Deep water blackout

Freediving blackout, breath-hold blackout or apnea blackout is a class of hypoxic blackout, a loss of consciousness caused by cerebral hypoxia towards the end of a breath-hold (freedive or dynamic apnea) dive, when the swimmer does not necessarily experience an urgent need to breathe and has no other obvious medical condition that might have caused it. It can be provoked by hyperventilating just before a dive, or as a consequence of the pressure reduction on ascent, or a combination of these. Victims are often established practitioners of breath-hold diving, are fit, strong swimmers and have not experienced problems before. Blackout may also be referred to as a syncope or fainting.

Divers and swimmers who blackout or grey out underwater during a dive will usually drown unless rescued and resuscitated within a short time. Freediving blackout has a high fatality rate, and mostly involves males younger than 40 years, but is generally avoidable. Risk cannot be quantified, but is clearly increased by any level of hyperventilation.

Freediving blackout can occur on any dive profile: at constant depth, on an ascent from depth, or at the surface following ascent from depth and may be described by a number of terms depending on the dive profile and depth at which consciousness is lost. Blackout during a shallow dive differs from blackout during ascent from a deep dive in that deep water blackout is precipitated by depressurisation on ascent from depth while shallow water blackout is a consequence of hypocapnia following hyperventilation.

Different types of freediving blackout have become known under a variety of names, these include:

In this article constant pressure blackout and shallow water blackout refers to blackouts in shallow water following hyperventilation and ascent blackout and deep water blackout refers to blackout on ascent from depth. Some free divers consider blackout on ascent to be a special condition or subset of shallow water blackout but the primary underlying mechanisms differ. This confusion is exacerbated by the fact that in the case of blackout on ascent, hyperventilation induced hypocapnia also may be a contributory factor even if depressurisation on ascent is the actual precipitator.

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