Intermittent hypoxic training

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Intermittent hypoxic training (IHT), also known as intermittent hypoxic therapy, is a non-invasive, drug-free technique aimed at improving human performance and well-being by way of adaptation to reduced oxygen.


An IHT session consists of an interval of several minutes breathing hypoxic (low oxygen) air, alternated with intervals breathing ambient (normoxic) or hyperoxic air. This procedure is repeated over a 45- to 90-minute session per day, with a full treatment course taking three to four weeks.

Standard practice is for the patient to remain stationary while breathing hypoxic air via a hand-held mask. The therapy is delivered using a hypoxicator during the day time, allowing the dosage to be monitored. Biofeedback can be delivered using a pulse oximeter.


The phenomenon of IHT is that it delivers a non-damaging training stimulus that naturally triggers a cascade of beneficial adaptive responses without adverse effects. The response is almost instant[1] and is evident at various levels, from systemic down to cellular.[2][3] Treatment dosage of IHT can be measured and expressed using the hypoxic training index.

It is important to differentiate between physiological adaptations to mild hypoxia and re-oxygenation episodes (i.e., the IHT protocol) and frequent nocturnal suffocation awakenings produced by sleep apnea, which might result in various pathologies.[4]


When used for performance enhancement in sports settings IHT improves mitochondrial status,[5][6] leading to improvements in aerobic and anaerobic performance.[7][8]

IHT can be beneficial for the treatment of a wide range of degenerative diseases, including:[9][10][11]

  • chronic heart and lung diseases
  • hypertension
  • asthma and chronic bronchitis
  • liver and pancreatic diseases
  • anxiety and depression
  • iron-deficiency anaemia
  • lack of energy and fatigue

IHT is contra-indicated in case of:[citation needed]

  • acute somatic and viral diseases
  • chronic obstructive pulmonary disease (COPD-II and COPD-III)
  • chronic diseases with symptoms of decompensation or terminal illness
  • individual intolerance of oxygen insufficiency
  • cancer, unless IHT is prescribed by a doctor
  • people with epilepsy, pacemakers or heart arrhythmias, unless treatment (including IHT) is under direct medical supervision.

Although there are no reported adverse effects with IHT, basic treatment protocol suggested by the manufacturer must be followed.[citation needed]

See also[edit]


  1. ^ Huang LE, Gu J, Schau M, Bunn HF (July 1998). "Regulation of hypoxia-inducible factor 1α is mediated by an O2-dependent degradation domain via the ubiquitin-proteasome pathway". Proceedings of the National Academy of Sciences of the United States of America. 95 (14): 7987–92. doi:10.1073/pnas.95.14.7987. PMC 20916Freely accessible. PMID 9653127. 
  2. ^ Manukhina EB, Downey HF, Mallet RT (April 2006). "Role of nitric oxide in cardiovascular adaptation to intermittent hypoxia". Experimental Biology and Medicine (Maywood, N.J.). Advances in Experimental Medicine and Biology. 231 (4): 343–65. doi:10.1007/0-387-29540-2_6. ISBN 978-0-387-29543-5. PMID 16565431. 
  3. ^ Gore CJ, Clark SA, Saunders PU (September 2007). "Nonhematological mechanisms of improved sea-level performance after hypoxic exposure". Medicine and Science in Sports and Exercise. 39 (9): 1600–9. doi:10.1249/mss.0b013e3180de49d3. PMID 17805094. 
  4. ^ Serebrovskaya TV, Manukhina EB, Smith ML, Downey HF, Mallet RT (June 2008). "Intermittent hypoxia: cause of or therapy for systemic hypertension?". Experimental Biology and Medicine. 233 (6): 627–50. doi:10.3181/0710-MR-267. PMID 18408145. 
  5. ^ Prokopov AF (December 2007). "Theoretical paper: exploring overlooked natural mitochondria-rejuvenative intervention: the puzzle of bowhead whales and naked mole rats". Rejuvenation Research. 10 (4): 543–60. doi:10.1089/rej.2007.0546. PMID 18072884. 
  6. ^ Hoppeler H, Vogt M, Weibel ER, Flück M (January 2003). "Response of skeletal muscle mitochondria to hypoxia". Experimental Physiology. 88 (1): 109–19. doi:10.1113/eph8802513. PMID 12525860. 
  7. ^ Hamlin MJ, Hellemans J (February 2007). "Effect of intermittent normobaric hypoxic exposure at rest on haematological, physiological, and performance parameters in multi-sport athletes". Journal of Sports Sciences. 25 (4): 431–41. doi:10.1080/02640410600718129. PMID 17365530. 
  8. ^ Katayama K, Matsuo H, Ishida K, Mori S, Miyamura M (2003). "Intermittent hypoxia improves endurance performance and submaximal exercise efficiency". High Altitude Medicine & Biology. 4 (3): 291–304. doi:10.1089/152702903769192250. PMID 14561235. 
  9. ^ Serebrovskaya TV (2002). "Intermittent hypoxia research in the former soviet union and the commonwealth of independent States: history and review of the concept and selected applications". High Altitude Medicine & Biology. 3 (2): 205–21. doi:10.1089/15270290260131939. PMID 12162864. 
  10. ^ Tin'kov AN, Aksenov VA (2002). "Effects of intermittent hypobaric hypoxia on blood lipid concentrations in male coronary heart disease patients". High Altitude Medicine & Biology. 3 (3): 277–82. doi:10.1089/152702902320604250. PMID 12396881. 
  11. ^ Rybnikova EA, Samoilov MO, Mironova VI, et al. (September 2008). "The possible use of hypoxic preconditioning for the prophylaxis of post-stress depressive episodes". Neuroscience and Behavioral Physiology. 38 (7): 721–6. doi:10.1007/s11055-008-9038-x. PMID 18709460.