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Articles in the Daily Mail and the New York Post allege that

Nyla Anderson, 10, died on December 12 after she took part in the dangerous Blackout Challenge which encourages participants to hold their breath until they pass out.

Here are some key points from the Daily Mail article:

A Pennsylvania family is warning parents about a dangerous TikTok challenge after their 10-year-old daughter died attempting to hold her breath until she passed out.

Nyla Anderson, 10, passed away on December 12 in her bedroom at her family's Chester home after attempting the viral 'Blackout Challenge.'

The online dare, which has been linked to several child deaths, encourages participants to hold their breath until they pass out. While it predates social media, the deadly has recently made the rounds on TikTok.

A lot of people are saying that the way this girl died is impossible, as you will start to breathe again once you have passed out from holding your breath. The question is: did this really happen?

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  • Passing out does not happen altogether. First the conscious part of your mind is shut down then the rest. When the conscious mind is shut down the body resumes breathing. Holding your breath by itself is not enough to die, something else must happen after the person passes out.
    – FluidCode
    Jan 2, 2022 at 20:32
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    @FluidCode "All together" means "all at once". "Altogether" means "entirely".
    – Acccumulation
    Jan 3, 2022 at 1:48
  • Where I grew up, a youngster died trying to dive for a long distance in a public swimming pool. Your brain doesn't react to lack of oxygen, but to too much CO2. If you inhale and exhale deeply for a few minutes, you can very much lower your normal CO2 level, and then you are capable of diving until you pass out because your brain doesn't register the lack of oxygen. And under water, with nobody getting you out, you'll die.
    – gnasher729
    Jan 5, 2022 at 13:18

2 Answers 2

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I think the key issue with this claim is the part about "holding your breath".

A Pennsylvania family is warning parents about a dangerous TikTok challenge after their 10-year-old daughter died attempting to hold her breath until she passed out

(emphasis added). While the Daily Mail and New York Post do refer to "breath-holding", and I don't have any proof to the contrary, I strongly suspect that the deaths are not from unassisted breath-holding (except perhaps from accidents/trauma following on from passing out after breath-holding). It's hard to know exactly what happened; another article says that she was found unconscious and that the family said she "might’ve accidentally injured herself while playing the game" (the direct quote is from the article, not the family).

If you go back through the CDC reports and other articles you'll see that it's not called the "breath-holding game", but usually something like the "choking game"

The challenge has been identified as the "Choking Game," the "Passout Challenge," the "Game of Choking," the "Fainting Game," the "Space Monkey" and more.

Although I haven't dug around to get all the gory details (I don't want to and I suspect they're often suppressed to discourage imitation), I would guess that all of these deaths are caused either by someone else choking the victim, or by the victim choking themselves with some object — not by breath-holding alone.

I would be very surprised if an otherwise healthy person hurt themselves seriously from holding their breath until they passed out (except by falling/drowning/etc.); as far as I know it's basically impossible (see links below), although a 1554 precursor of Romeo and Juliet had Juliet commit suicide by holding her breath (!)

This article from WebMD says "[t]he risks of passing out include hitting your head or injuring yourself while falling" (or drowning, if you're in the water when holding your breath). It does say that breath-holding can cause irregular heartbeat, kidney and liver damage, a seizure, or brain injury (@Feryll points out in a comment that even these deleterious effects are poorly linked to voluntary breath-holding in the source material; they are attested as more general problems associated with hypoxia, e.g. from severe asthmatic attacks).

This blog post talks about the physiological mechanisms that kick in to force you to start breathing again.

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    To me, this is the more socially and scientifically aware answer. The choking game is nothing new, while acute injury from holding one's breath very much would be, and there are numerous reasons why the family or the media wouldn't go into the gory details as to exactly how the girl died, whether that be from strangulation or concussing herself.
    – Feryll
    Jan 3, 2022 at 0:01
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    For the record, I looked into that article from WebMD, and the only source I could find about breath-holding causing irregular heartbeat, seizure, and brain injury (the Ohio State blog article) itself has no sources to back it up. It mentions that lack of oxygen to the heart can damage the kidney and liver, but by its phrasing, I suspect it's just an extrapolation of the well-known effects of circulatory blockage on your body in the long term, i.e. not something induced by one-off attempts at breath-holding.
    – Feryll
    Jan 3, 2022 at 0:09
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    It seems quite plausible that if a child passed out by holding their breath and got a fatal head injury while falling, then a newspaper could describe it as "died attempting to hold her breath until she passed out" and that would technically be true.
    – Peteris
    Jan 3, 2022 at 16:57
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Unless her medical records and an autopsy are released it would probably not be possible to know for sure that her death was caused by her trying the challenge, but there seems to be good reason to assume that's the case. Another article from Today quotes Elizabeth Wood, a clinical social worker at the hospital where Nyla was treated

We believe this was an (accident) and we know that she had a history of viewing these videos on social media...Children and adolescents, their brains are developing and they do not have the capacity to understand the consequences of their behavior and that it is not safe.

The statement here is couched with "we believe," but given that the family (who would have the most firsthand knowledge of the decedent's condition) seems convinced that she died as a result of the challenge it's a reasonable assumption that she did in fact die as a result of trying to hold her breath until she fell unconscious. The Today article also lists other cases where children have died as a result of trying this.

It should not be surprising that depriving your brain of oxygen can lead to serious complications or death. From the US National Institute of Health National Library of Medicine:

Brain cells are very sensitive to a lack of oxygen. Some brain cells start dying less than 5 minutes after their oxygen supply disappears. As a result, brain hypoxia can rapidly cause severe brain damage or death.

Hypoxia can occur before the person falls unconscious. The NLM lists mild symptoms of cerebral hypoxia as:

  • Change in attention (inattentiveness)
  • Poor judgment
  • Uncoordinated movement

Note that these are all symptoms that would occur while someone is still conscious.

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    Scientific consensus is that you can't kill yourself by holding your breath: as soon as you fall unconscious, your autonomous nervous system will take over and you'll resume breathing normally.
    – Mark
    Jan 3, 2022 at 8:44

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