People practice asphyxiophilia in a variety of ways, such as hanging, suffocation with a plastic bag, self-strangulation with a ligature, volatile solvent or gas, chest compressions, or a combination of these.
Asphyxiophilia compresses the carotid arteries on either side of the neck, which carry oxygen-rich blood from the heart to the brain. During asphyxiophilia, oxygen is suddenly lost in the brain at the same time that carbon dioxide accumulates. This creates feelings of giddiness and euphoria and leads to a state known as hypoxia, which can heighten sexual stimulation and orgasm.
Some suggest that this rush is as addictive and powerful as an illicit drug like cocaine. It has also been likened to the euphoric feelings experienced by climbers at high altitudes.
Asphyxiophilia is incredibly dangerous, and is responsible for between 250 and 1000 deaths in the United States every year. These numbers may be conservative as these deaths can be mistaken for suicide or even murder. Deaths can occur when the loss of consciousness which comes from partial asphyxia leads to a loss of control over the strangulation, thus leading to continued asphyxia. Many prominent figures have died due to asphyxiophilia including Michael Hutchence, David Carradine, and composer Frantisek Kotzwara. The majority of people who die through asphyxiophilia are male, perhaps because they are more likely to engage in risky behavior than women.