Breathing into a paper bag has become a symbol of hyperventilating and anxiety attacks. It’s used to help balance your breathing.

This technique is helpful during an anxiety attack and panic attack because it can help regulate hyperventilation.

Hyperventilation or “overbreathing” happens when you have rapid or shallow breathing. People having an anxiety or panic attack sometimes hyperventilate.

When you hyperventilate, you exhale too much air. This can decrease the amount of carbon dioxide (CO2) you have in your blood.

But isn’t less carbon dioxide good for you? Actually, having very low carbon dioxide levels in your blood causes an imbalance in your body.

Low carbon dioxide also leads to low oxygen levels. This can lower blood and oxygen flow to your brain.

Symptoms of low CO2 levels

Low blood carbon dioxide causes many of the symptoms you have when you hyperventilate, like:

  • shortness of breath
  • lightheartedness
  • fast heart rate
  • numbness or tingling in hands, face, and other areas
  • achy chest muscles
  • fainting

Why does breathing into a paper bag help?

Breathing into a paper bag is a technique that can help you regulate hyperventilation. It works by putting some of the lost carbon dioxide back into your lungs and body. This helps to balance oxygen flow in your body.

However, breathing into a paper bag must be done properly and may not work for everyone. Medical research on using it to help hyperventilation is divided on whether it really works.

Some case studies don’t recommend using this breathing technique.

Other medical review studies find that breathing into a paper bag can help some patients with hyperventilation.

How to do it

To use a paper bag to help you breathe when you’re hyperventilating, follow these steps:

  • Hold a small paper bag (the kind used for lunches) over your mouth and nose.
  • Take 6 to 12 normal breaths.
  • Remove the bag from your mouth and nose.
  • Take a few breaths.
  • Repeat as needed.

Do’s and don’ts

  • Don’t breathe into a paper bag for more than 12 breaths.
  • Do remove the paper bag from your mouth and nose after 12 breaths.

  • Other tips to calm you

    Other remedies to help you calm down during an anxiety attack or when you’re hyperventilating include:

    • deep belly breathing
    • laying down on a sofa, bed, or floor
    • putting your head down between your knees
    • breathing through pursed lips, like you’re whistling
    • breathing in and smelling an essential oil or a scent you like
    • holding your breath for 10 to 15 seconds
    • breathing slowly into your own cupped hands
    • breathing through alternate nostrils (hold one nostril closed at a time)
    • breathing in through your nose and out through your mouth
    • jogging or walking briskly while breathing in through your nose and out through your mouth

    When to talk with a doctor

    Tell your healthcare provider or mental health professional if you have symptoms of an anxiety attack often or hyperventilate frequently.

    Get urgent medical help if you:

    • hyperventilate for longer than 30 minutes
    • think you’ll faint or lose consciousness
    • don’t feel better after trying home remedies during an anxiety or panic attack
    • experience severe or frequent symptomsDo hold your own paper bag for breathing. If someone else holds it for you, they may not know when you’ve taken up to 12 breaths.

      Does it have to be a paper bag?

      Yes. Always use a small paper bag, not a plastic one. A plastic bag doesn’t work the same way and can be dangerous.

      The thin plastic can get sucked into your mouth when you’re breathing in. This can be especially dangerous for smaller children and older adults.

      Drawbacks

      The paper bag technique won’t help an asthma attack and can even make it worse, because you may not get enough oxygen into your body.

      Don’t use this breathing technique if you have any heart or lung conditions.

      Also, breathing can be more difficult than normal if you’re at a high altitude. Breathing into a paper bag won’t help with elevation changes in breathing.

      Only use the bag method if you’re sure you’re having an anxiety attack. Other causes of hyperventilating include an asthma attack, fever, or other illnesses.

      You might have other anxiety symptoms like:

      • shortness of breath
      • feeling like you’re choking
      • a pounding or racing heart
      • heart palpitations (feeling your heart is stopping or missing a beat)
      • dizziness
      • nausea
      • sweating
      • racing thoughts
      • feeling like you’re losing control
      • thinking you might die
      • aggressiveness

    The bottom line

    Breathing into a paper bag may help you breathe better during an anxiety or panic attack. This breathing technique can help some people regulate hyperventilation. However, it may not work for everyone.

    You can hyperventilate for many reasons, including some health conditions. You may need other medical treatments, including oxygen therapy and medications.

    Call 911 if you hyperventilate for longer than 30 minutes or begin to lose consciousness. You may need urgent medical care.