Hypoventilation training

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Hypoventilation training is a physical training method in which periods of exercise with reduced breathing frequency are interspersed with periods with normal breathing. The hypoventilation technique consists of short breath holdings and can be performed in different types of exercise: running, cycling, swimming, rowing, skating, etc.

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Generally, there are two ways to carry out hypoventilation: at high lung volume or at low lung volume. At high lung volume, breath holdings are performed with the lungs full of air (inhalation then breath hold). Conversely, during hypoventilation at low lung volume, breath holdings are performed with the lung half full of air. To do so, one has to first exhale normally, without forcing, then hold one's breath. This is called the exhale-hold technique.

The scientific studies have shown that only hypoventilation at low lung volume could lead to both a significant decrease in oxygen (O2) concentrations in the body and an increase in carbon dioxide concentrations (CO2), which are indispensable for the method to be effective. [1] [2]

History

The first known form of hypoventilation occurred in the 1950s during training of the runners of Eastern Europe and former USSR. [3] One of the most famous athletes to have used this method is Emil Zátopek, the Czech long-distance runner, four times Olympic gold medalist and former holder of 18 world records. Zátopek, who was a precursor in training, regularly used to run by holding his breath to harden his training and simulate the conditions of competition. However, at that time, the effects of hypoventilation training were completely unknown and the method was applied very empirically.

At the beginning of the 1970s, American swim coach James Counsilman used a new training technique which involved taking a limited number of inhalations while swimming laps in a pool. The effect of this kind of training was determined to decrease the body's O2 content and simulate altitude training. [4] Due to the method's efficacy, hypoventilation became a common training method for many swimmers.

It is especially from the 1980s that the scientific studies on exercise with reduced breathing frequency began to be published. While the method advocated by Counsilman attracted a following in some runners and athletics coaches, the results of the studies contradicted the hypotheses put forward by the World of Sport. They showed that this training method did not decrease body O2 concentrations and provoked only a hypercapnic effect, i.e. an increase in CO2 concentrations. [5] [6] Both the effectiveness and legitimacy of hypoventilation training were strongly challenged.

Since the middle of the 2000s, a series of studies has been conducted by French researchers of Paris 13 University to propose a new approach to hypoventilation training. Dr Xavier Woorons and his team hypothesized that if breath holdings were carried out with the lungs half-full of air, rather than full of air as performed so far, it would be possible to significantly reduce body oxygenation. The results that were published confirmed the hypotheses. They demonstrated that through hypoventilation at low lung volume, that is the exhale-hold technique, it was possible, without leaving sea level, to decrease O2 concentrations in the blood and in the muscles at levels corresponding to altitudes above 2000 m. [7]

Physiological effects

When exercise is being performed, if the exhale-hold technique is properly applied, a decrease in O2 concentrations and an increase in CO2 concentrations occur in the lungs, the blood and the muscles. [1] The combined effect of hypoxia and hypercapnia act as a strong stimulus whose main consequence is to increase lactic acid and hydrogen ions production, and therefore to provoke a strong acidosis in the body. Thus, during exercise with hypoventilation, the blood and muscle acid–base homeostasis is highly disturbed. The studies have also reported an increase in all heart activity when hypoventilation is carried out in terrestrial sports. Cardiac output, heart rate, stroke volume and sympathetic modulation to the heart are greater when exercise with hypoventilation is performed in running or cycling. [8] A slightly higher blood pressure has also been recorded. In swimming on the other hand, no significant change in the heart activity has been found. [2]

After several weeks of hypoventilation training, physiological adaptations occur that delay the onset of acidosis during a maximal exertion test. The studies have shown that at a given workload, pH and blood bicarbonate concentrations were higher, whereas lactate concentrations had a tendency to decrease. The reduction in acidosis would be due to an improvement in buffer capacity at the muscle level. However, no change advantageous to aerobic metabolism has been found. Maximal oxygen uptake (VO2max), the number of red blood cells and the anaerobic threshold were not modified after hypoventilation training.

