The dimensionality of a system can fundamentally impact the behaviour of interacting quantum particles. Classic examples range from the fractional quantum Hall effect to high temperature superconductivity. As a general rule, one expects confinement to favour the binding of particles. However, attractively interacting bosons apparently defy this expectation: while three identical bosons in three dimensions can support an infinite tower of Efimov trimers, only two universal trimers exist in the two dimensional case. We reveal how these two limits are connected by investigating the problem of three identical bosons confined by a harmonic potential along one direction. We show that the confinement breaks the discrete Efimov scaling symmetry and destroys the weakest bound trimers. However, the deepest bound Efimov trimer persists under strong confinement and hybridizes with the quasi-two-dimensional trimers, yielding a superposition of trimer configurations that effectively involves tunnelling through a short-range repulsive barrier. Our results suggest a way to use strong confinement to engineer more stable Efimov-like trimers, which have so far proved elusive.