SAFETY & CONTRAINDICATIONS

Last updated: May 30, 2026

Breath-hold training and breathwork carry real, documented risks including loss of consciousness (blackout), motor-control loss (samba / LMC), and drowning. This page lists the contraindications you should know about before training with ELEMENT | 08, and the core safety measures every freediver follows.

This page is not medical advice. It is not exhaustive and it does not replace certified freediving instruction or a consultation with your doctor. If any of the conditions below apply to you, or if you are unsure, do not train without first speaking to a medical professional and a certified freediving instructor.

// THE NON-NEGOTIABLES

Whatever else changes, these do not:

• Never train in or near water alone. Always have a qualified buddy supervising you directly, within arm's reach for any maximal attempt.
• Never train in water without a trained safety person present. A spectator is not a safety. Your buddy must know how to perform a rescue.
• Hyperventilation increases blackout risk significantly. More than two or three slow, full breaths is too many. Hyperventilation lowers your CO2 trigger and is the single most common cause of blackout.
• Stop immediately if you feel unwell, dizzy, weak, anxious, or anything you cannot explain. "Push through" is the wrong instinct in apnea.
• Get certified before training seriously. AIDA, SSI, Molchanovs, PFI, or RAID. A weekend course will change how you think about everything below.

// CONTRAINDICATIONS: BREATH-HOLD TRAINING

The conditions below are considered contraindications for breath-hold training in mainstream freediving education. The list is not exhaustive. Clearance from a doctor familiar with freediving is the right baseline if you have any chronic or recent medical condition.

Cardiovascular

• Any history of cardiac arrhythmia, structural heart disease, congenital heart defect, or coronary artery disease
• Recent cardiac event or cardiac surgery
• Uncontrolled or severe hypertension
• Implanted pacemaker or defibrillator (case by case, with cardiologist clearance)

Respiratory

• Asthma, especially exercise-induced or uncontrolled
• Chronic obstructive pulmonary disease (COPD) or other chronic lung conditions
• Previous pneumothorax (collapsed lung)
• Recent respiratory infection or active cold / flu
• Severe seasonal allergies during an active flare

Neurological

• Epilepsy or any history of seizures
• Recent concussion or traumatic brain injury
• History of stroke or transient ischaemic attack
• Active migraine episode

Metabolic and systemic

• Pregnancy, in particular dynamic, depth, or maximal breath-hold work
• Diabetes if blood sugar is unstable or you are at risk of hypoglycaemia
• Sickle cell disease or sickle cell trait
• Severe anaemia
• Active infection or fever
• Recent abdominal, thoracic, or spinal surgery
• Chronic conditions managed with medications that affect heart rate, blood pressure, or central nervous system function, unless cleared by your prescribing doctor

Temporary or situational

• Alcohol within the previous 24 hours
• Recreational or psychoactive drugs
• Significant sleep deprivation
• Strong dehydration or extreme caffeine intake
• Recent intense aerobic effort within the past two hours
• High emotional stress, panic, or grief
• Cold exposure that has not been followed by proper warming

// CONTRAINDICATIONS: BREATHWORK

Intense breathwork practices (extended pranayama, connected breathing, holotropic styles, Wim Hof method, and similar) shift blood gases and the autonomic nervous system far enough that they carry their own contraindication profile. Gentle CO2 and O2 table breathing is lower risk, but most of the items below still apply.

Medical

• All cardiovascular contraindications listed above, especially arrhythmia history
• Epilepsy or seizure history. Intense hyperventilation can lower the seizure threshold
• Glaucoma or detached retina history
• Pregnancy, especially intense or forced-breathing practices
• Recent abdominal, thoracic, or eye surgery
• Uncontrolled diabetes or brittle blood sugar
• Severe anaemia, sickle cell, or iron deficiency
• Active infection or fever

Mental health

• Bipolar disorder, psychosis, or schizophrenia spectrum conditions. Intense breathwork can destabilise
• Active acute PTSD, recent severe trauma, or dissociative disorders without therapeutic supervision
• Acute panic disorder if hyperventilation is a known trigger
• Active suicidal ideation

