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Why holding your breath underwater can be so dangerous

Nolan Royer's family said he died playing a game to see who could stay underwater the longest. This common challenge can lead to a dangerous condition called shallow water blackout.

Shallow water blackout may have caused Nolan Royer, 17, to drown in children's pool at Saskatoon hotel

Seeing how long you can hold your breath underwater can lead to a shallow water blackout, during which a lack of oxygen to the brain causes a swimmer to faint. (Brian Rodgers/CBC)

A game children often play while swimming can be deadly, warns the provincial operations manager for the Canadian Red Cross in Saskatchewan.

"As kids, we've always tried to see how far you can swim across the pool holding your breath, and I don't think people have ever thought of it as having the potential of death, but it is really serious," Rebecca Benko said.

This common challenge can lead to a dangerous condition called shallow water blackout, which may have caused 17-year-old Nolan Royer's death on Nov. 10.

His family said he died in the pool at the Sheraton Cavalier Hotel in Saskatoon while playing a game to see who could stay underwater the longest.

'Almost no chance of getting the person back'

Swimming Canada said that while there are no hard statistics, up to 20 per cent of deaths from drowning worldwide may be due to shallow water blackout, during which a lack of oxygen to the brain causes a swimmer to faint.

Swim Saskatchewan provincial coach Aaron Maszko said the biggest problem with shallow water blackout is that the likelihood of resuscitation is extremely low.

"Even if you get the person out of the water in 30 seconds to do mouth-to-mouth and CPR, the lungs are so filled with water, because there's been no restriction of the airway to stop water from going in, that there's almost no chance of getting the person to come back," Maszko said.

Swimming Canada estimates that up to 20 per cent of drowning deaths may be due to shallow water blackout. (Supplied by Shallow Water Blackout Prevention)

The reason people usually feel the need to gasp for air when we hold our breath is not actually due to a lack of oxygen, but due to high levels of carbon dioxide in our bloodstream.

Shallow water blackouts often happen because people preparing to hold their breath cause hyperventilation by taking several deep breaths, or many shallow breaths before going under.

This artificially lowers the amount of carbon dioxide in their system and the body's automatic response to take a breath isn't triggered because carbon dioxide levels are at normal levels.

"It's very possible that [Nolan Royer] did black out and didn't necessarily feel the urge to breathe, and that's the real danger with shallow water blackouts," Maszko said.

Lifeguards not required at hotel pools

The Red Cross' Benko says lifeguards are trained to watch for many different types of behaviours, including people playing this type of game.

Rebecca Benko with the Canadian Red Cross says it's common for kids to see how far they can swim across a pool holding their breath, but most people don't realize how dangerous it can be. (Chanss Lagaden)

"They know that if they see a group of kids kind of congregated and one's going under and hold [their] breath for a long time, they're aware of the fact that that's probably what's happening, and they would go over and talk to the kids, educate the kids, and get them to stop it right away," she said.

In Saskatchewan, lifeguards are not required at hotels and motels if a sign is posted that advises swimmers of supervision requirements.

Shelby Rushton, CEO of the Saskatchewan branch of the Lifesaving Society, said she thinks this arrangement needs to be addressed.

"The government says we don't need lifeguards at hotel pools and motel pools," she said. "We've had more drownings in hotels and motels in the last couple years than we have in public pools."

The advocacy group Shallow Water Blackout Prevention offers these safety tips. (Submitted by Shallow Water Blackout Prevention)