Last updated: 27 July 2026

Please read this carefully before taking part in any session, workshop, retreat or programme with The Breath Manifest. You will be asked to confirm that you have read and understood it as part of your health screening, before your first session. Your confirmation is recorded and dated.

If anything here is unclear, or you are unsure whether something applies to you, please ask before you practise rather than after.

1. This is not a medical service

The Breath Manifest offers breathwork facilitation and coaching for general wellbeing. It is educational and self-care work. It is not, and does not claim to be:

• a medical or clinical service
• a diagnostic or therapeutic tool
• psychotherapy, counselling or a mental health service
• a substitute for advice, diagnosis, treatment or care from a qualified healthcare professional

Ryan Samtani is a trained breathwork facilitator and coach, not a doctor, psychiatrist, psychologist or psychotherapist, and cannot give medical advice.

We make no claim that breathwork will treat, cure, reduce or prevent any medical condition. Where benefits are described, they relate to subjective experience and general wellbeing.

If you are receiving treatment for a physical or mental health condition, breathwork should sit alongside that care, not replace it. Please do not stop or change any prescribed treatment because of anything you experience in a session.

2. You are responsible for deciding this is right for you

Nothing here limits or excludes our liability for death or personal injury caused by our negligence, or for fraud or fraudulent misrepresentation, or for any other liability that cannot lawfully be limited or excluded.

Subject to that, you take part at your own risk and you are responsible for deciding whether a practice is suitable for you. If you have any doubt about your fitness to take part, consult a qualified healthcare professional first.

You are also responsible for the accuracy of what you tell us in your health screening. We make decisions about what is safe to offer you based on that information, so an incomplete answer is not a small thing — it removes our ability to keep you safe.

3. Not all breathwork is the same

This matters for everything that follows. The practices we use fall broadly into two groups, and they carry very different risk profiles.

Regulating practices — diaphragmatic breathing, extended exhales, coherent or resonant breathing, box breathing, alternate nostril breathing, the physiological sigh. These are gentle, work within your normal breathing range, and are safe for the large majority of people.

Activating practices — conscious connected breathwork, circular breathing, rapid or forceful techniques, and anything involving sustained breath retention. These deliberately shift your blood chemistry, produce much stronger effects, and carry the real contraindications.

Where a caution below applies only to the second group, we say so. Being excluded from conscious connected breathwork does not mean breathwork is closed to you — it usually means we work differently.

What activating practices can feel like

• light-headedness, dizziness or unsteadiness
• tingling, or temporary muscular tightening in the hands, feet and around the mouth
• changes in heart rate
• temperature changes, shaking or trembling
• strong emotional release — crying, laughter, anger, grief
• vivid memory, imagery or altered perception
• occasionally, temporary loss of consciousness

Most of these are ordinary responses to changing carbon dioxide levels and are not in themselves harmful. But they are real, they can be disorientating, and in the wrong setting or for the wrong person they can be dangerous.

4. When not to take part

You should not take part in breathwork, or should speak to a qualified healthcare professional first, if any of the following apply. Please disclose all of these on your health screening even if you believe they are resolved or well managed.

4.1 Cardiovascular conditions

• Heart disease, including coronary artery disease, angina, heart failure, or a history of heart attack
• High blood pressure that is uncontrolled or poorly controlled
• A history of stroke or transient ischaemic attack
• Arrhythmias, including atrial fibrillation
• A pacemaker, implantable defibrillator or other cardiac implant
• An aneurysm of any kind

4.2 Neurological and psychiatric conditions

• Epilepsy or any history of seizures. This matters more than people expect: rapid breathing is used clinically to provoke seizure activity during EEG testing, so it is a genuine risk rather than a precaution
• Current or recent psychosis or schizophrenia
• Bipolar disorder, particularly during or close to a manic or psychotic episode
• Severe PTSD, unless your treating clinician has agreed it is appropriate
• Active suicidal thoughts, or a recent suicide attempt
• Significant dissociative disorders
• A current or recent eating disorder, or active mania, where intense practice could destabilise recovery

For several of these, breathwork is not permanently off the table — but it needs your clinician's involvement, and usually a regulating rather than activating approach.

