Background Repeated exposure to intermittent normobaric hypoxia improves exercise tolerance in cardiac patients. Little is known on the effects of intermittent normobaric hypoxia‐hyperoxia exposure in coronary artery disease (CAD) patients (New York Heart Association II–III). Hypothesis IHHT improves exercise tolerance, cardiometabolic profile, and quality of life in CAD patients. Methods The study design was a nonrandomized, controlled, before‐and‐after trial. Forty‐six CAD patients volunteered to take part in the study: a group of 27 patients undertook the intermittent hypoxia (O2 at 10%)–hyperoxia (O2 at 30%) training (IHHT), whereas a control group (CTRL) of 19 patients, who already completed an 8‐week standard cardiac rehabilitation program, was allocated to sham‐IHHT treatment (breathing room air, O2 at 21%). Exercise performance, blood and metabolic profiles, and quality of life (Seattle Angina Questionnaire [SAQ]) were measured before and after in the IHHT group (IHHG) and sham‐IHHT in the CTRL group. Results The IHHG showed improved exercise capacity, reduced systolic and diastolic blood pressures, enhanced left ventricle ejection fraction, and reduced glycemia, but only at 1‐month follow‐up. Angina as a reason to stop exercising was significantly reduced after treatment and at 1‐month follow‐up. The IHHT SAQ profile was improved in the IHHG and not significantly different to the CTRL group after standard rehabilitation. The IHHG was also compared to the CTRL group at 1‐month follow‐up, and no differences were found. Conclusions In CAD patients, an IHHT program is associated with improved exercise tolerance, healthier risks factors profile, and a better quality of life. Our study also suggests that IHHT is as effective as an 8‐week standard rehabilitation program.

IntroductionIntermittent hypoxic–hyperoxic training (IHHT) may complement a multimodal training intervention (MTI) for improving cognitive function and exercise tolerance in geriatric patients.MethodsThirty-four patients (64–92 years) participated in this randomized controlled trial. Before and after the 5- to 7-week intervention period (MTI + IHHT vs. MTI + ambient air), cognitive function was assessed by the Dementia-Detection Test (DemTect) and the Sunderland Clock-Drawing Test (CDT), and functional exercise capacity by the total distance of the 6-Minute Walk Test (6MWT).ResultsDemTect and CDT indicated significantly larger improvements after MTI + IHHT (+16.7% vs. −0.39%, P < .001) and (+10.7% vs. −8%, P = .031) which was also true for the 6MWT (+24.1% vs. +10.8%, P = .021).DiscussionIHHT turned out to be easily applicable to and well tolerated by geriatric patients up to 92 years. IHHT contributed significantly to improvements in cognitive function and functional exercise capacity in geriatric patients performing MTI.

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Overtraining syndrome (OTS) is a major concern among endurance athletes and is a leading cause in preventing them to perform for long periods. Intermittent exposure to hypoxia has been shown to be an effective way of improving performance without exercising. Aim of this pilot study was to evaluate intermittent hypoxia-hyperoxia training combined with light exercise as an intervention to facilitate athletes with OTS to restore their usual performance level. Thirty-four track and field athletes were recruited: 15 athletes with OTS volunteered to participate and undertook a conditioning programme consisting of repeated exposures to hypoxia (O at 10%) and hyperoxia (O at 30%) (6-8 cycles, total time 45 min-1 h), three times a week, delivered 1·5-2 h after a low-intensity exercise session (2 bouts of 30 min, running at 50% of VO with 10 min rest between bouts) over 4 weeks. Nineteen healthy track and field athletes volunteered to participate as a control group and followed their usual training schedule. Measurements before and after the intervention included exercise capacity, analysis of heart rate variability and hematological parameters. In athletes with OTS, a 4-week light exercise combined with intermittent hypoxia-hyperoxia training improved exercise performance (191·9 ± 26·9 W versus 170·8 ± 44·8 W in exercise capacity test, P = 0·01). Heart rate variability analysis revealed an improved sympatho-parasympathetic index (low frequency/high frequency ratio, 8·01 ± 7·51 before and 1·45 ± 1·71 after, P = 0·007). Hematological parameters were unchanged. Our pilot study showed that intermittent hypoxia-hyperoxia training and low-intensity exercise can facilitate functional recovery among athletes with OTS in a relatively short time.

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Background Additional benefits of passive exposures to intermittent hypoxia and hyperoxia on cognitive performance and functional exercise capacity have been demonstrated in geriatric patients who performed a multimodal training program. The main goal of the present study was to evaluate effects of adding intermittent hypoxic-hyperoxic training (IHHT) to a multimodal training intervention (MTI) on mobility and perceived health in old individuals at a Geriatric Day Hospital. Methods Thirty-four patients between 64 and 92 years participated in the double blind, randomized and controlled clinical trial. The elderly patients attended in a 5–7 weeks lasting MTI (strength, endurance, balance, reaction, flexibility, coordination, and cognitive exercises) and performed IHHT (breathing 10–14% oxygen for 4–7 min followed by 2–4 min 30–40% oxygen) in the Hypoxic Group (HG) or placebo treatment with ambient air in the Normoxic Group (NG) in parallel. Before and after all treatments, mobility was assessed by the Tinetti Mobility Test (TMT), the Timed-Up-and-Go Test (TUG) and Barthel-Index, while perceived health was assessed by one part of the EQ-5D Test, the EQ visual analogue scale (EQ VAS). Results After the MTI plus IHHT or normoxia sessions, results of the TMT, TUG, Barthel Index and EQ-VAS revealed no significant difference between HG and NG (+ 14.9% vs + 15.4%, p = 0.25; − 21% vs − 26.3%, p = 0.51; + 4.2% vs + 3.6%, p = 0.56; + 37.9% vs + 33.9%, p = 0.24;). Conclusions IHHT added to MTI did not elicit additional improvements in perceived health and mobility compared to MTI alone.