Is it possible to get permanent damage from static breath holds?

[Avery_]

About 2 month ago I definitely strained myself in some way, by doing CO2 tables and then immediately trying to break my personal best like... 2-3 times?

I did not hold my breath for more than 3 minutes at a time, and I didn't blackout. But I felt really bad after all that, and I still do.

I'm suffering from motion sickness, fatigue and brain fog. Neurologist couldn't find anything on an MRI, and my blood test came out fine in terms of possible anemia.

I was wondering if it's even possible to get brain damage (definitely microscopic in this case, as it doesn't show up on an MRI) just by doing breath holds?

I've heard a few times people saying that you should rest between any sort of breath hold training. But what would happen if one didn't? What type of strain or damage would such a person experience? What is the science behind this?

 

[SDC79]

I'm probably not the best person to answer what appears to be a medical question, but it might be helpful to others reading this if you are a little more specific.

I realise you probably did a table and then attempted a maximum static apnea, but to check: by personal best, do you mean static, dynamic or depth? They're not equivalent to each other physiologically. If you were in water, particularly if at depth, have you experienced any issues with your ears? Did you suffer a squeeze of any kind, and if so, where in your body? When you say you strained yourself, what do you mean? What made you stop your breath-hold in each case? How was your table set up with respect to your maximal hold at that time, i.e., what percentage of your recent personal best performance was your hold, and how long was your recovery? Do you have any preexisting medical conditions, and did your doctor do a medical examination, e.g., for blood pressure, heart rate, lung function, etc.? Did he or she only check for anaemia in your blood test, and do you have a prior baseline to compare your recent results against?

Beyond that, I believe there's now some research supporting recovery periods between training tables, and if so (I haven't looked for it myself), the need for rest days is no longer anecdotal, i.e., just what seems to have worked best for others in the past. But note also that whilst there is a physiological and nervous system component, a large part of the benefit of training tables is psychological: you're making yourself familiar with the symptoms of (in this case) hypercapnia, so that (a) you know how it feels and therefore are less likely to panic when it happens in water (in theory, at least - many divers experience hypercapnia differently during an active dive when compared with a static), and (b) you know when you're approaching your personal limits. You arguably cannot do this as well if your holds are all really stressful because they're right at your limit.

You asked what science says about it. I could provide some details, but it's actually pretty scary without proper context and I think if you've had an MRI it would have been found anyway. Ideally you should do a freediving course that covers it. When I started freediving, I think AIDA 3* covered the majority, with some additional details given in 4*, but I'm aware that the course materials have changed a lot since then, so check the content with the instructor.

I hope you get your current issue resolved so that you can resume your training, but until then rest up - and once you're training again, take it more slowly, preferably under the guidance of a reputable instructor.

 

[Avery_]

I'm probably not the best person to answer what appears to be a medical question, but it might be helpful to others reading this if you are a little more specific.

I realise you probably did a table and then attempted a maximum static apnea, but to check: by personal best, do you mean static, dynamic or depth? They're not equivalent to each other physiologically. If you were in water, particularly if at depth, have you experienced any issues with your ears? Did you suffer a squeeze of any kind, and if so, where in your body? When you say you strained yourself, what do you mean? What made you stop your breath-hold in each case? How was your table set up with respect to your maximal hold at that time, i.e., what percentage of your recent personal best performance was your hold, and how long was your recovery? Do you have any preexisting medical conditions, and did your doctor do a medical examination, e.g., for blood pressure, heart rate, lung function, etc.? Did he or she only check for anaemia in your blood test, and do you have a prior baseline to compare your recent results against?

Beyond that, I believe there's now some research supporting recovery periods between training tables, and if so (I haven't looked for it myself), the need for rest days is no longer anecdotal, i.e., just what seems to have worked best for others in the past. But note also that whilst there is a physiological and nervous system component, a large part of the benefit of training tables is psychological: you're making yourself familiar with the symptoms of (in this case) hypercapnia, so that (a) you know how it feels and therefore are less likely to panic when it happens in water (in theory, at least - many divers experience hypercapnia differently during an active dive when compared with a static), and (b) you know when you're approaching your personal limits. You arguably cannot do this as well if your holds are all really stressful because they're right at your limit.

You asked what science says about it. I could provide some details, but it's actually pretty scary without proper context and I think if you've had an MRI it would have been found anyway. Ideally you should do a freediving course that covers it. When I started freediving, I think AIDA 3* covered the majority, with some additional details given in 4*, but I'm aware that the course materials have changed a lot since then, so check the content with the instructor.

I hope you get your current issue resolved so that you can resume your training, but until then rest up - and once you're training again, take it more slowly, preferably under the guidance of a reputable instructor.

