December 20, 2015 posted by The Fitness Impresario

Evaluating Altitude & Breath Training

Evaluating Altitude & Breath Training

I was recently asked to evaluate the Training Mask, along with other altitude training devices and realized that, while I’ve been playing with breathing exercises for most of my life, I’ve never posted on altitude specifically. My article on the importance of breath hold training is one of the more popular things on this blog. This is a follow up, looking specifically at breath training protocols that also help you perform at altitude.

In its most simple sense, exercising or living at altitude increases your body’s natural hematocrit (red blood cell) levels. This gives your body better oxygen carrying capacity, which improves your ability to endure.

There are two applications for altitude training, both real and simulated: acclimation for performance at altitude and simply increased general performance. Since these are different I’ll use my experience to rate both for each.

High Altitude Training


The old school thought was that gains made at high altitude meant low altitude improvements. Back in high school and college, I’d organize high altitude training camps. We felt like it helped, but evidence seems as though that was probably more mental than anything else. Effectiveness varies by length, as the more you sleep at altitude the better your improvements. Changes don’t come quickly. This evaluation is for short term, a week or less or, for those who can go up and down daily, simply training high and sleeping low.

When you train at altitude for short durations, your training capacity diminishes. You do adapt to altitude, and get better over time, but for short periods that trade off is likely moot or even a net negative. It does, however, help you acclimate to performing at altitude if that is your goal.

Depending on where you live, cost and practicality vary, but it’s safe to say that it’s never very practical and can be downright prohibitive. This makes it a poor choice for most of us, no matter how well it worked for Rocky.

Rating: Sea level performance: Altitude performance: B Cost: D Practicality: D

Train low, sleep high

New school thought is that if you can sleep at altitude, but train at low elevation, you get the benefit of both recovering in rarified air with low elevation intensity. It makes sense, and it works pretty well on both fronts. It’s not a strategy for acclimation to performing at altitude, where you need to train high also, though if you’re already sleeping high training as necessary should be no issue. You also need to do it for at least a week for much improvement to happen, and keep going back at regular intervals to keep it.

While a great strategy technically, it is absurdly impractical unless you have massive free time and/or are very rich.

Rating: Sea level performance: Altitude performance: A Cost: F Practicality: F

Oxygen Tents


To facilitate the above effects, athletes often sleep in oxygen tents wherever they live that simulate high altitude. While this improves practicality, they are generally very expensive and have more famously been used as “smoke screens” for convicted dopers than anything else. There is also an not-totally-understood oddity in that they effectiveness seems to diminish over time as athletes tend to get good bumps during initial usage, which lessen in repeat cycles. Those bumps are never nearly as high as, say, EPO but they are generally effective. Practicality and cost, as you might imagine, are less than ideal.  Oxygen tents are expensive (starting at thousands of dollars) and I’ve yet to hear a single person rave about sleeping in them, and most find it rather unpleasant.

Rating: Sea level performance: Altitude performance: B Cost: D Practicality: C-

Alto Lab


This is a device that filters the air you breath to simulate elevation through something like looks like a massive bong. It’s simple to use and studies show that it works better than altitude tents, probably because you have to actively breath through it as opposed to just sleeping. While you can do it while reading or watching TV, it’s not totally passive. You get your blood oxygen to drop to a prescribed level, then you breath in intervals. I would often get pretty dizzy, so I could barely do simple reading or viewing as my brain capacity was diminished. Training takes an hour a day, and you do it in blocks of 5 to 14 days, with about that much time off in between. After a longer initial phase, you spend less time maintaining.

My wife and I used this system to train for Everest and The Yak Attack. It worked very well, as we both pretty much crushed at elevation. It’s not a cheap system, about $500 initial investment and more over time as the filters wear out. But it’s much cheaper, and heaps more convenient, than the above choices.

While it’s probably the best choice currently available, I’m not sure I’d recommend it for everyone. Endurance athletes and those going to altitude will benefit, but I don’t see it as a huge advantage for power athletes who don’t plan to compete at elevation. Some help, sure, but not enough to justify the cost unless you’re looking for every tiny advantage.

Rating: Sea level performance: B+ Altitude performance: B+ Cost: C Practicality:  B

Training Mask


This is a super hero (or psycho) looking mask that you see promoted by heaps of MMA people. Lacking the sophistication of Alto Lab, as all it really does is reduce your air and make it hard to breath. There is no CO2 scrubbing. The plus side is that it’s cheap. About $75 bucks can set you up. The downside is that it doesn’t work all that well, especially for adapting to altitude.

Basically, it’s a device that forces you to focus on breathing, but that is definitely a training advantage (discussed a bit here). The claims they make about elevation improvements and increased hematocrit are mostly BS, at least compared to the above protocols. That shouldn’t diminish your enthusiasm. You get what you pay for and this device is helpful if you’re nit-picky about your training, which I certainly would be if my sport involved people trying to kick me in the head.

I would say you could over use this mask. You don’t want to interfere with your most intense training effect by hindering your ability to breathe. But used wisely, in conjunction with your other training, it can be a cheap and effective training tool. I would not recommend it to get ready to go to altitude unless it’s all you can afford. But as a standard rule, breathing practice is always better than no breathing practice.

Rating: Sea level performance: C+ Altitude performance: C- Cost: A Practicality: A

The Wim Hof Method


Known as The Iceman and popular in the media these days, Hof is a guy who uses breathing techniques and cold immersion to improve his ability to perform in heat, cold, altitude and stave off illness. His stuff seems hippyish, as it’s grounded in yoga, zen, and other holistic practices, yet he is constantly subjecting himself to modern study and results. While new and inconclusive, results are promising.

Hof preaches practicality. Do what you can, whenever and wherever is his motto. A resourceful person can find most of his teaching on the web for free, or you can pay $200 dollars for a ten-week program that requires no equipment or further cost.

I was only exposed to this a few months ago, so it’s hard to gauge its effectiveness.  My ability to hold my breath and withstand cold are improved.  This would indicate that I’d improve at somewhat at altitude, too, though I have not seen a bump in hematocrit. I definitely breathe better, and I was already a fairly efficient breather, and that can’t be bad. Improvements feel better than the Training Mask, though the latter took less specificity. It’s also hard to dispute the things Hof has done, which include high performance at altitude coming straight from living at sea level.

Like the Training Mask, there is less definitive science at work than the top choices, but it’s also cheap and very easy to implement. At this stage, the cold immersion (which has scientifically been show to improve bone marrow production) gives it a nod for effectiveness, though the mask requires less alterations and time from your current lifestyle. The jury is still out but, so far, I highly recommend it.

Rating: Sea level performance: B+ Altitude performance: C+ Cost: A- Practicality: A-

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