Brief Report
No access
Published Online: 1 September 2016

Sleep Disordered Breathing During Live High-Train Low in Normobaric Versus Hypobaric Hypoxia

Publication: High Altitude Medicine & Biology
Volume 17, Issue Number 3


Saugy, Jonas J., Laurent Schmitt, Sibylle Fallet, Raphael Faiss, Jean-Marc Vesin, Mattia Bertschi, Raphaël Heinzer, and Grégoire P. Millet. Sleep disordered breathing during live high-train low in normobaric versus hypobaric hypoxia. High Alt Med Biol. 17:233–238, 2016.—The present study aimed to compare sleep disordered breathing during live high-train low (LHTL) altitude camp using normobaric hypoxia (NH) and hypobaric hypoxia (HH). Sixteen highly trained triathletes completed two 18-day LHTL camps in a crossover designed study. They trained at 1100–1200 m while they slept either in NH at a simulated altitude of 2250 m or in HH. Breathing frequency and oxygen saturation (SpO2) were recorded continuously during all nights and oxygen desaturation index (ODI 3%) calculated. Breathing frequency was lower for NH than HH during the camps (14.6 ± 3.1 breath × min−1 vs. 17.2 ± 3.4 breath × min−1, p < 0.001). SpO2 was lower for HH than NH (90.8 ± 0.3 vs. 91.9 ± 0.2, p < 0.001) and ODI 3% was higher for HH than NH (15.1 ± 3.5 vs. 9.9 ± 1.6, p < 0.001). Sleep in moderate HH is more altered than in NH during a LHTL camp.

Get full access to this article

View all available purchase options and get full access to this article.


