Hiccups are a reflex: involuntary spasms of the diaphragm — the dome-shaped muscle that does most of the work of breathing — together with the muscles between the ribs. The characteristic “hic” is the sudden inhale being cut off by the closing glottis (Stacey & Bassett, 2024).
Most hiccups stop on their own within a few minutes, and the NHS says you can usually just wait them out. When they don’t stop, most people reach for a folk remedy. Be clear about what you’re reaching for. The NHS lists the usual self-help options with the caveat that “there’s no evidence that they work for everyone,” and the authors of a 2024 case series on a breathing technique open their paper like this:
“Few methods for terminating hiccups have been published in the scientific literature.”
What follows is ordered by cost and safety, not by proof.
Start here: the breath hold
The CO2 build:
- Take a deep but not maximum inhale through the nose. Aim for about 75% full.
- Hold the breath for 20 to 30 seconds. Longer than feels comfortable but well short of any distress.
- Exhale slowly and breathe normally for one or two cycles.
- If hiccups persist, repeat once.
The published version is a little different. In the HAPI technique described by Stacey and Bassett, you breathe in as far as you can, then keep trying to breathe in — glottis open, not a closed-throat hold — for 30 seconds in total, then exhale slowly. Their case series describes 21 patients, all of whom reported immediate relief. It doesn’t tell you how often the technique fails, there was no control group, the authors say further studies are needed, and since hiccups usually stop on their own, a result like that is hard to read. It is still more than any other breathing trick we found has.
The case for carbon dioxide as the mechanism has at least some measurements behind it. Obuchi et al. (2018) had two patients with persistent hiccups rebreathe from a 20-litre bag; the hiccups stopped at 195 and 359 seconds, once exhaled CO2 had reached 50 and 53 mmHg. That is two patients and minutes of monitored rebreathing, not a 30-second hold. Treat the CO2 story as plausible, not proven.
Backup protocols when the first one fails
We found no study of any of these for hiccups. They’re here because they’re cheap and easy to try in sequence.
4-7-8 with extra long exhale.Inhale 4 seconds, hold 7, exhale 8 — but extend the exhale to 12 seconds. Repeat 4 cycles.
The water + bent-forward method.Bend forward at the waist. Take small sips of cold water slowly for 30 seconds while staying bent. Not a breathing protocol strictly, but it’s in the same family of physical interventions, and leaning forward and sipping ice-cold water are both on the NHS self-help list.
Pursed-lip exhale. Inhale normally, exhale through tightly pursed lips for as long as possible. The option to reach for if breath retention feels difficult.
Folk remedies with a catch
Breathing into a paper bagis the one folk remedy with both a measured mechanism and a measured hazard. The NHS lists it. Obuchi’s patients needed exhaled CO2 around 50 mmHg before their hiccups stopped; in Callaham’s (1989) paper-bag study of 20 volunteers who had first hyperventilated, a few reached 50 but many never reached 40. Meanwhile, oxygen in the bag fell by an average of 16 mmHg in the first 30 seconds and kept falling. The same paper reports three deaths where paper-bag rebreathing was wrongly used on patients whose real problem was low blood oxygen or myocardial ischaemia. If you use it for hiccups, keep it short, and never use it for breathlessness.
Holding your breath while a friend presses on your eyeballs. Pressure on the eyeball triggers the oculocardiac reflex, which characteristically slows the heart by more than 20 percent and has been documented causing arrhythmia, asystole and cardiac arrest. Don’t do this.
The rest of the folk canon
We found no controlled trial of any of these. That isn’t proof they fail; it means nobody knows how often they work.
- Being startled. Hard to test by design — you can’t schedule a surprise.
- Swallowing granulated sugar. On the NHS self-help list, with the same no-evidence caveat as everything else on it.
- Drinking from the far side of a glass. The acrobatics are the whole appeal.
- Tongue pulling. Inelegant, and no better studied than the rest.
- Peanut butter on the roof of the mouth. The internet’s favorite. No trial. Tasty though.
When hiccups warrant a doctor
The NHS says to see a GP if hiccups last longer than 48 hours, or keep coming back and are affecting your life. The research literature uses two thresholds, as defined in a Cochrane review (Moretto et al., 2013):
- Persistent hiccups:more than 48 hours. The NHS notes that in rare cases these are due to a medical condition or a medicine you’re taking. A systematic review by Steger et al. (2015) found management was most effective when aimed at the underlying condition, and that an empirical trial of anti-reflux therapy may be appropriate. Worth seeing a primary care provider.
- Intractable hiccups: more than a month. Rare. Requires a medical workup for the cause.
- Hiccups with other symptoms: chest pain, swallowing difficulty, severe weight loss, or persistent vomiting. See a doctor without delay.
Even for the long-lasting kind, treatment evidence is thin. The Cochrane review found insufficient evidence to guide treatment of persistent or intractable hiccups, with drugs or anything else, and Steger’s review found no high-quality data to base recommendations on.
For the normal episode — a few minutes of hiccups after eating too fast or a fizzy drink — the breath hold at the top of this page is the cheapest thing to try. If it fails, the likeliest outcome is that the hiccups stop on their own anyway. Either way, you can leave the peanut-butter jar alone.
Quick reference
- Standard hiccup: deep inhale → hold 20–30s → release. Repeat once if needed.
- The published version (HAPI): breathe in fully → keep trying to breathe in, throat open, 30s in total → slow exhale.
- Backup: 4 cycles of 4-7-12 (4 in, 7 hold, 12 exhale).
- Paper bag: only if you’re otherwise well, and keep it short. Never for breathlessness.
- Hiccups + 48 hours: see a doctor.