In 1995, the CDC began collecting data on a dangerous adolescent phenomenon called “the choking game” in which teens (typically in a group setting but sometimes alone) self-strangulate or have another person strangulate them to induce cerebral hypoxia.
The strangulation may take a number of forms including special holds or the use of a belt or ligature. The resulting hypoxia can induce a brief feeling of euphoria but may also lead to unconsciousness, seizure, brain damage, physical injury, sexual assault (during unconsciousness), and death.
It is unclear whether this game has risen in popularity or has just become a subject of increased study recently, but data from the CDC and other sources indicates that the game is widely popular among young people. The majority of deaths from the game occur in youth between the ages of 6 and 19.
One study published in the journal Clinical Pediatrics, found 65 YouTube videos featured the game in a single month, with over 279,000 collective views. While there was no clear causative link found between the videos and an increase in game participation, these videos may lead to normalization of the behavior, increasing the likelihood of new participants.
Most parents of young people whose cause of death is determined to be the choking game had no prior knowledge of the game. Parents and professionals should be on the lookout for signs of this dangerous game, which include:

  • bloodshot eyes
  • mention of the choking game (by any of its names*)
  • mentions of other high-risk games/activities (such as huffing)
  • frequent and severe headaches
  • Nicks, bruises, or discoloration on the neck
  • disorientation after being alone
  • ropes or other ligatures (belts, scarves) attached to furniture or doorknobs or lying knotted on the floor

*Alternate Names May Include: California high, tingling, suffocation roulette, space monkey, breath play, funky chicken, rising sun, sleeperhold, American dream, airplaning, and others.