Same-day

• Alcohol or recreational drugs in the past 24 hours
• Strong stimulants (high-dose caffeine, pre-workout, others)
• Very full stomach

// BEFORE EACH SESSION

• Check in with yourself honestly: are you rested, hydrated, fed, calm, free of cold or flu symptoms?
• If a contraindication has changed since your last session, skip the session.
• Confirm your buddy is ready, sober, and knows the planned dives or holds.
• Agree on hand signals and a recovery protocol before you start.
• For water training: rescue equipment in reach, surface conditions and depth checked, no boats or hazards in the training area.

// DURING TRAINING

• Stop immediately on any of these: tingling in the hands or face, vision change, unusual weakness, anxiety, loss of focus, strong urge to abandon. None of them are a sign to push through.
• Respect the surface-interval rule. ELEMENT | 08 surfaces a conservative reference (dive time multiplied by ambient pressure) and tints the SI when it is short.
• Equalise early and gently. If equalisation does not come, turn the dive.
• If you are doing breathwork on dry land near hard surfaces, sit or lie down. Syncope on intense breathwork is real and head injuries from a fall are the usual harm.

// AFTER A SESSION

• Active recovery breathing after every hold or dive (the "hook breath" style is taught by most agencies).
• Stay in or near the water with your buddy for at least thirty seconds after a maximal attempt before you swim away. Most blackouts happen in the first thirty seconds after surfacing.
• Hydrate and refuel. Log the session honestly, including the things that did not go to plan.

// WHAT CAN GO WRONG

• Blackout (loss of consciousness): can happen suddenly and without warning. The diver may have no memory of warning signs even if they were present. Most likely near or just after surfacing. Hyperventilation makes blackout more likely.
• Samba (loss of motor control, LMC): involuntary shaking or jerking on or near the surface. A samba indicates the diver came very close to a blackout and must be supported through their recovery breathing.
• Hypoxic blackout on land ("dry blackout"): can occur after intense breathwork or during a dry maximal hold. Practise breathwork sitting or lying down.
• Squeeze (barotrauma): lung or trachea damage from depth, aggressive equalisation, or poor body position. Coughing blood after a depth dive is never normal. Stop training and see a doctor.
• Decompression illness: rare in single freedives, but repetitive deep diving without adequate surface intervals can produce it. The SI heuristic in the app exists for this reason.
• Ear and sinus barotrauma: from forced equalisation or descent without equalising. Painful and slow to heal.

// IF SOMETHING GOES WRONG

This is a brief summary, not a rescue course. Take a real freediving course before you train in water. The rescue is part of the training.

• Get the casualty's airway out of the water immediately. Support the head and the neck.
• Turn the casualty onto their back, remove the mask and the nose clip.
• "Blow, tap, talk": blow on the face, tap the cheek, talk to the casualty. Most blackouts resolve within seconds of airway exposure.
• If breathing does not resume within fifteen seconds, give rescue breaths. If there is no pulse, begin CPR and call emergency services.
• Even if the casualty recovers fully, they must rest, hydrate, and stop training for the day. Any casualty that needed assistance should be seen by a doctor.

// GET CERTIFIED

A two-day entry-level freediving course teaches you the rescue, the recovery breathing, the safety roles, and the limits you are working with. There is no substitute and the cost is small. The major agencies that teach freediving:

• AIDA International
• SSI Freediving
• Molchanovs
• PFI (Performance Freediving International)
• RAID Freediving

// NOT MEDICAL ADVICE

The content on this page is general safety guidance for freedivers. It is not exhaustive, it is not a substitute for personalised medical advice, and it is not a replacement for certified freediving instruction. If you have any medical condition, take medication regularly, are pregnant, or have any doubt about your fitness to train, consult a doctor and a certified freediving instructor before training.

ELEMENT | 08 is a tool that supports your training. It does not decide for you, and it cannot save you in the water. That is what your buddy and your training are for.