MRI Claustrophobia Tips: How to Stay Calm During Your Scan

• Between 10% and 30% of people experience some degree of anxiety or claustrophobia during MRI scans
• Multiple effective strategies exist, from relaxation techniques to medication, to help you complete your scan
• Open MRI and wide-bore MRI machines are available alternatives that reduce the enclosed feeling
• Preparation and communication with the MRI team are the most important steps you can take
• With the right approach, the vast majority of claustrophobic patients successfully complete their MRI scans

Claustrophobia during an MRI is extremely common. The combination of a narrow tube, loud noises, the need to hold still, and the feeling of being confined can trigger anxiety even in people who do not normally consider themselves claustrophobic.

Why MRI triggers claustrophobia:

• The scanner is a long, narrow tube approximately 60 cm (24 inches) in diameter
• Your face may be only inches from the top of the machine
• The machine makes loud knocking and thumping sounds throughout the scan
• You must remain completely still for 30 to 60 minutes
• You are alone in the room (though the technologist monitors you constantly)
• Some scans require a special coil placed over your face or head

Physical symptoms of claustrophobia can include:

• Rapid heartbeat and palpitations
• Shortness of breath or feeling unable to breathe
• Sweating
• Trembling or shaking
• Nausea
• Chest tightness
• Intense urge to escape or move
• Dizziness or lightheadedness

If you have experienced any of these symptoms during a previous MRI or in other enclosed spaces, it is important to tell your doctor and the MRI facility before your appointment.

The most effective way to manage MRI claustrophobia starts well before the day of your scan.

Talk to Your Doctor

Do not wait until the day of the scan to mention your concerns. When your doctor orders the MRI, let them know you are claustrophobic. They can:

• Prescribe a mild sedative to take before the scan
• Refer you to a facility with an open or wide-bore MRI machine
• Consider whether a different imaging test could provide the same information
• Refer you to a therapist for anxiety management techniques

Visit the Facility Beforehand

Many imaging centers allow you to visit before your appointment to see the MRI machine and meet the staff. This can help reduce fear of the unknown. During your visit:

• See the actual scanner you will use
• Lie on the table and see how far inside you will go
• Meet the technologist who will be with you
• Ask about the facility's specific procedures for anxious patients

Choose the Right Facility

Not all MRI machines are the same. Ask your doctor about these options:

Wide-bore MRI: These machines have a larger opening (typically 70 cm instead of 60 cm) and are shorter in length. They provide a much less confined feeling and can accommodate larger patients.

Open MRI: These machines are open on the sides or completely open, eliminating the enclosed tunnel entirely. They are excellent for claustrophobic patients but may produce lower-quality images for certain types of studies.

Stand-up or sitting MRI: Some specialized facilities offer upright MRI machines where you sit or stand during the scan, with nothing enclosing your body.

Plan Your Day

• Schedule your scan at a time when you are naturally less stressed (for most people, this is morning)
• Avoid caffeine on the day of the scan, as it can increase anxiety
• Eat a light meal beforehand (unless instructed otherwise)
• Arrange for someone to drive you home if you will be taking a sedative
• Arrive early so you do not feel rushed

These techniques can be practiced in the weeks before your scan and used during the procedure itself.

Controlled Breathing

The 4-7-8 breathing technique is particularly effective for anxiety:

1. Breathe in slowly through your nose for 4 seconds
2. Hold your breath for 7 seconds
3. Exhale slowly through your mouth for 8 seconds
4. Repeat this cycle

Practice this technique daily in the weeks before your scan so it becomes automatic.

Box breathing is another option:

1. Breathe in for 4 seconds
2. Hold for 4 seconds
3. Breathe out for 4 seconds
4. Hold for 4 seconds
5. Repeat

Progressive Muscle Relaxation

Systematically tense and relax each muscle group in your body, starting from your toes and working up to your head. This technique reduces physical tension and gives your mind something to focus on.

Guided Imagery

Close your eyes and imagine yourself in a calm, open, beautiful place. Make the visualization as detailed as possible:

• A wide, sunny beach with the sound of waves
• A mountaintop with panoramic views
• A peaceful garden with flowers and birds
• Any place where you feel safe and relaxed

Practice this visualization before your scan so you can easily enter this mental space during the procedure.

Mental Distraction

Give your brain a complex task to focus on:

• Count backward from 1,000 by 7s
• Name a city starting with each letter of the alphabet
• Recite the lyrics to a favorite song
• Mentally walk through a familiar place in great detail
• Plan a hypothetical vacation, including every detail

Clothing and Comfort

• Wear comfortable, loose-fitting clothing without metal
• Ask for a blanket if you feel cold (many facilities provide them)
• Request a small cloth or mask over your eyes so you cannot see the enclosed space
• Some facilities provide headphones with music or earplugs to reduce the noise

Communication with the Technologist

• The technologist can hear and see you throughout the scan
• You will be given a squeeze ball or call button to alert the technologist
• Tell the technologist about your anxiety before the scan begins
• Ask the technologist to tell you how long each sequence will last
• Request breaks between scan sequences if needed
• Ask the technologist to tell you before each loud sequence begins

Positioning Matters

• Ask to go in feet-first if possible (this keeps your head closer to the opening for most body scans)
• Request a pillow under your knees to reduce back strain
• Ask for padding around your head if you are having a brain MRI
• Some facilities allow a slight elevation of the head portion of the table

For moderate to severe claustrophobia, medication can be very effective.