Bano M, Chiaromanni F, Corrias M, Turco M, De Rui M, Amodio P, Merkel C, Gatta A, Mazzotta G, Costa R, and Montagnese S. (2014). The influence of environmental factors on sleep quality in hospitalized medical patients. Front Neurol 5:267.
Chapman RF. (2013). The individual response to training and competition at altitude. Br J Sports Med 47 Suppl 1:i40–i44.
Conkin J. (2016). Equivalent air altitude and the Alveolar Gas Equation. Aerosp Med Hum Perform 87:61–64.
Conkin J, and Wessel JH III. (2008). Critique of the equivalent air altitude model. Aviat Space Environ Med 79:975–982.
Cook CJ, Crewther BT, Kilduff LP, Drawer S, and Gaviglio CM. (2011). Skill execution and sleep deprivation: Effects of acute caffeine or creatine supplementation—A randomized placebo-controlled trial. J Int Soc Sports Nutr 8:2.
Coppel J, Hennis P, Gilbert-Kawai E, and Grocott MP. (2015). The physiological effects of hypobaric hypoxia versus normobaric hypoxia: A systematic review of crossover trials. Extrem Physiol Med 4:2.
Davenne D. (2008). Sleep of athletes—Problems and possible solutions. Biol Rhythm Res 40:45–52.
Debevec T, Pialoux V, Saugy J, Schmitt L, Cejuela R, Mury P, Ehrstrom S, Faiss R, and Millet GP. (2015). Prooxidant/antioxidant balance in hypoxia: A cross-over study on normobaric vs. hypobaric “Live High-Train Low”. PLoS One 10:e0137957.
Dempsey JA, and Morgan BJ. (2015). Humans in hypoxia: A conspiracy of maladaptation?! Physiology (Bethesda) 30:304–316.
DiPasquale DM, Strangman GE, Harris NS, and Muza SR. (2015). Hypoxia, hypobaria, and exercise duration affect acute mountain sickness. Aerosp Med Hum Perform 86:614–619.
Faiss R, Pialoux V, Sartori C, Faes C, Deriaz O, and Millet GP. (2013). Ventilation, oxidative stress, and nitric oxide in hypobaric versus normobaric hypoxia. Med Sci Sports Exerc 45:253–260.
Fulco CS, Beidleman BA, and Muza SR. (2013). Effectiveness of preacclimatization strategies for high-altitude exposure. Exerc Sport Sci Rev 41:55–63.
Fulco CS, Muza SR, Beidleman BA, Demes R, Staab JE, Jones JE, and Cymerman A. (2011). Effect of repeated normobaric hypoxia exposures during sleep on acute mountain sickness, exercise performance, and sleep during exposure to terrestrial altitude. Am J Physiol Regul Integr Comp Physiol 300:R428–R436.
Halson S. (2008). Nutrition, sleep and recovery. Eur J Sport Sci 8:119–126.
Hang LW, Wang HL, Chen JH, Hsu JC, Lin HH, Chung WS, and Chen YF. (2015). Validation of overnight oximetry to diagnose patients with moderate to severe obstructive sleep apnea. BMC Pulm Med 15:24.
Heinzer R, Saugy JJ, Rupp T, Tobback N, Faiss R, Bourdillon N, Haba Rubio J, and Millet GP. (2016). Comparison of sleep disorders between real and simulated 3450-m altitude. Sleep May 3. pii:. [Epub ahead of print].
Hoshikawa M, Suzuki Y, and Oriishi M. (2013). Effects of normobaric hypoxia equivalent to 2,000-m altitude on sleep and physiological conditions of athletes: A study using sheet-type sensor. J Strength Cond Res 27:2309–2313.
Kinsman TA, Hahn AG, Gore CJ, Martin DT, and Chow CM. (2003). Sleep quality responses to atmospheric variation: case studies of two elite female cyclists. J Sci Med Sport 6:436–442.
Latshang TD, Lo Cascio CM, Stowhas AC, Grimm M, Stadelmann K, Tesler N, Achermann P, Huber R, Kohler M, and Bloch KE. (2013). Are nocturnal breathing, sleep, and cognitive performance impaired at moderate altitude (1,630–2,590 m)? Sleep 36:1969–1976.
Lavie L. (2003). Obstructive sleep apnoea syndrome—An oxidative stress disorder. Sleep Med Rev 7:35–51.
Lavie L. (2008). Intermittent hypoxia: The culprit of oxidative stress, vascular inflammation and dyslipidemia in obstructive sleep apnea. Expert Rev Respir Med 2:75–84.
Levine BD, and Stray-Gundersen J. (1997). “Living high-training low”: Effect of moderate-altitude acclimatization with low-altitude training on performance. J Appl Physiol (1985) 83:102–112.
Loeppky JA, Roach RC, Maes D, Hinghofer-Szalkay H, Roessler A, Gates L, Fletcher ER, and Icenogle MV. (2005). Role of hypobaria in fluid balance response to hypoxia. High Alt Med Biol 6:60–71.
Luks AM, McIntosh SE, Grissom CK, Auerbach PS, Rodway GW, Schoene RB, Zafren K, Hackett PH, and Wilderness Medical Society. (2010). Wilderness Medical Society consensus guidelines for the prevention and treatment of acute altitude illness. Wilderness Environ Med 21:146–155.
Millet GP, Faiss R, and Pialoux V. (2012). Point: Hypobaric hypoxia induces different physiological responses from normobaric hypoxia. J Appl Physiol (1985) 112:1783–1784.
Muza SR. (2007). Military applications of hypoxic training for high-altitude operations. Med Sci Sports Exerc 39:1625–1631.
Nespoulet H, Wuyam B, Tamisier R, Saunier C, Monneret D, Remy J, Chabre O, Pepin JL, and Levy P. (2012). Altitude illness is related to low hypoxic chemoresponse and low oxygenation during sleep. Eur Respir J 40:673–680.
Oliver SJ, Costa RJ, Laing SJ, Bilzon JL, and Walsh NP. (2009). One night of sleep deprivation decreases treadmill endurance performance. Eur J Appl Physiol 107:155–161.
Ribon A, Pialoux V, Saugy JJ, Rupp T, Faiss R, Debevec T, and Millet GP. (2016). Exposure to hypobaric hypoxia results in higher oxidative stress compared to normobaric hypoxia. Respir Physiol Neurobiol 223:23–27.
Richard NA, and Koehle MS. (2012). Differences in cardio-ventilatory responses to hypobaric and normobaric hypoxia: A review. Aviat Space Environ Med 83:677–684.
Roach GD, Schmidt WF, Aughey RJ, Bourdon PC, Soria R, Claros JC, Garvican-Lewis LA, Buchheit M, Simpson BM, Hammond K, Kley M, Wachsmuth N, Gore CJ, and Sargent C. (2013). The sleep of elite athletes at sea level and high altitude: A comparison of sea-level natives and high-altitude natives (ISA3600). Br J Sports Med 47 Suppl 1:i114–i120.
Sargent C, Schmidt WF, Aughey RJ, Bourdon PC, Soria R, Claros JC, Garvican-Lewis LA, Buchheit M, Simpson BM, Hammond K, Kely M, Wachsmuth N, Gore CJ, and Roach GD. (2013). The impact of altitude on the sleep of young elite soccer players (ISA3600). Br J Sports Med 47 Suppl 1:i86–i92.
Saugy JJ, Rupp T, Faiss R, Lamon A, Bourdillon N, and Millet GP. (2015). Cycling time trial is more altered in hypobaric than normobaric hypoxia. Med Sci Sports Exerc 48:680–688.
Saugy JJ, Schmitt L, Cejuela R, Faiss R, Hauser A, Wehrlin JP, Rudaz B, Delessert A, Robinson N, and Millet GP. (2014). Comparison of “Live High-Train Low” in normobaric versus hypobaric hypoxia. PLoS One 9:e114418.
Saugy JJ, Schmitt L, Hauser A, Constantin G, Cejuela R, Faiss R, Wehrlin JP, Rosset J, Robinson N, and Millet GP. (2016). Same performance changes after Live High-Train Low in normobaric versus hypobaric hypoxia. Front Physiol 7:138.
Savourey G, Launay JC, Besnard Y, Guinet A, and Travers S. (2003). Normo- and hypobaric hypoxia: are there any physiological differences? Eur J Appl Physiol 89:122–126.
Schommer K, Menold E, Subudhi AW, and Bartsch P. (2012). Health risk for athletes at moderate altitude and normobaric hypoxia. Br J Sports Med 46:828–832.
Young A, and Reeves J. (2002). Human adaptations to high terrestrial altitude. In Medical Aspects of Harsh Envrionments. Lounsbury DE, Bellamy RF, and Zajtchuk R, eds. Office of the Surgeon General, Borden Institute, Washinghton DC. pp. 647–691.

