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Erotic asphyxiation or breath control play is the intentional restriction of oxygen to the brain for sexual arousal. The sexual preference for that behavior is variously called asphyxiophilia, autoerotic asphyxia, hypoxyphilia. Colloquially, a person engaging in the activity is sometimes called a gasper. The erotic interest in asphyxiation is classified as a paraphilia in the Diagnostic and Statistical Manual of the American Psychiatric Association.

Deaths often occur when the loss of consciousness caused by partial asphyxia leads to loss of control over the means of strangulation, resulting in continued asphyxia and death. While often asphyxiophilia is incorporated into sex with a partner, others enjoy this behaviour by themselves, making it potentially more difficult to get out of dangerous situations. Victims are often found to have rigged some sort of “rescue mechanism” that has not worked in the way they anticipated as they lost consciousness.

In some fatality cases, the body of the asphyxiophilic individual is discovered naked or with genitalia in hand, with pornographic material or sex toys present, or with evidence of having orgasmed prior to death.Bodies found at the scene of an accidental death often show evidence of other paraphilic activities, such as fetishistic cross-dressing and masochism.In cases involving teenagers at home, families may disturb the scene by “sanitizing” it, removing evidence of paraphilic activity. This can have the consequence of making the death appear to be a deliberate suicide, rather than an accident.

The great majority of known erotic asphyxial deaths are male; among all known cases in Ontario and Alberta from 1974 to 1987, only one out of 117 cases was female. Some individual cases of women with erotic asphyxia have been reported. The mean age of accidental death is mid-20s, but deaths have been reported in adolescents and in men in their 70s.

Autoerotic asphyxiation has at times been incorrectly diagnosed as murder and especially so when a partner is present. Some hospitals have teaching units specifically designed to educate doctors in the correct diagnosis of the condition.

Lawyers and insurance companies have brought cases to the attention of clinicians because some life insurance claims are payable in the event of accidental death, but not suicide.

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