This page is a curated collection of peer-reviewed research relevant to hypoxic conditioning for altitude—including normobaric hypoxic sleeping, intermittent hypoxic training, and related methods used by mountain athletes preparing for high-altitude objectives.
Uphill Athlete’s understanding of hypoxic conditioning has evolved significantly over the past several years. We were initially skeptical of normobaric hypoxic methods based on the limited evidence available. Through ongoing coaching experience and research led by Martin Zhor, we have identified that individually dosed, daily-monitored protocols produce meaningfully different outcomes than generic tent use. We now offer Hypoxic Conditioning Coaching as a service. For the full account of how our position evolved and what our current practice looks like, read our companion article: What We Know About Hypoxic Conditioning for High-Altitude Climbing.
The original research review was spearheaded by Dr. Monica Piris, who culled recent editions of High Altitude Medicine and Biology and conducted searches of PubMed and PLOS One. It is worth noting that most of the studies below span periods of 7 to 14 days and only test moderate altitudes. We will continue to update this page as new publications become available and as Martin’s ongoing research produces findings suitable for public discussion.
If you are aware of a public, peer-reviewed study relevant to this topic that is not listed here, please email us at coach@uphillathlete.com. Upon review, we will add it to this resource.
Normobaric Hypoxic Tent Research: List of Journal Articles
Bailey, Damian M., Christopher K. Willie, Ryan L. Hoiland, Anthony R. Bain, David B. MacLeod, Maria A. Santoro, Daniel K. DeMasi, Andrea Andrijanic, Tanja Mijacika, Otto F. Barak, Zeljko Dujic, and Philip N. Ainslie. “Surviving Without Oxygen: How Low Can the Human Brain Go?” High Altitude Medicine & Biology 2017;18(1):73–79.
Brocherie, Franck, Olivier Gerard, Raphael Faiss, and Gregoire P. Millet. “Effects of Repeated-Sprint Training in Hypoxia on Sea-Level Performance: A Meta-Analysis.” Sports Medicine 2017;47(8):1651–1660.
“Counterpoint: Hypobaric Hypoxia Does Not Induce Different Responses from Normobaric Hypoxia” and “Rebuttal from Millet, Faiss, and Pialoux.” Journal of Applied Physiology 2012;112(10):1784–1786.
Czuba, M, Fidos-Czuba O, Ptoszczyca K, Zajac A, and Langfort J. “Comparison of the effect of intermittent hypoxic training vs. the live high, train low strategy on aerobic capacity and sports performance in cyclists in normoxia.” Biology of Sport 2018;35(1):39–48.
Czuba, Milosz, Zbigniew Waskiewicz, Adam Zajac, Stanislaw Poprzecki, Jaroslaw Cholewa, and Robert Roczniok. “The effects of intermittent tent hypoxic training on aerobic capacity and endurance performance in cyclists.” Journal of Sports Science and Medicine 2011;10(1):175–183.
Dehnert, Cristoph, MD, Astrid Böhm, Igor Grigoriev, Elmar Menold, and Peter Bärtsch, MD. “Sleeping in Moderate Hypoxia at Home for Prevention of Acute Mountain Sickness (AMS): A Placebo-Controlled, Randomized Double-Blind Study.” Wilderness & Environmental Medicine 2014;25:263–271.
Fulco, Charles S., Beth A. Beidleman, and Stephen R. Muza. “Effectiveness of Preacclimatization Strategies for High-Altitude Exposure.” Exercise and Sport Sciences Reviews 2013;41(1):55–63.
Girard, Olivier, Donald R. McCrimmon, and Gregoire P. Millet. “High-Intensity Exercise in Hypoxia—Beneficial Aspects and Potential Drawbacks.” Frontiers in Physiology 2018.
Kurdziel, Marta, Jaroslaw Wasilewski, Karolina Gierszewska, Anna Kazik, Gracjan Pytel, Jacek Waclawski, Adam Krajewski, Anna Kurek, Lech Polonski, and Mariusz Gasior. “Echocardiographic Assessment of Right Ventricle Dimensions and Function After Exposure to Extreme Altitude: Is an Expedition to 8000 m Hazardous for Right Ventricular Function?” High Altitude Medicine & Biology 2017;18(4):330–337.
Lizamore, Catherine A., and Michael J. Hamlin. “The Use of Simulated Altitude Techniques for Beneficial Cardiovascular Health Outcomes in Nonathletic, Sedentary, and Clinical Populations: A Literature Review.” High Altitude Medicine & Biology 2017;18(4):305–321.
MacKenzie, Richard W. A., Peter W. Watt, and Neil S. Maxwell. “Acute Normobaric Hypoxia Stimulates Erythropoietin Release.” High Altitude Medicine & Biology 2008;9(1):28–37. doi: 10.1089/ham.2007.1043.
Pun, Matiram. “Periodic High Altitude Exposure and Chronic Intermittent Hypoxia Are They the Same?” High Altitude Medicine & Biology 2017;18(1):84–85.
Raphael Faiss, Bertrand Leger, Jean-Marc Vesin, Pierre-Etienne Fournier, Yan Eggel, Olivier Deriaz, Gregoire P. Millet. “Significant Molecular and Systemic Adaptations after Repeated Sprint Training in Hypoxia.” PLOS One 2013;8(2): e56522.
Stray-Gundersen, James, Robert F. Chapman, and Benjamin D. Levine. “’Living high-training low’ altitude training improves sea level performance in male and female elite runners.” Journal of Applied Physiology 2001;91(3):1113–1120. [Note that this article addresses “real” altitude, not simulated altitude.]
Vogt, M., A. Puntschart, J. Geiser, C. Zuleger, R. Billeter, and H. Hoppeler. “Molecular adaptations in human skeletal muscle to endurance training under simulated hypoxic conditions.” Journal of Applied Physiology 2001;91(1):173–182.