Benefits of the method

By delaying acidosis, hypoventilation training would also delay the onset of fatigue and would therefore improve performance during strenuous exertions of short to moderate durations. After several weeks of hypoventilation training, performance gains between 1 and 4% have been reported in running [9] [10] and swimming. [11] [12] The method could be interesting to use in sports requiring strenuous repeated or continuous exertions, whose duration does not exceed a dozen minutes: swimming, middle-distance running, cycling, combat sports, team sports, racquet sports, etc. [ citation needed ]

Another advantage of hypoventilation training is to stimulate the anaerobic metabolism without using high exercise intensities, which are more traumatizing for the locomotor system and therefore increase the risk of injuries. Athletes who return progressively to their sporting activity after being injured, and who therefore have to protect their muscles, joints and tendons, could train at low or moderate intensity with hypoventilation.

Disadvantages of the method

Hypoventilation training is physically demanding. This method is intended for highly motivated athletes, who do not have pulmonary or cardiovascular issues and whose primary objective is performance. Furthermore, exercising with hypoventilation can provoke headaches if the breath holdings are maintained too long or repeated over a too long period of time. Finally, this training method does not seem to be beneficial for endurance sports.[ citation needed ]

See also

Related Research Articles

<span class="mw-page-title-main">Hypoxia (medical)</span> Medical condition of lack of oxygen in the tissues

Hypoxia is a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level. Hypoxia may be classified as either generalized, affecting the whole body, or local, affecting a region of the body. Although hypoxia is often a pathological condition, variations in arterial oxygen concentrations can be part of the normal physiology, for example, during strenuous physical exercise.

<span class="mw-page-title-main">Respiratory system</span> Biological system in animals and plants for gas exchange

The respiratory system is a biological system consisting of specific organs and structures used for gas exchange in animals and plants. The anatomy and physiology that make this happen varies greatly, depending on the size of the organism, the environment in which it lives and its evolutionary history. In land animals the respiratory surface is internalized as linings of the lungs. Gas exchange in the lungs occurs in millions of small air sacs; in mammals and reptiles these are called alveoli, and in birds they are known as atria. These microscopic air sacs have a very rich blood supply, thus bringing the air into close contact with the blood. These air sacs communicate with the external environment via a system of airways, or hollow tubes, of which the largest is the trachea, which branches in the middle of the chest into the two main bronchi. These enter the lungs where they branch into progressively narrower secondary and tertiary bronchi that branch into numerous smaller tubes, the bronchioles. In birds the bronchioles are termed parabronchi. It is the bronchioles, or parabronchi that generally open into the microscopic alveoli in mammals and atria in birds. Air has to be pumped from the environment into the alveoli or atria by the process of breathing which involves the muscles of respiration.

Apnea, BrE: apnoea, is the temporal cessation of breathing. During apnea, there is no movement of the muscles of inhalation, and the volume of the lungs initially remains unchanged. Depending on how blocked the airways are, there may or may not be a flow of gas between the lungs and the environment. If there is sufficient flow, gas exchange within the lungs and cellular respiration would not be severely affected. Voluntarily doing this is called holding one's breath. Apnea may first be diagnosed in childhood, and it is recommended to consult an ENT specialist, allergist or sleep physician to discuss symptoms when noticed; malformation and/or malfunctioning of the upper airways may be observed by an orthodontist.

Dead space is the volume of air that is inhaled that does not take part in the gas exchange, because it either remains in the conducting airways or reaches alveoli that are not perfused or poorly perfused. It means that not all the air in each breath is available for the exchange of oxygen and carbon dioxide. Mammals breathe in and out of their lungs, wasting that part of the inhalation which remains in the conducting airways where no gas exchange can occur.

<span class="mw-page-title-main">Obesity hypoventilation syndrome</span> Condition in which severely overweight people fail to breathe rapidly or deeply enough

Obesity hypoventilation syndrome (OHS) is a condition in which severely overweight people fail to breathe rapidly or deeply enough, resulting in low oxygen levels and high blood carbon dioxide (CO2) levels. The syndrome is often associated with obstructive sleep apnea (OSA), which causes periods of absent or reduced breathing in sleep, resulting in many partial awakenings during the night and sleepiness during the day. The disease puts strain on the heart, which may lead to heart failure and leg swelling.

Hypoventilation occurs when ventilation is inadequate to perform needed respiratory gas exchange. By definition it causes an increased concentration of carbon dioxide (hypercapnia) and respiratory acidosis. Hypoventilation is not synonymous with respiratory arrest, in which breathing ceases entirely and death occurs within minutes due to hypoxia and leads rapidly into complete anoxia, although both are medical emergencies. Hypoventilation can be considered a precursor to hypoxia and its lethality is attributed to hypoxia with carbon dioxide toxicity.

