Choking during sex can produce brain damage from neuronal death from anoxia, reperfusion injury, and changes in heartbeat.

Asphyxia during sex can be done using an air choke or a blood choke, which block air entry or the blood supply to the brain, respectively.

Death by autoerotic asphyxiation is less common that thought. Still, choking is the most deathly BDSM activity.

Several surveys show that college students increasingly practice choking during sex

Controversial issues in BDSM include sexual predators, consent, choking, drugs, mental problems and domestic discipline.