Harnessing brain rhythms to activate the glymphatic pathway via controlled breathing and intermittent CO2

Abstract

In this work, we discuss the potential of controlled breathing and rhythmic CO2 exposure to increase CSF oscillations and vasomotion, potentially promoting glymphatic influx and waste clearance from the brain. While previous studies have largely focused on the psychological outcomes of controlled breathing, particularly its role in reducing stress and anxiety, our findings advance the novel benefit of enhancing the glymphatic pathway and reflect a mechanistic framework to guide future work. We discuss the prior literature that demonstrated that respiration induced changes in thoracic pressure can immediately generate large-scale CSF flow. Whether initiated indirectly via structured breathing protocols or directly through intermittent CO2 inhalation, we also emphasize the importance of oscillatory CO2 as a potent driver of vasomotion and CSF flow. This emerging paradigm highlights respiratory-based interventions not only as tools for mental health and stress resilience, but also as potential noninvasive strategies to promote brain health, maintain cognitive function, and have therapeutic value in mitigating age-related decline and neurodegeneration.