To the fullest extent the law allows, the publisher accepts no liability for any loss, injury or harm arising from the use of this site or from reliance on anything published on it. Nothing on this page limits any liability that cannot lawfully be limited. The full terms are in the terms of service, and what data the site does and does not collect is set out in the privacy policy.

Sources cited on this page

  1. Krishnaprasadh D, Sharma S. Hypocarbia. StatPearls, NCBI Bookshelf. ncbi.nlm.nih.gov/books/NBK493167 — quoted for the effect of low carbon dioxide on cerebral blood flow and for the symptoms of acute hypocapnia.
  2. Albuja AC, Ighodaro ET, Khan GQ. Absence Seizure. StatPearls, NCBI Bookshelf. ncbi.nlm.nih.gov/books/NBK499867 — quoted for hyperventilation being used clinically to provoke seizure activity during EEG.
  3. Bart RM, Murray BP, Lau H. Shallow Water Blackout. StatPearls, NCBI Bookshelf. ncbi.nlm.nih.gov/books/NBK554620 — quoted for the definition of the condition that the chapter records from the American Red Cross, the YMCA and USA Swimming, who renamed it hypoxic blackout.
  4. Boyd C, Levy A, McProud T, Huang L, Raneses E, Olson C. Fatal and Nonfatal Drowning Outcomes Related to Dangerous Underwater Breath-Holding Behaviors — New York State, 1988–2011. MMWR, 22 May 2015. pmc.ncbi.nlm.nih.gov/articles/PMC4584570 — quoted for why hyperventilation before submersion delays the urge to surface.
  5. Kim YW, Lee DH, Lim HB, Oh B-L, Kim YK, Girard MJA, Mari JM, Park KH, Jeoung JW (2019). Age-Dependent Variation of Lamina Cribrosa Displacement During the Standardized Valsalva Maneuver. Scientific Reports. pmc.ncbi.nlm.nih.gov/articles/PMC6491605 — quoted for the measured rise in intraocular pressure during a Valsalva manoeuvre in 63 healthy volunteers without glaucoma. A relaxed breath-hold is not a Valsalva manoeuvre, so this measures a harder effort than the practice on this site and is cited as the nearest evidence found, not as a measurement of breathing practice.
  6. Crisis line details were taken from each service's own page: 988lifeline.org, samaritans.org, lifeline.org.au, embracelebanon.org, and the IASP crisis centres page.

Contact and review

This page is written and maintained by Georges Rayess, an individual, and is reviewed at least every six months. If you believe something on it is wrong, unclear or unsafe, please write to contact@helpmebreath.com and quote the sentence. Safety corrections are the fastest thing on this site to get changed.

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