Exhalation is the flow of the breath out of an organism. In animals, it is the movement of air from the lungs out of the airways, to the external environment during breathing. This happens due to elastic properties of the lungs, as well as the internal intercostal muscles which lower the rib cage and decrease thoracic volume. As the thoracic diaphragm relaxes during exhalation it causes the tissue it has depressed to rise superiorly and put pressure on the lungs to expel the air. During forced exhalation, as when blowing out a candle, expiratory muscles including the abdominal muscles and internal intercostal muscles generate abdominal and thoracic pressure, which forces air out of the lungs.

Acidosis is a process causing increased acidity in the blood and other body tissues. If not further qualified, it usually refers to acidity of the blood plasma.

In physiology, respiration is the movement of oxygen from the outside environment to the cells within tissues, and the removal of carbon dioxide in the opposite direction that's to the environment.

<span class="mw-page-title-main">Hypercapnia</span> Abnormally high tissue carbon dioxide levels

Hypercapnia (from the Greek hyper = "above" or "too much" and kapnos = "smoke"), also known as hypercarbia and CO2 retention, is a condition of abnormally elevated carbon dioxide (CO2) levels in the blood. Carbon dioxide is a gaseous product of the body's metabolism and is normally expelled through the lungs. Carbon dioxide may accumulate in any condition that causes hypoventilation, a reduction of alveolar ventilation (the clearance of air from the small sacs of the lung where gas exchange takes place) as well as resulting from inhalation of CO2. Inability of the lungs to clear carbon dioxide, or inhalation of elevated levels of CO2, leads to respiratory acidosis. Eventually the body compensates for the raised acidity by retaining alkali in the kidneys, a process known as "metabolic compensation".

The control of ventilation is the physiological mechanisms involved in the control of breathing, which is the movement of air into and out of the lungs. Ventilation facilitates respiration. Respiration refers to the utilization of oxygen and balancing of carbon dioxide by the body as a whole, or by individual cells in cellular respiration.

<span class="mw-page-title-main">Hypocapnia</span> State of reduced carbon dioxide in the blood

Hypocapnia, also known as hypocarbia, sometimes incorrectly called acapnia, is a state of reduced carbon dioxide in the blood. Hypocapnia usually results from deep or rapid breathing, known as hyperventilation.

<span class="mw-page-title-main">Altitude training</span> Athletic training at high elevations

Altitude training is the practice by some endurance athletes of training for several weeks at high altitude, preferably over 2,400 metres (8,000 ft) above sea level, though more commonly at intermediate altitudes due to the shortage of suitable high-altitude locations. At intermediate altitudes, the air still contains approximately 20.9% oxygen, but the barometric pressure and thus the partial pressure of oxygen is reduced.

<span class="mw-page-title-main">Respiratory acidosis</span> Medical condition

Respiratory acidosis is a state in which decreased ventilation (hypoventilation) increases the concentration of carbon dioxide in the blood and decreases the blood's pH.

<span class="mw-page-title-main">Hypoxemia</span> Abnormally low level of oxygen in the blood

Hypoxemia is an abnormally low level of oxygen in the blood. More specifically, it is oxygen deficiency in arterial blood. Hypoxemia has many causes, and often causes hypoxia as the blood is not supplying enough oxygen to the tissues of the body.

<span class="mw-page-title-main">James Counsilman</span>

James Edward "Doc" Counsilman was an Olympic and hall-of-fame swimming coach from the United States. He was the head swimming coach at Indiana University (IU) from 1957 to 1990. He served as head coach for the USA's Olympic swim teams for 1964 and 1976; and was inducted as an Honors Coach into the International Swimming Hall of Fame in 1976.

The Alveolar–arterial gradient, is a measure of the difference between the alveolar concentration (A) of oxygen and the arterial (a) concentration of oxygen. It is a useful parameter for narrowing the differential diagnosis of hypoxemia.

<span class="mw-page-title-main">Breathing</span> Process of moving air in and out of the lungs

Breathing is the process of moving air into and from the lungs to facilitate gas exchange with the internal environment, mostly to flush out carbon dioxide and bring in oxygen.

