Erotic Asphyxiation: How to do Breath Control Play Safely

Within the broad spectrum of human sexuality, few practices are as controversial as erotic asphyxiation. Often shrouded in allure and fantasy, this activity involves the restriction of oxygen to the brain to enhance arousal of the whole body. While it's a source of heightened sensations for some, erotic asphyxiation carries risks. These risks can be mitigated by careful intentionality and rigorous safety measures, emphasizing the critical need for comprehensive education before engaging in this kind of play.

Let's demystify erotic asphyxiation, exploring the different types of play, the appeal of this practice, and, most importantly, its potential dangers and how to play safely. To get all the answers you're looking for, I spoke with Kirstyn C. RN, BSN, CEN, a Clinical Nurse Coordinator specializing in emergency medicine for with over 10 years of experience.

Let's dive in!

What is erotic asphyxiation? 

Erotic asphyxiation, sometimes referred to by terms such asphyxiophilia or hypoxyphilia, encompasses a wide range of activities involving breath control play. These aim to increase sexual excitement through oxygen depletion.

Techniques can vary, including: choking, strangulation, chest compression, and even acts like facing-sitting asphyxia or smothering kinks. There are more extreme techniques for folks who like to play on the edge such as waterboarding, consensual drowning, or suffocation, which require much more training and safety considerations.

Each type of erotic asphyxiation play involves the careful manipulation of air supply, under the close supervision of a partner, to reach a desired altered headspace. In some instances, like erotic choking or sexual choking, the sensation of pressure and release is central to the experience.

Erotic Asphyxiation vs. Autoerotic Asphyxiation 

While erotic asphyxiation and autoerotic asphyxiation are often conflated with each other, it's important to understand the difference between these types of breath control play. Erotic asphyxiation is a partnered activity that involves negotiated breath play with a trusted person. In contrast, auto-erotic asphyxiation is a solo endeavor.

Autoerotic asphyxiation is significantly more dangerous due to the absence of someone who can step in if something goes wrong, which increases the risk of accidental death or injury. Though it can be appealing, especially if you don’t have someone to experience this form of play with, we highly recommended refraining from breath play by yourself. 

Why do people engage in erotic asphyxiation?

The appeal of erotic asphyxiation lies in its unique combination of physiological and psychological effects. On a physiological level, the act may induce a state of altered consciousness, making physical sensations more acute and vivid. This can result in a unique sensory experience. For a lot of people, breath play can increase feeling in the genital region which may intensify orgasms.

Psychologically, the intimacy involved in entrusting one's safety to another can enhance connection. For many, engaging in breath play is a way to navigate themes of control and vulnerability, enabling them to explore personal boundaries and the interplay of power within a safe and consensual environment. The attraction is amplified by the combination of danger and desire, which can elevate the overall time shared. Is there a more profound sense of trust or power transfer than when you place your life in someone’s hands?

Some participants experience a cathartic release during or after breath control play. This can be related to the sense of surrender, heightened emotions, or the breaking of barriers.

The receiver can also experience a fear response, which may heighten sexual arousal. The temporary loss of breath can lead to a surge of adrenaline and endorphins that flood the brain, enhancing feelings of euphoria and pleasure.

Risks and Dangers of Erotic Asphyxiation

Despite its enticing nature, erotic asphyxiation does carry significant risks.

Physical injuries can occur, such as vision changes, crushed trachea, dislocated esophagus, bruising, difficulty swallowing, inability to speak, or even broken bones, particularly if the techniques are not done well or boundaries are not respected during play.

Due to the stress and strain oxygen restriction puts on the body, someone may also develop what is known as petechiae. This is caused by bleeding from tiny blood vessels under the skin and presents as tiny red or brown spots which may be found on the chest and above, including in the eyes. Usually when evidence of petechiae appears, it is recommended to stop breath play activities.

Kirstyn added that there are, “much more serious consequences such as cerebral hypoxia or anoxic brain injury where the brain is deprived of oxygen for too long and can have lasting side effects such as impaired memory and judgment, seizures and decreased overall brain function.”

And of course, the biggest risk is accidental death.

The psychological effects, though less visible, can also be profound, including long-term impact on mental health and relationships if experiences are negative or boundaries violated. The fear or anxiety associated with breathlessness can trigger past trauma or lead to panic, which can be especially true for those with respiratory issues.

If someone struggles with societal or personal stigmas surrounding kink practices, feelings of guilt or shame may arise afterwards. This can then lead to feelings of isolation or confusion about one’s desires. There can be significant emotional after-effects post scene, including mood swings, depressive episodes, or heightened vulnerability.

My extensive experience in the BDSM community has shown that even those who practice BDSM at its most extreme levels tend to steer clear of serious erotic asphyxiation, particularly when there’s a loss of consciousness as deeper exploration heightens the dangers considerably.

Safety Guidelines for Erotic Asphyxiation 

Exploring the limits of erotic asphyxiation can be thrilling, but it's essential to put safety first by always playing with a trusted individual who is knowledgeable and supportive. You may consider exploring with an experienced professional Dominatrix to learn all the ins and outs of this type of play before you try it yourself.

Establishing clear safe words and gestures is essential because this is the only way the receiver can get immediate attention if needed. As you venture into this type of play, be sure to take it slow, setting and respecting boundaries that everyone feels comfortable with.

Kirstyn offered that “some signs that breath play has gone too far is a change in your partner's skin color, like their face turning significantly red or purple, their body going limp, a complete loss of consciousness or apnea (when someone stops breathing). Play should stop immediately if any of these things occur and emergency services should be called.”

Remember to educate yourself by going to classes and consider working with a mentor to learn about potential hazards and how best to avoid them. If in doubt, seek guidance from a sex educator or therapist to further enhance your understanding and seek professional help to manage any of the mental health issues that may arrive.

Having a debrief during aftercare is imperative in order to process what happened and to create even more fulfilling encounters in the future. During this time, make sure that the giver is sharing their feelings as there could be psychological effects for them as well.

Alternatives to Erotic Asphyxiation

For those who are intrigued by breath control but wary of its risks, several safer alternatives exist that provide similar endorphin rushes.

You can start by simply commanding your partner to hold their breath which eliminates a lot of the dangers and can play heavily into the power exchange element.

There are toys that can help aid in these situations such as gags, gas masks, and hoods which can all limit a person’s ability to breathe normally, mimicking restrictions without fully cutting off the oxygen supply.

Engaging in other interests within the BDSM realm can elevate the brain chemicals in the same way that breath control does. Sensory deprivation such as employing blindfolds or ear plugs to heighten other senses can provide an exhilarating adventure.

Wax play offers a visual and tactile element, enhancing your moments through sight and touch, which can deepen bonds between partners.

Make sure you are utilizing appropriate and reliable tools. It's also important to ensure that there are no broken parts and everything is in proper working order.

To create power imbalances in your intimacy, consider flirting with other forms of dominance and submission play such as kneeling, crawling, dirty talk, begging, rituals, and service.

The Bottom Line

Erotic asphyxiation can be a mix of danger and sensuality but remember, it can also be a hazardous exploration. Understanding the associated risks as well as prioritizing informed consent are of the utmost importance.

Open communication with partners and a commitment to safety can transform potentially scary situations into profoundly intimate shared times. The key to this type of play, as with all BDSM play, lies in being responsible, ensuring that every encounter is both pleasurable and safe.