Comparative effects of ayahuasca and breathwork on self-reported cognitive flexibility, emotion regulation, positive affect, and sleep quality

Abstract Background and aims Research on classical psychedelics like ayahuasca is increasingly focused on treating mental disorders and enhancing well-being. Ayahuasca has shown promise in improving cognitive flexibility, emotion regulation, and sleep, though findings are mixed and further research is needed. This study tracked participants over three months, assessing cognitive flexibility, positive affect, emotion regulation, and sleep before and after ayahuasca ceremonies, compared to a breathwork control group. The hypothesis was that ayahuasca would offer greater benefits than breathwork, with cognitive flexibility improvements preceding gains in emotion regulation and sleep. Methods Using a longitudinal observational study, we collected data from participants who attended either a single ayahuasca ceremony (involving two consecutive doses about 3 h apart) or a single breathwork session. Online questionnaires were administered via the Qualtrics platform one week before the interventions (baseline, T0) and at one, six, and twelve weeks (T1, T6, and T12) post-session. Results Both treatments significantly improved cognitive flexibility, emotion regulation, positive affect, and sleep quality over time compared to baseline. Cognitive flexibility improvements preceded changes in emotion regulation, partially confirming our hypotheses. Conclusions While this study showed lasting positive effects of ayahuasca and breathwork on cognitive flexibility, emotion regulation, positive affect, and sleep quality, the temporal order of these effects remains unclear. The role of attendee experience and internal motivation in these outcomes is also uncertain. Future research should include more frequent assessments closer to the experience and consider both the acute experience and participants' motivation to better understand the drivers of these changes.