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Hypoxic blackout in dynamic apnea: A case report
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences (HOV). (Swedish Winter Sport Research Centre)ORCID iD: 0000-0002-6916-4121
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences (HOV). (Swedish Winter Sport Research Centre)
Karolinska University Hospital, Solna, Sweden.
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2026 (English)In: Journal of Physiological Sciences, ISSN 1880-6546, E-ISSN 1880-6562, Vol. 76, no 1, article id 100060Article in journal (Refereed) Published
Abstract [en]

Blackout (BO) in breath-hold diving is attributed to cerebral hypoxia, yet direct observations are rare. We continuously recorded arterial oxygen saturation (SpO₂) and heart rate (HR) in 11 trained freedivers (5 females) performing two dynamic apneas (75 m, 100 m) using a waterproof forehead oximeter. One diver experienced BO at the end of a 100 m dive (SpO₂ 51 %), recovering within 5 s. Group SpO₂ fell from 98 ± 1 % to 77 ± 9 % (75 m) and 68 ± 9 % (100 m; range 51–83 %), while mean HR declined from 83 ± 12 to 43 ± 8 and 40 ± 4bpm, respectively. No arrhythmias were detected. Within-diver SpO₂ nadirs were consistent between distances (r = 0.93), whereas HR nadirs were not (r = 0.40). This case confirms BO can occur at SpO₂ values around 50 %, even in the absence of arrhythmia. The BO diver consistently showed the lowest SpO₂, indicating profound hypoxemia as the most likely contributing factor. Findings support individualized risk screening based on early desaturation patterns in submaximal dives. 

Place, publisher, year, edition, pages
Elsevier BV , 2026. Vol. 76, no 1, article id 100060
Keywords [en]
Breath-holding, Freediving, Hypoxia, Loss of consciousness, Safety
National Category
Physiology and Anatomy
Identifiers
URN: urn:nbn:se:miun:diva-56595DOI: 10.1016/j.jphyss.2026.100060ISI: 001683373900001Scopus ID: 2-s2.0-105028951271OAI: oai:DiVA.org:miun-56595DiVA, id: diva2:2037170
Available from: 2026-02-10 Created: 2026-02-10 Last updated: 2026-02-23Bibliographically approved

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Mulder, EricSchagatay, Erika

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