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Aerobic Intermittent Hypoxic Training Is Not Beneficial for Maximal Oxygen Uptake and Performance: A Systematic
Gianluigi Dorelli1, Gaia Giuriato1, Giovanni Zamboni1
1Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Scandinavian Journal of Medicine & Science in Sports
|June 23, 2025
Summary
Intermittent hypoxic training (IHT) does not significantly improve maximal oxygen uptake (V̇O2max) or athletic performance compared to normoxic training (NT). This meta-analysis found no added benefit of training in hypoxia for aerobic adaptations.
Area of Science:
- Exercise Physiology
- Sports Science
- Altitude Training Research
Background:
- Inconsistent findings exist regarding the benefits of intermittent hypoxic training (IHT) versus normoxic training (NT) for maximal oxygen uptake (V̇O2max) and sea-level performance.
- Variability in results may stem from differences in study populations, training protocols, and hypoxic methods.
- A need exists for a comprehensive meta-analysis with strict criteria to clarify the efficacy of IHT.
Purpose of the Study:
- To systematically review and analyze parallel-design studies comparing aerobic IHT to NT.
- To assess the effects of aerobic IHT on V̇O2max and sea-level aerobic performance.
- To investigate potential moderating factors like fitness level and exercise modality.
Main Methods:
- Systematic literature search conducted following PRISMA guidelines.
- Inclusion of 35 parallel-design studies with 524 participants.
- Analysis considered population characteristics, training protocols, hypoxic methods, and publication details.
Main Results:
- Aerobic IHT did not significantly improve V̇O2max, peak power output, or time to exhaustion compared to NT.
- Subgroup analyses revealed no significant differences based on participant fitness level or exercise modality.
- A significant publication bias was detected, suggesting potential overestimation of IHT benefits in the literature.
Conclusions:
- Aerobic intermittent hypoxic training does not provide superior improvements in V̇O2max or performance compared to normoxic training.
- The addition of hypoxia to aerobic exercise does not appear to enhance training adaptations.
- Publication bias may have influenced previous enthusiastic findings on IHT.
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