29/08/2026
Is it true that people claiming "I can't breathe" really can't breathe during restraint?
Yes, it is true, it is called positional asphyxia.
Speaking doesn't require normal breathing capacity, air can be forced through the airway to form words while still being seriously compromised.
This can happen for several reasons during restraint including;
Reduced chest movement due to prressure on the chest or abdomen which can make each breath smaller, restricted diaphragm movement, being held in certain positions can make it difficult for the diaphragm to expand the lungs, partial airway obstruction, a person's airway can be narrowed without being completely blocked, high carbon dioxide, CO₂ can build up and create an intense feeling of suffocation, making someone urgently say they can't breathe and stress and panic, adrenaline can dramatically increase breathing demand, making a person feel unable to get enough air even when some airflow remains.
During and after restraint it is imperative that the person is observed for warning signs that can include difficulty or abnormal breathing, inability to speak normally, blue/grey lips or skin which is known as cyanosis, increasing confusion or unusual behaviour, extreme weakness, vomiting, loss of consciousness, seizure-like movements abd absence of normal breathing.
After the restraint is released a person can remain in danger as their oxygen levels may still be low, carbon dioxide can remain elevated, they may have become exhausted from struggling to breathe, aspiration can occur, underlying medical issues may arise or already be present and always remember a person may deteriorate suddenly after initially appearing to recover therefore close monitoring for several hours and up to three days post restraint is advised.
During and immediately after restraint the person should be assessed promptly if they had difficulty breathing, altered consciousness, or significant struggle. For the first several hours it is particularly important because respiratory or neurological deterioration can become apparent, delayed complications are possible, but a person who is completely well and breathing normally becomes less likely to suddenly die from positional asphyxia as time passes.
If the person becomes unconscious and stops breathing commence CPR immediately.
If someone actually experienced suspected positional asphyxia—especially if they lost consciousness, stopped breathing normally, required CPR, vomited, or remained confused/drowsy afterward—they should be medically assessed rather than relying on a particular monitoring period.
The best way to prevent positional asphyxia is to release the restraint every three minutes, release pressure from the chest, abdomen and neck, restraints can also be modified from prone to side control if it is to dangerous to release the restraint.
