psychiatric disorders
Sexual Masochism Disorder
Autoerotic asphyxiation (asphyxiophilia)
Asphyxiophilia is considered a subtype of sexual masochism disorder. As part of the diagnostic process, the clinician should note whether this behavior is "present" or "absent." In this disorder, people restrict their breathing (partial asphyxiation)—or allow a partner to do so—at or near the time of orgasm to enhance the sexual experience, not as a way to harm themselves. Typically, people use articles of clothing (eg, scarves, underwear) as a ligature to choke themselves. The ligature is often suspended from an object in the room (eg, doorknob, bedpost). Loss of consciousness can occur rapidly because obstruction of venous return from the brain impairs cerebral perfusion even before hypoxia and hypercarbia become significant. People who asphyxiate themselves in such a way that the ligature does not release if they lose consciousness can inadvertently have permanent brain damage or die. 