It was all done on dry land, I go about the incident in a bit more detail here https://forums.deeperblue.com/threads/dizzy-and-lightheaded-3-weeks-after-dry-static-apnea.127701/

The CO2 static table that I did before that was calculated by an app, it's 7 1:20 holds with rest times going from 2 minutes to 45 seconds. I felt completely fine afterwards and didn't even think it could cause anything.

I really didn't know anything like that could happen, and I also don't know now if it actually did or if I'm making this whole thing up and it's just my anxiety causing all those symptoms. That's why I was asking for the scientific part. I can't find a single case of anything similar anywhere.

 

[SDC79]

Thanks. Again, I'm not the right person to be giving medical advice, but I can say that that's a modest table for many people - but that doesn't mean it's right for you. If you really think it was the table then maybe seek a second medical opinion, but also consider what else it might be. If you do speak to another doctor maybe try to not lead them too much - there might be something they miss for focusing on what you tell them happened. You could ask for a full physical examination/workup if you're really worried, maybe by a dive doctor. I know that's not very helpful, but I'm not a clinician.

If you think you're imagining it, maybe ask yourself why. Did you find the tables and/or maximum holds stressful? Stress isn't inherently bad, but it needs to be proportionate: there's a helpful level of stress ('eustress') and a level that hinders you ('distress'). Why do you want to be able to hold your breath? If you're putting yourself under stress it's often helpful to understand why you're doing it. Taking breaks helps, too - very, very few people can put themselves under consistent stress at any level without breaking. Athletes can work on technical skills while they give their bodies a chance to recover.

I've seen quite a few freedivers who have seen others' training routines online and think that they should be doing those too. Advice is great, but most ordinary freedivers don't post their training online. If the routine they've seen is that of an elite freediver it's probably not appropriate for most people. I'm not elite at anything but I've trained with elite athletes in two sports and they're just different from the rest of us.

I maintain that if you're training, you should do so under proper instruction, preferably in person given that you've already experienced an apparent injury. It might be that you're unconsciously doing something that's causing you undue stress. I was unable to equalise for years and thought it was my ears, eustachian tubes, etc., but my doctor couldn't find anything wrong with them. In the end a dive buddy noticed that I was trying really, really hard to equalise and, in doing so, tensing my neck and shoulders. Once I relaxed them equalising was easy - there really was nothing wrong with my ears. Hopefully there's something similar here and a simple piece of advice allows you to continue training.

 

[Avery_]

Thanks. Again, I'm not the right person to be giving medical advice, but I can say that that's a modest table for many people - but that doesn't mean it's right for you. If you really think it was the table then maybe seek a second medical opinion, but also consider what else it might be. If you do speak to another doctor maybe try to not lead them too much - there might be something they miss for focusing on what you tell them happened. You could ask for a full physical examination/workup if you're really worried, maybe by a dive doctor. I know that's not very helpful, but I'm not a clinician.

If you think you're imagining it, maybe ask yourself why. Did you find the tables and/or maximum holds stressful? Stress isn't inherently bad, but it needs to be proportionate: there's a helpful level of stress ('eustress') and a level that hinders you ('distress'). Why do you want to be able to hold your breath? If you're putting yourself under stress it's often helpful to understand why you're doing it. Taking breaks helps, too - very, very few people can put themselves under consistent stress at any level without breaking. Athletes can work on technical skills while they give their bodies a chance to recover.

I've seen quite a few freedivers who have seen others' training routines online and think that they should be doing those too. Advice is great, but most ordinary freedivers don't post their training online. If the routine they've seen is that of an elite freediver it's probably not appropriate for most people. I'm not elite at anything but I've trained with elite athletes in two sports and they're just different from the rest of us.

I maintain that if you're training, you should do so under proper instruction, preferably in person given that you've already experienced an apparent injury. It might be that you're unconsciously doing something that's causing you undue stress. I was unable to equalise for years and thought it was my ears, eustachian tubes, etc., but my doctor couldn't find anything wrong with them. In the end a dive buddy noticed that I was trying really, really hard to equalise and, in doing so, tensing my neck and shoulders. Once I relaxed them equalising was easy - there really was nothing wrong with my ears. Hopefully there's something similar here and a simple piece of advice allows you to continue training.

You mentioned some scientific data that would scare me without context. Could you share it anyway?

 

[SDC79]

You mentioned some scientific data that would scare me without context. Could you share it anyway?

Cerebral ischaemia and/or ischaemic hypoxia (they're not the same thing). So far as I understand them (which isn't very much), both can lead to stroke. I think it's sensible to minimise the risk of suffering them if possible.

Again, a freediving course run by a reputable instructor would be a good idea.