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Altitude Training Approaches

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==This is a comparison of the various approaches to [[Altitude Training]], their pros and cons. Personally I use a [[DIY Altitude Training Approaches==There are various ways of using |home made altitude to improve performancesystem]] for [[Intermittent Hypoxic Exposure]]. ===Live High, Train High===By moving to altitude, you are exposed to lower oxygen all the time. While this approach can have a good effect on altitude acclimatization, it makes training much harder. Therefore the benefit of altitude on increased red blood cell count are offset by the reduced ability to train hard. There is also evidence that LHTH reduces [[Muscle|muscle]] mass<ref name="muscle"/>. ===Live High, Train Low===Sleeping at altitude produces the increase in red blood cells, and training at low altitude provides optimum training benefits. This effect can be achieved by literally living at a high altitude and travelling traveling to a lower level to train. However, this approach is also possible by using a hypoxia generator to reduce the level of oxygen O₂ in a tent. The downside to an altitude tent is that the quality of sleep can be significantly degradedeven more than living at altitude and the equipment is expensive. ===Intermittent Hypoxic Training=Exposure==Being exposed to low oxygen IHE uses lower O₂ concentrations than LHTH or LHTL, but for short shorter periods has been shown to provide similar benefits to other altitude training approaches. The technique usually involves breathing air with reduced oxygen content for a few minutes, followed by breathing Typical regimes are 5 min hypoxia + 5 min normal air for a few minutes, repeating for about an hourrepeated 6 times. IHT can provide the increase in red blood cell count as longer periods, as well as improving oxygen delivery to the muscles. IHT is normally performed at rest rather than when training, See [[Intermittent Hypoxic Exposure]] and uses a pulse oximeter to verify the impact [[The Science of the hypoxia. IHT uses lower oxygen content than other forms of altitude trainingIntermittent Hypoxic Exposure]]. ==Intermittent Hypoxic Training==IHT promises a number of advantages over other techniques. It does not reduce training intensity in the way that Live Highuses O₂ similar to IHE, Train High does. It does not impair sleep in but unlike IHE exercise is undertaken while exposed to the way that an altitude tent doeslow O₂ concentrations. The biggest advantage is that chemical based IHT can be obtained for much less than other systemsThis tends to significantly compromise training quality. ==Summary==The evidence for IHT is rather mixed. Some studies<ref name{| class="wikitable"| align="center" style="EPObackground:#f0f0f0;"/><ref name|'''Type'''| align="acucenter"/><ref namestyle="altobackground:#f0f0f0;"/> show improvements with IHT type approaches, at least one well designed study<ref name|'''Pros'''| align="jackcenter"/> showed no improvement. There are claims that the USSR<ref namestyle="USSRbackground:#f0f0f0;"|'''Cons'''|-| LHTH||Easy if you live at altitude||Reduced training benefits, loss of muscle mass|-| LHTL||No detraining unlike LHTH, no extra time taken like IHT||Requires travel or altitude tent|-| IHE||No sleep issues like LHTL, No detraining unlike LHTH, equipment cheap||Takes time (~1 hour/> used day) where activity is limited|-| IHT extensively. ||No sleep issues like LHTL||Detraining as with LHTH, equipment varies and requires a [[Treadmill|treadmill]] for runners|}

==Altitude Training for Sea Level Performance==

An excellent meta-analysis<ref name="HypoxicMeta"/> (review of scientific studies) looked at how [[Altitude Training]] has been shown to improve sea level performance. The meta-analysis showed that:

* For sub-elite athletes

** IHE was very likely to improve performance

** Natural LHTL was likely to improve performance (living at altitude rather than an altitude tent)

** Artificial LHTL could possibly improve performance

* For elite athletes only natural LHTL was likely to improve performance (living at altitude rather than an altitude tent)

It should be noted that one of the most important conclusions of the meta-analysis is the lack of good quality studies. For instance, there were only two IHE studies for elite athletes, and one of these was flawed by providing far too low a level of hypoxia for most of the study.

==Elevation Training Mask==

The [http://www.trainingmask.com Elevation Training Mask] (ETM) is a device that covers the nose and mouth to restrict [[Breathing|breathing]]. The ETM claims that it "mimics the effects of High Altitude Training", and it even talks about equivalent altitudes of 12,000-18000ft. The ETM web site states "The Mask reduces the partial pressure of oxygen"<ref name="TrainingMaskCase"/>, but there is no supporting evidence, or any indication of any possible mechanism that would reduce the partial pressure of oxygen. The only mention of [[SpO2|SpO₂]] indicated a low value of 96%, well within the range of normal sea level respiration and well above the level needed for [[Intermittent Hypoxic Exposure| IHE]]. The manufacturer has a "clinical trial" that show ETM combined with [[High Intensity Interval Training]] (HIIT) improves [[VO2max|V̇O₂max]]<ref name="TrainingMaskTrial"/>, but this trial did not have controls to see if the improvements where just due to the HIIT. The improvements in [[VO2max|V̇O₂max]] shown in the studies are in line with other studies of HIIT alone, so the benefit of the ETM is unclear at best. Note that this trial was published as a blog entry, not published in peer reviewed journals. The ETM may improve the strength of the breathing muscles, but there is no evidence that this alone improves performance. I would not recommend the ETM, nor do I believe it constitutes 'altitude training' and it is only included in this section because it is a common question.

==See Also==

* [[The Science of Altitude Training]]* [[Hypoxia Comparison of Altitude Training Systems]]* [[Book Review – - Altitude Training and Athletic Performance]]* [[Intermittent Hypoxic Exposure]] and [[The Science of Intermittent Hypoxic Exposure]]* [[AltoLab]]

==References==

<references>

<ref name="EPOmuscle">http://japwww.physiologyhypoxico.orgcom/cgiimages/contentpdfs/abstract/73/3/837 Erythropoietin response Response_of_skeletal_muscle_mitochondria_tohypoxia_Hoppel.pdf Response of skeletal muscle mitochondria to acute normobaric hypoxia in humans</ref><ref name="acuHypoxicMeta">http://japSea-level exercise performance following adaptatio...physiology[Sports Med.org/cgi/content/abstract/66/4/1785?ijkey=5bbdebe4e97a65aad9ea16d9d6a7f0c9de2d7dc0&keytype2=tf_ipsecsha Rate of erythropoietin formation in humans in response to acute hypobaric hypoxia</ref><ref name="alto">2009] - PubMed result http://www.pharmapacificncbi.comnlm.nih.gov/imagespubmed/AltoLab_Clinical_Research_Study.pdf Running performance and altitude exposure19203133</ref><ref name="jackTrainingMaskTrial">Elevation Training Mask Technical Report Clinical Trial http://japblog.physiologytrainingmask.org/cgi/content/full/96com/5elevation-training-mask-technical-report-clinical-trial/1800 Intermittent normobaric hypoxia does not alter performance or erythropoietic markers in highly trained distance runners</ref><ref name="USSRTrainingMaskCase">Elevation Training Mask and The Effects: A Case Report http://wwwblog.ncbitrainingmask.nlm.nih.gov/pubmedcom/12162864 Intermittent hypoxia research in the former soviet union elevation-training-mask-and -the commonwealth of independent States: history and review of the concept and selected applications.-effects-a-case-report/</ref>

</references>

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