4.3 Respiratory conditions

• Severe or poorly controlled asthma
• Chronic obstructive pulmonary disease
• A current acute chest or respiratory infection
• A recent collapsed lung, or any history of spontaneous pneumothorax

If you use an inhaler, bring it and keep it within reach.

4.4 Recent surgery, injury or acute illness

• Any surgery in the last three months, particularly abdominal, chest, cardiac, eye or brain surgery
• Recent fractures, especially of the ribs, or significant musculoskeletal injury that deep breathing could aggravate
• Any acute illness with fever

4.5 Other

• Glaucoma, recent eye surgery, or a history of retinal detachment
• Severe untreated osteoporosis
• Severe migraine triggered by changes in breathing
• Diabetes, particularly if your blood sugar is unstable
• Anything else for which a doctor has advised you to avoid intense breathing, breath holding or similar practice

5. Pregnancy and postpartum

Pregnancy is not a barrier to breathwork. Breathing practice is one of the most useful things available to you during pregnancy and birth, and many people come to it precisely for that reason. What changes is which practices are appropriate.

Suitable during pregnancy

Regulating practices are generally safe and often actively helpful: diaphragmatic breathing, extended exhales, coherent breathing, gentle box breathing without long holds, alternate nostril breathing, and breathing specifically for birth preparation.

Not suitable during pregnancy

We do not offer conscious connected breathwork, circular breathing, rapid or forceful techniques, or breath retention during pregnancy.

The reason is straightforward. Sustained fast breathing lowers your carbon dioxide levels, and low maternal carbon dioxide both narrows the blood vessels supplying the uterus and makes your blood hold on to oxygen more tightly. Both reduce oxygen delivery to your baby. Breath holding carries the same concern more directly. The effects are unlikely to be dramatic, but there is no reason to accept the risk when gentler practices give you most of what you came for.

We also avoid forceful abdominal techniques such as kapalabhati and bhastrika, and any strong abdominal engagement or locks.

Practical points

From around the middle of the second trimester, please avoid lying flat on your back for extended periods — the weight of the uterus can compress a major vein and make you feel faint. We will set you up on your left side or propped up instead. Lying face down is out from early on.

If you have any pregnancy complication — pre-eclampsia, high blood pressure, placenta praevia, a history of miscarriage or preterm labour, or anything your midwife or obstetrician is monitoring — please tell us, and check with them before we begin.

Postpartum

Gentle regulating practice can usually begin as soon as you feel ready. For conscious connected breathwork we ask you to wait until you have had your postnatal check and feel recovered — around six weeks for an uncomplicated birth, and longer after a caesarean or a complicated delivery.

If you have abdominal separation (diastasis recti), tell us, as it changes how we approach forceful or strongly abdominal breathing.

6. Substances, medication and environment

Do not take part while under the influence of alcohol, cannabis, psychedelics or other recreational drugs. If you have used a substance in the preceding 24 hours, tell us.

Never combine breathwork with water. Do not practise breath retention in a swimming pool, bath, hot tub, the sea or any other body of water. Breath-hold practices in water have caused deaths through shallow water blackout, which gives no warning — you do not feel yourself losing consciousness. This applies without exception and regardless of your experience level.

Do not practise while driving or operating machinery, or anywhere you could fall — near heights, edges, stairs, glass or a hard-edged environment.

Medication. If you take prescription medication, especially anything affecting heart rate, blood pressure, mood, anxiety, seizures or the central nervous system, speak to your prescribing clinician before starting an activating practice, and tell us on your screening.

7. Online sessions

If we work together online, please read this section carefully, because the setting changes the risks.

In an online session we cannot physically reach you. We cannot steady you if you become unsteady, support you if you faint, or call for help on your behalf as quickly as we could in person. That responsibility shifts to you and to your environment.

