Source Core Rulebook pg. 478 4.0
You can hold your breath for a number of rounds equal to 5 + your Constitution modifier. Reduce your remaining air by 1 round at the end of each of your turns, or by 2 if you attacked or cast any spells that turn. You also lose 1 round worth of air each time you are critically hit or critically fail a save against a damaging effect. If you speak (including casting spells with verbal components or activating items with command components) you lose all remaining air.
When you run out of air, you fall unconscious and start suffocating. You can’t recover from being unconscious and must attempt a DC 20 Fortitude save at the end of each of your turns. On a failure, you take 1d10 damage, and on a critical failure, you die. On each check after the first, the DC increases by 5 and the damage by 1d10; these increases are cumulative. Once your access to air is restored, you stop suffocating and are no longer unconscious (unless you’re at 0 Hit Points).