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 home made altitude system for Intermittent Hypoxic Exposure.

1 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 mass[1].

2 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 traveling to a lower level to train. However, this approach is also possible by using a hypoxia generator to reduce the level of O2 in a tent. The downside to an altitude tent is that the quality of sleep can be degraded even more than living at altitude and the equipment is expensive.

3 Intermittent Hypoxic Exposure

IHE uses lower O2 concentrations than LHTH or LHTL, but for shorter periods. Typical regimes are 5 min hypoxia + 5 min normal air, repeated 6 times. See Intermittent Hypoxic Exposure and The Science of Intermittent Hypoxic Exposure.

4 Intermittent Hypoxic Training

IHT uses O2 similar to IHE, but unlike IHE exercise is undertaken while exposed to the low O2 concentrations. This tends to significantly compromise training quality.

5 Summary

Type Pros 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/day) where activity is limited
IHT No sleep issues like LHTL Detraining as with LHTH, equipment varies and requires a treadmill for runners

6 Altitude Training for Sea Level Performance

An excellent meta-analysis[2] (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.

7 Elevation Training Mask

The Elevation Training Mask (ETM) is a device that covers the nose and mouth to restrict 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"[3], 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 indicated a low value of 96%, well within the range of normal sea level respiration and well above the level needed for IHE. The manufacturer has a "clinical trial" that show ETM combined with High Intensity Interval Training (HIIT) improves V̇O2max[4], but this trial did not have controls to see if the improvements where just due to the HIIT. The improvements in 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.

8 See Also

9 References

  1. Response of skeletal muscle mitochondria to hypoxia
  2. Sea-level exercise performance following adaptatio... [Sports Med. 2009] - PubMed result
  3. Elevation Training Mask and The Effects: A Case Report
  4. Elevation Training Mask Technical Report Clinical Trial