Before an online session:

• Practise lying down or seated on the floor, not on a chair, sofa, bed or anywhere you could fall from
• Clear the space around you of hard edges, glass and obstacles
• Keep a phone within reach
• Have someone else in the home where possible, particularly for your first few sessions or any activating practice
• Keep your camera on, so we can see you and respond if something looks wrong

If you are not able to meet these conditions, tell us and we will adapt the session or reschedule. This is not a formality.

8. During a session — stop if

Stop, return to normal breathing, and tell us straight away if you experience:

• dizziness or faintness that concerns you
• chest pain or unusual heart sensations
• a severe or sudden headache
• numbness or tingling that does not settle when you return to normal breathing
• muscular cramping that becomes painful or does not release
• emotional distress that feels overwhelming rather than releasing
• anything at all that frightens you

You can stop at any moment, for any reason, without explaining yourself. You never need permission, and stopping is not a failure of the practice — knowing when to stop is part of the practice.

If you feel unable to speak, raise a hand. We will notice.

9. Emotional and psychological responses

Breathwork can surface unexpected emotion, memory or sensation. For many people this is the heart of the work and is safe and valuable.

It can also be destabilising. If you find that a session leaves you shaken for more than a short period, disturbs your sleep, worsens existing mental health symptoms, or brings up material you do not feel resourced to hold, please stop practising and speak to a qualified mental health professional. Tell us too, so we can adjust or pause.

We are not equipped to support anyone through an acute mental health crisis, and it would be dishonest to suggest otherwise.

If you are in crisis:

• UK: Samaritans on 116 123, free, 24 hours. NHS 111 and select the mental health option. Your GP. In an emergency, 999.
• Elsewhere in Europe: 112 for emergencies, plus your country's national mental health line.
• US: 988 for the Suicide and Crisis Lifeline; 911 in an emergency.
• Anywhere else: your local emergency number and national helpline.

10. Your health can change — tell us when it does

Your health screening is a snapshot, not a permanent record. Please tell us before a session if anything has changed: a new diagnosis, a new medication, a pregnancy, a surgery, an injury, a bereavement, or a period of acute stress or poor mental health.

You will be asked to review and re-confirm your screening periodically. Please treat that as a real question rather than a form to click through.

11. Group sessions, workshops and retreats

In a group setting we are dividing attention across everyone present, so your own awareness of your limits matters more than in a one-to-one.

Please also be aware that other people's emotional release can be audible and visible, and can be affecting to witness. You are free to leave the room at any point.

What is shared in a group stays in the group. We ask everyone to respect that, though we cannot guarantee the conduct of other participants.

12. Under 18s

Sessions are intended for adults aged 18 and over.

We will only work with someone under 18 where a parent or guardian has given written consent, has completed the health screening with them, and is present or contactable throughout.

13. Liability

Nothing in this section limits or excludes our liability for death or personal injury caused by our negligence, or for fraud or fraudulent misrepresentation, or any liability that cannot lawfully be limited or excluded.

Subject to that, and to the fullest extent permitted by law, we accept no liability for adverse health outcomes arising from your participation, particularly where they arise from information you did not disclose on your health screening, or from disregarding the guidance in this document.

Nothing here affects your rights as a consumer under UK law, including the Consumer Rights Act 2015.

14. Your acknowledgement

Before your first session you will be asked to confirm that:

• you have read and understood this Health Disclaimer
• you have considered whether any contraindication in section 4 applies to you
• where one does apply, or where you have any health concern, you have either consulted a qualified healthcare professional or decided on your own responsibility that the practice is safe for you
• the information you have given in your health screening is accurate and complete
• you accept responsibility for your participation

Your confirmation is recorded and dated. How we store and protect that information is set out in our Privacy Policy.

15. Questions

Email ryan@thebreathmanifest.com.

We cannot give medical advice. For anything medical, please speak to a qualified healthcare professional — and please do, rather than deciding on your own that it will probably be fine.

This disclaimer should be read alongside our Privacy Policy and our Terms and Conditions.