The Effects of Intermittent Hypoxic Training on Anaerobic Performance in Young Men (2024)

Four weeks of intermittent hypoxic interval training in untrained young men produced a significant increase in peak anaerobic power (both absolute and relative) compared to identical training at sea level. Normoxic trainers saw no such gains, indicating hypoxic sessions can uniquely enhance peak power output.

The effects of intermittent hypoxic training on the aerobic capacity of exercisers: a systematic review and meta-analysis (2023)

A meta-analysis of 19 studies concluded that intermittent hypoxic training (IHT) significantly improves aerobic capacity. IHT groups showed higher maximal oxygen uptake and increased hemoglobin concentration versus control groups, supporting the efficacy of simulated altitude exposures for boosting VO₂max.

Optimal type and dose of hypoxic training for improving maximal aerobic capacity in athletes: a network meta-analysis (2023)

This comprehensive review of 59 studies found all hypoxic training modalities (e.g. Live-High Train-High, Live-High Train-Low, Intermittent Hypoxic Training) yielded greater VO₂max improvements than normoxic training. Notably, Live High Train Low camps combined with low-altitude workouts were ranked most effective for increasing aerobic capacity.

The Effect of Natural or Simulated Altitude Training on High-Intensity Intermittent Running Performance in Team-Sport Athletes: A Meta-Analysis (2018)

An analysis of 10 studies (Sports Medicine, 2018) showed that hypoxic interventions (simulated or real altitude) yielded additional improvement in high-intensity intermittent run performance over sea-level training. Both intermittent hypoxia exposure and live-high protocols led to likely beneficial gains (~13-19% extra Yo-Yo test improvement) compared to controls, and performance benefits persisted at least 4 weeks post-intervention.

Efficacy of intermittent hypoxic training on hemodynamic function and exercise performance in competitive swimmers (2018)

In a 6-week RCT, competitive swimmers training under normobaric hypoxia (simulated ~3000 m) showed significant enhancements in maximal oxygen uptake and 400-m swim time that were not seen in the sea-level training group. The hypoxic group also exhibited greater improvements in hemodynamic parameters (e.g. lower exercise heart rate and higher stroke volume), suggesting altitude-simulated training improved cardiovascular efficiency and endurance performance.

Ten days of simulated live high–train low altitude training increases Hbmass in elite water polo players (2013)

Short-duration Live High-Train Low camps with normobaric hypoxia induced an ~4% increase in hemoglobin mass in national-team water polo athletes. Over three <2-week altitude blocks (2,500-3,000m simulated), players’ oxygen-carrying capacity rose significantly, which could augment aerobic power.

Application of altitude/hypoxic training by elite athletes (2011)

This study reviewed how elite athletes across various sports use altitude and hypoxic training methods to enhance performance. It found that Live High, Train Low is the most widely adopted and effective strategy, leading to improvements in VO₂ max, red blood cell mass, and race performance - especially in endurance sports. 

Hypoxic training methods for improving endurance exercise performance (2015)

This review analyzed different hypoxic training strategies - like Live High Train Low, Live Low Train High, and Intermittent Hypoxic Training - and their effects on endurance performance. It concluded that while Live High, Train Low consistently improves aerobic capacity and endurance, other methods like IHT and LLTH can also enhance muscle efficiency, oxygen utilization, and performance when applied correctly. 

“Living High-Training Low” for Olympic Medal Performance: What Have We Learned 25 Years After Implementation? (2023)

The study confirms that, when thoughtfully implemented, Live High Train Low can significantly enhance endurance performance, as evidenced by its successful use in Olympic and World Championship preparations. However, it also highlights that benefits are not guaranteed and depend on meticulous planning, monitoring, and individualization of the training approach.

Intermittent hypoxic training on aerobic capacity and biometric indicators among obese women (2024)

In a pilot trial, 41 obese women underwent 4 weeks of exercise training under normobaric hypoxia versus normoxia. The hypoxic-training group achieved significantly greater weight loss and improvements in VO₂max than the sea-level training and control groups. The study suggests that adding simulated altitude to moderate exercise can enhance weight reduction and cardiorespiratory fitness in obesity, with no major safety issues noted.

