Sleeping at Altitude

Prolonged Hypoxic Exposure (PHE)

Also known as hypoxic sleep, this altitude training method involves spending at least 8 hours per night in an oxygen-reduced environment.

Live High

Sleeping at altitude triggers an increase in erythropoietin (EPO) production, which enhances the oxygen-carrying capabilities of blood through a subsequent increase in red blood cell production and hemoglobin concentration. This adaptation results in a greater tolerance for the reduced oxygen intake experienced at high altitudes.

Hypoxic sleep is also beneficial for increasing aerobic performance through a Live High, Train Low (LHTL) routine. This involves sleeping at altitude during the night to achieve the associated blood benefits, then performing active daytime workouts at low altitude in order to maintain maximum exercise intensity.

The Benefits

Decades of scientific research have shown the following physiological benefits to occur as a result of sleeping at altitude:

Increased erythropoietin (EPO) production ^{3, 30, 31}
Increased red blood cell (RBC) mass and production ^{3, 32, 42, 45}
Increased hemoglobin concentration ^{3, 8, 33}
Reduced symptoms of acute mountain sickness (AMS) ^58-64
Improved physical performance at altitude ^{1, 64, 66}
Increased sea-level aerobic performance ^{1, 14, 30}

Sources

Who & What It's For

Sleeping at altitude is beneficial to a wide range of people and applications. The most common include:

Athletes

Runners, boxers, swimmers, cyclists, and any other type of endurance athlete can greatly benefit from the aerobic performance increase obtained by sleeping at altitude prior to an event.

In addition, sports teams traveling to high altitudes for a match (such as those occurring in South America) can pre-acclimatize beforehand so they aren’t defeated before even setting foot on the pitch.
Mountaineers

Pre-acclimatizing to high altitude prior to an expedition saves time and money, and increases the chance of a successful summit by reducing the symptoms of AMS and increasing performance at altitude. Each year, dozens of climbers successfully conquer Mount Everest, Kilimanjaro, and other mountains in reduced time after pre-acclimatizing first at home.
Travelers

Anyone traveling to high altitude locations - whether for sightseeing at Machu Picchu or skiing in Aspen - can make their vacation more enjoyable by pre-acclimatizing first at home. This will reduce the symptoms of altitude sickness that often occur during the first few days after arriving, saving both time and money.
Hunters

From Colorado to Tajikistan, some of the world’s best hunting occurs in remote wilderness locations where long periods of time will be spent at high altitude. By preparing at home in advance, hunters can spend their time focusing on the hunt, not feeling tired and sick.
Therapy

Spending extended periods in a hypoxic environment can to provide relief to individuals with various health conditions. However, hypoxic therapy should only be performed under the guidance of a medical professional.

How to Sleep at Altitude

Hypoxico's altitude training systems make it easy for anyone to sleep at altitude, regardless of where they live. It's no longer necessary to physically travel to high altitude in order to obtain the benefits.

Altitude Tents

The most popular way to sleep at altitude is inside an altitude tent connected to an altitude generator. This system offers the ideal balance between cost, comfort, and portability.
LEARN MORE
Altitude Sleep Mask

For maximum portability and for users who don't want to sleep in a tent, a sleep mask can be attached directly to an altitude generator. However, this may be uncomfortable for some.
LEARN MORE
Bedroom Conversion

Users who desire maximum comfort and will be training multiple times or for extended periods can have their bedroom seamlessly converted into an altitude chamber.
LEARN MORE

Training Guidelines

The key to effective altitude sleep training is gradually achieving, and then maintaining, a level of hypoxic stimulus that facilitates maximum adaptation with minimal disruption to sleep.

Because everyone has a different tolerance for altitude, it’s important for users to monitor their reaction and stay within their own personal limits.

The following sample protocol is the best place for most individuals to start their training:

1 Start Low

Those who live at sea level or lower altitudes should start sleeping at around 5,000 feet. This is an ideal early stimulus for most people.

2 For users above sea level

Users already living above sea level will already have acclimatized to their living altitude, and therefore can start sleeping higher than 5,000 feet.

3 Ascend in small increments

Altitude should be increased by about 500 feet each night. If sleep quality is poor on any given night, users should remain at the previous night’s altitude until they are sleeping well enough to continue increasing. It can take some time to get used to the stimulus, and it's normal to spend multiple nights in a row without ascending.

4 Maintain max altitude

For the majority of users who live at sea level or lower altitudes, 9,000 feet is the optimal maximum altitude. Once this level is reached, it should be maintained for the duration of the training period. Experienced mountaineers, users with an abnormally high tolerance, and users already living at a higher altitude may choose to sleep higher, but this may require a custom protocol involving increasing and then decreasing altitude on consecutive nights.

5 Blood Oxygen Saturation (SpO2)

In the morning before exiting the tent, SpO2 can be measured using a fingertip pulse oximeter. This will provide a good indicator on the level of stimulus and may help users make altitude adjustments to manage any sleep disruption. Generally 90% - 94% is optimal for achieving adaptation with minimal effect on sleep.

6 Training Duration

Ideally, a continuous 8+ hours per night should be spent sleeping at altitude. As for training duration, 4 weeks is the minimum recommended time for noticeable adaptation, and maximum adaptation occurs after 8 weeks.

FAQs

Why not sleep higher?

When training for a mountain, the goal is not to pre-acclimatize to summit altitude, as doing so will result in an unacceptable level of sleep disruption that negatively impacts critical pre-departure training and recovery. Pre-acclimatizing even as low as 9,000 feet provides substantial benefit because it allows for a more rapid and comfortable approach to base camp, as well as reduced time on-site before beginning the ascent.

For athletes focused on sea level performance, 9,000 feet is generally the optimal maximum.
When can I stop sleeping?

If pre-acclimatizing for a trip to high altitude, sleep at altitude right up until the date of departure. If training for an athletic event, it may be beneficial to stop sleeping at altitude 1 to 4 nights beforehand to maximize sleep quality on the final days. Loss of adaptation can begin to occur around 5 days after stopping sleep training and slowly tapers off from there.
How do I combine altitude training methods?

Combination altitude training is quite common, and the most important thing is to ensure that you don't overdo it or completely replace low altitude training. In order to not overwhelm the body with too much all at once, it's best to introduce each new altitude training method a week or two after starting the previous one.

Questions?

If you have any questions regarding altitude training and our systems, please don't hesitate to reach out and speak with one of our experts:

212-972-1009 · hello@hypoxico.com