Information & Authors


Published In

cover image High Altitude Medicine & Biology
High Altitude Medicine & Biology
Volume 17Issue Number 3September 2016
Pages: 233 - 238
PubMed: 27410774


Published in print: September 2016
Published online: 1 September 2016
Published ahead of print: 13 July 2016
Accepted: 12 May 2016
Received: 24 April 2016


Request permissions for this article.




Jonas J. Saugy
Faculty of Biology and Medicine, ISSUL, Institute of Sport Sciences, University of Lausanne, Switzerland.
Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Switzerland.
Laurent Schmitt
National School of Mountain Sports/National Ski-Nordic Centre, Prémanon, France.
Sibylle Fallet
Institute of Electrical Engineering, Swiss Federal Institute of Technology, Lausanne, Switzerland.
Raphael Faiss
Faculty of Biology and Medicine, ISSUL, Institute of Sport Sciences, University of Lausanne, Switzerland.
Jean-Marc Vesin
Institute of Electrical Engineering, Swiss Federal Institute of Technology, Lausanne, Switzerland.
Mattia Bertschi
Swiss Center for Electronics and Microtechnology, CSEM, Neuchâtel, Switzerland.
Raphaël Heinzer
Center for Investigation and Research in Sleep, CHUV, Lausanne, Switzerland.
Grégoire P. Millet
Faculty of Biology and Medicine, ISSUL, Institute of Sport Sciences, University of Lausanne, Switzerland.
Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Switzerland.


Address correspondence to:Grégoire P. Millet, PhDFaculty of Biology and MedicineISSUL, Institute of Sport SciencesUniversity of LausanneGeopolis, Quartier MoulineLausanne 1015Switzerland
E-mail: [email protected]

Author Disclosure Statement

No competing financial interests exist.

Metrics & Citations



Export citation

Select the format you want to export the citations of this publication.

View Options

Get Access

Access content

To read the fulltext, please use one of the options below to sign in or purchase access.

Society Access

If you are a member of a society that has access to this content please log in via your society website and then return to this publication.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options


View PDF/ePub

Full Text

View Full Text







Copy the content Link

Share on social media

Back to Top