Intermittent Hypoxic–Hyperoxic Exposures in Patients with Metabolic Syndrome: Correction of Cardiovascular and Metabolic Profile (2022)

This RCT (Biomedicines, 2022) found that three weeks of passive intermittent hypoxic–hyperoxic sessions (5 days/week, 45 min/day) led to clinically meaningful drops in blood pressure (−15 mmHg systolic on average) and improvements in lipid profiles in metabolic syndrome patients. The IHHE group saw significant reductions in systolic/diastolic BP, LDL cholesterol, liver fat indices, and arterial stiffness markers compared to sham controls, supporting IHHE as a safe adjunct therapy for hypertension, dyslipidemia, and obesity-related liver issues in MS.

Hypoxic training improves blood pressure, nitric oxide and hypoxia-inducible factor-1 alpha in hypertensive patients (2020)

A 2020 clinical trial in patients with hypertension demonstrated that a structured hypoxic exercise program can significantly lower resting blood pressure while increasing nitric oxide availability and HIF-1α levels (markers of vascular function). These results indicate simulated-altitude training induces beneficial cardiovascular adaptations in hypertensive individuals, especially those unable to tolerate high-intensity exercise at normoxia.

Effect of hypoxic training on inflammatory and metabolic risk factors: a crossover study (2014)

In this crossover study, 14 healthy men performed 4 weeks of identical treadmill exercise regimens under either normoxic or hypoxic conditions (~15% FiO₂, ~2,500m). Only the hypoxic training led to significant reductions in waist circumference, visceral fat thickness, arterial stiffness (pulse-wave velocity), and high-sensitivity CRP. Compared to the normoxic trial, short-term hypoxic exercise had a greater effect on lowering these metabolic syndrome risk markers, suggesting an added benefit for cardiovascular health (via reduced arterial stiffness and inflammation).

Improved exercise performance and skeletal muscle strength after simulated altitude exposure in patients with chronic heart failure (2012)

A pilot study of 12 heart failure patients showed that intermittent normobaric hypoxia (10 sessions over 22 days, gradually rising from 1,500m to 2,700m) was safe and well-tolerated, and it significantly improved exercise capacity. Peak VO₂ rose from 13.5 to 14.2 mL·kg^−1·min^−1 (≈5% increase, _p_ = 0.036) and 6‑minute walk distance, leg muscle strength, and quality-of-life scores all increased after the altitude exposure regimen. Benefits persisted 4 weeks post-intervention, indicating simulated altitude acclimatization can confer lasting functional gains in HF patients.

Influences of normobaric hypoxia training on fitness and metabolic risk in overweight subjects (2010)

This landmark 2010 study found that 4 weeks of moderate-intensity exercise under normobaric hypoxia (~15% O₂, equivalent to ~2,600m) elicited equal or greater benefits than the same training at sea level. Despite exercising at a lower workload, the hypoxia group achieved similar VO₂max gains and larger improvements in body composition and metabolic markers (lower body fat, lower respiratory exchange ratio at anaerobic threshold, etc.). The findings suggest altitude-simulated exercise allows overweight individuals to improve fitness and cardiometabolic health with reduced mechanical strain on the body.

Interval hypoxic training improves autonomic cardiovascular and respiratory control in patients with mild chronic obstructive pulmonary disease (2009)

This randomized, double-blind study investigated the effects of Intermittent Hypoxic Training (IHT) on patients with mild COPD. Over three weeks, participants underwent sessions involving brief periods of low-oxygen exposure. The results demonstrated significant improvements in autonomic cardiovascular function, including normalized baroreflex sensitivity and enhanced ventilatory response to elevated carbon dioxide levels. These findings suggest that IHT may serve as a non-pharmacological strategy to improve autonomic and respiratory control in individuals with mild COPD.