In some individuals, the effect of oxygen on chronic obstructive pulmonary disease is to cause increased carbon dioxide retention,

Human physiology of underwater diving is the physiological influences of the underwater environment on the human diver, and adaptations to operating underwater, both during breath-hold dives and while breathing at ambient pressure from a suitable breathing gas supply. It, therefore, includes the range of physiological effects generally limited to human ambient pressure divers either freediving or using underwater breathing apparatus. Several factors influence the diver, including immersion, exposure to the water, the limitations of breath-hold endurance, variations in ambient pressure, the effects of breathing gases at raised ambient pressure, effects caused by the use of breathing apparatus, and sensory impairment. All of these may affect diver performance and safety.

References

  1. 1 2 Woorons, Xavier; Bourdillon, Nicolas; Vandewalle, Henri; Lamberto, Christine; Mollard, Pascal; Richalet, Jean-Paul; Pichon, Aurélien (2010). "Exercise with hypoventilation induces lower muscle oxygenation and higher blood lactate concentration: Role of hypoxia and hypercapnia". European Journal of Applied Physiology. 110 (2): 367–77. doi:10.1007/s00421-010-1512-9. PMID   20503056. S2CID   24416926.
  2. 1 2 Woorons, Xavier; Gamelin, François-Xavier; Lamberto, Christine; Pichon, Aurélien; Richalet, Jean Paul (2014). "Swimmers can train in hypoxia at sea level through voluntary hypoventilation". Respiratory Physiology & Neurobiology. 190: 33–9. doi:10.1016/j.resp.2013.08.022. PMID   24012989. S2CID   26688092.
  3. ↑ Xavier Woorons, "Hypoventilation training, push your limits!", Arpeh, 2014, p. 21 ( ISBN   978-2-9546040-1-5)
  4. ↑ Counsilman, J. (1975). "Hypoxic training and other methods of training evaluated". Swim Tech. 12: 19–26.
  5. ↑ Holmer, I; Gullstrand, L (1980). "Physiological responses to swimming with controlled frequency of breathing". Scandinavian Journal of Medicine & Science in Sports. 2: 1–6.
  6. ↑ Dicker, Scott G.; Lofthus, Geraldine K.; Thornton, Norton W.; Bkooks, George A. (1980). "Respiratory and heart rate responses to tethered controlled frequency breathing swimming". Medicine & Science in Sports & Exercise. 12 (1): 20–23. doi: 10.1249/00005768-198021000-00005 . PMID   7392897.
  7. ↑ Woorons, Xavier; Mollard, Pascal; Pichon, Aurélien; Duvallet, Alain; Richalet, Jean-Paul; Lamberto, Christine (2007). "Prolonged expiration down to residual volume leads to severe arterial hypoxemia in athletes during submaximal exercise". Respiratory Physiology & Neurobiology. 158 (1): 75–82. doi:10.1016/j.resp.2007.02.017. PMID   17434347. S2CID   4847389.
  8. ↑ Woorons, X.; Bourdillon, N.; Lamberto, C.; Vandewalle, H.; Richalet, J.-P.; Mollard, P.; Pichon, A. (2011). "Cardiovascular Responses During Hypoventilation at Exercise". International Journal of Sports Medicine. 32 (6): 438–45. doi:10.1055/s-0031-1271788. PMID   21563023.
  9. ↑ Woorons, Xavier; Mollard, Pascal; Pichon, Aurélien; Duvallet, Alain; Richalet, Jean-Paul; Lamberto, Christine (2008). "Effects of a 4-week training with voluntary hypoventilation carried out at low pulmonary volumes". Respiratory Physiology & Neurobiology. 160 (2): 123–30. doi:10.1016/j.resp.2007.09.010. PMID   18160351. S2CID   24080708.
  10. ↑ "HV: l'altitude à p'tit prix!". 2010.
  11. ↑ Lavin, K. M.; Guenette, J. A.; Smoliga, J. M.; Zavorsky, G. S. (2013). "Controlled-frequency breath swimming improves swimming performance and running economy". Scandinavian Journal of Medicine & Science in Sports. 25 (1): 16–24. doi:10.1111/sms.12140. PMID   24151982. S2CID   44657818.
  12. ↑ Kapus, Jernej; Ušaj, Anton; Kapus, Venceslav; Štrumbelj, Boro (2005). "The influence of training with reduced breathing frequency in front crawl swimming during a maximal 200 metres front crawl performance". Kinesiologia Slovenica. 11 (2): 17–24. Archived from the original on 2 February 2014. Retrieved 29 January 2014.
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