Oral Sedatives

Your doctor may prescribe a mild sedative to take 30 to 60 minutes before your scan. Common options include:

Important considerations with sedation:

• You cannot drive yourself home after taking a sedative
• Arrange for a responsible adult to accompany you and drive
• Sedatives can make you drowsy for several hours
• Do not combine sedatives with alcohol
• Inform the MRI facility that you have taken a sedative

IV Sedation

For severe claustrophobia, some facilities offer IV (intravenous) sedation during the scan. This provides deeper relaxation and is administered and monitored by a nurse or anesthesiologist. This option requires more preparation and is more expensive but can be very effective for patients who cannot tolerate the scan otherwise.

Nitrous Oxide

Some specialized facilities offer nitrous oxide (laughing gas) through a mask during the scan. This provides mild sedation and anxiety relief, and wears off quickly after the scan so you can drive yourself home.

If you have severe claustrophobia, an open MRI may be the best option for you.

Types of Open MRI

Open-sided MRI: The machine is open on two or three sides. You lie on a table with nothing above or around you on the open sides. The magnet sits above and below you.

Wide-bore MRI: Not fully open but has a significantly wider opening (70 cm vs 60 cm) and is shorter in length. Many patients who cannot tolerate a standard MRI do fine with a wide-bore machine.

Upright MRI: You sit or stand during the scan, and nothing encloses your body. These are the least claustrophobic option available.

Limitations of Open MRI

• Image quality: Open MRI machines typically have lower magnetic field strength (0.3 to 0.5 Tesla vs 1.5 to 3.0 Tesla for standard machines), which can result in lower image quality
• Not suitable for all studies: Some types of MRI require the stronger magnetic field of a closed machine
• Less availability: Open MRI machines are not as widely available as standard machines
• May take longer: Lower field strength can mean longer scan times

Discuss with your doctor whether an open MRI would be appropriate for your specific clinical question. For many types of studies, open MRI produces perfectly adequate images.

For long-term management of MRI anxiety, cognitive behavioral techniques can be very helpful.

Reframe Your Thinking

Instead of: "I am trapped in a small space and cannot get out." Try: "I am lying in a tube that is helping my doctor find out what is wrong. The technologist is watching me and I can leave at any time."

Instead of: "I cannot breathe in there." Try: "There is plenty of air flowing through the machine. My breathing is fine; it is just anxiety making me feel this way."

Instead of: "I cannot do this." Try: "I have prepared for this. I have tools to help me stay calm. I can do this one minute at a time."

Desensitization

If you know you will need repeated MRI scans, consider working with a therapist on gradual exposure therapy. This involves progressively practicing being in enclosed spaces until your anxiety decreases. Some therapy programs use virtual reality MRI simulations to help you practice.

For Children

Children can be especially anxious about MRI scans. Strategies that help include:

• Child-friendly explanations of the procedure using age-appropriate language
• Practice sessions at home (lying still in a pretend "spaceship" or "rocket")
• Having a parent in the room during the scan (they can hold the child's foot or hand)
• Child life specialists who are trained to help children cope with medical procedures
• Pediatric MRI facilities with decorated rooms, movies, and child-friendly environments

For People with Anxiety Disorders

If you have a diagnosed anxiety disorder, panic disorder, or post-traumatic stress disorder (PTSD), discuss this with both your doctor and the MRI facility well in advance. You may benefit from:

• A pre-scan consultation with the imaging team
• Higher-dose sedation
• Referral to a facility specializing in anxious patients
• Coordination with your mental health provider

What percentage of people cannot complete an MRI due to claustrophobia? Studies suggest that approximately 2% to 5% of patients are unable to complete an MRI due to claustrophobia, while 10% to 30% experience some degree of anxiety during the scan.

Can I have someone in the room with me? Many facilities allow a companion in the room during the scan, provided they have been screened for metal implants and safety. Ask about this when scheduling your appointment.

Will the technologist stop the scan if I panic? Yes. You will have a call button or squeeze ball. If you use it, the technologist will stop the scan immediately, slide you out, and check on you. You can take a break and try again, or stop entirely.

Is sedation safe? When prescribed by your doctor and used as directed, mild oral sedation for MRI is very safe. IV sedation carries slightly more risk but is administered by trained professionals with monitoring equipment.

Can I listen to music during my MRI? Most facilities provide MRI-safe headphones and allow you to listen to music during the scan. You can usually bring your own music selection. Music serves as both a distraction and a calming influence.

What if I need to sneeze or cough? Try to hold still, but if you must sneeze or cough, do so. One moment of movement usually only affects a few images, and the technologist can repeat that sequence if needed. Use the call button if you feel a sneeze coming so the technologist can pause the scan.

How can I prepare my child for an MRI? Use simple, honest explanations. Practice lying still at home. Visit the facility beforehand if possible. Ask about child life services. Some pediatric facilities use mock scanners for practice sessions.

Are there any VR or technology solutions for MRI anxiety? Some facilities now offer virtual reality headsets compatible with MRI machines, allowing you to watch calming scenes during the scan. Audio-visual systems with special MRI-safe goggles and headphones are also becoming more common.

Claustrophobia during MRI is a common and completely understandable experience. The good news is that there are many effective strategies to manage it, from simple breathing techniques and mental exercises to medication and open MRI alternatives.

The most important step is to communicate your concerns to your doctor and the imaging facility well before your appointment. With proper preparation and the right combination of techniques, almost anyone can successfully complete an MRI scan.

Use WellAlly to track your imaging appointments, store notes about what strategies worked for you during previous scans, and share your preferences with your healthcare team for future visits.