Oct 15, 2024
Key summary (TL;DR)
What is it? A passive, aerobic therapy that uses controlled oxygen levels to train your cells and improve metabolic health.
How does it work? It boosts mitochondrial health by mimicking high-altitude (hypoxia) to stress your cells, followed by high oxygen (hyperoxia) to accelerate recovery. This stimulates the cells to remove damaged mitochondria and promotes the growth of healthy, energy-producing ones.
What are the Health Benefits:
Improves energy production (mitochondrial health)
Enhance recovery and overall well-being
Supports healthy-aging and longevity
Improve cardiovascular fitness and VO₂ max
Improves cognitive function
Who is it for? Suitable for (almost) anyone—athletes, older adults, and those with chronic conditions or fatigue.
Session details: You sit back and relax while breathing through a mask. It is completely painless, and your SpO2 levels are monitored as a safety precaution.
How many sessions do I do? requires 5-10 sessions for results, followed by optional ongoing maintenance sessions.
What is IHHT (Hypoxia Recovery)?
Our 'Hypoxia Recovery' is known by many names, most commonly IHHT ('Intermittent Hypoxia Hyperoxia Therapy' or 'Interval Hypoxia Hyperoxia Training'), but also: Intermittent Hypoxia Exposure (IHE), Altitude Training, and others. For the rest of this article we will refer to it as 'IHHT'.
It starts in the area of energy metabolism and is therefore a kind of cell training or oxygen therapy. Central to the science of IHHT are the different oxygen concentrations that are inhaled during the procedure.
Core to, IHHT is the simulation of being at high altitude. There, the air is, as they say, 'thinner.' Thanks to the lower air pressure, you're not able to take in as much oxygen. So the higher you go up a mountain, the harder it is to breathe (and therefore also move!) The resulting lack of oxygen is called hypoxia...
Hypoxia and Hyperoxia
Hypoxia is, by definition, a lack of oxygen in the body and tissues, which leads to various adaptation mechanisms that can have a positive effect on energy supply. However, you don't have to go to the mountains to induce hypoxia. By breathing in air with a low level of oxygen through a mask, we can effectively simulate being at altitude (and deliver controlled Hypoxia).
With IHHT, the effect is greater than just going skiing at Zermatt (although, admittedly less fun), by alternating between Hypoxia and Hyperoxia—air with levels of oxygen higher than normal air, we can promote a faster recovery after Hypoxia¹,².
IHHT protocol, duration and costs
Protocol
During an IHHT session, you will sit or lie down and relax, while breathing through a mask that delivers the air with differing oxygen levels. The normal level of oxygen in the air is 20.95% ('Normoxic'). Hypoxic air has 9–18% O₂ and Hyperoxic air, 30–40% O₂. The process is completely painless.
While you relax and breathe through the oxygen mask, your blood oxygen levels (SpO2) is measured to ensure the level of oxygen is never too low that it could be dangerous.
Under normal conditions, your SpO2 is about 98%. During Hypoxia, we aim for an SpO2 below 90% (and as low as 75% depending on physical condition). During the following Hyperoxia, the phase with high oxygen levels, we aim for values above the usual, so 98-100%.
Duration
Generally a Hypoxia phase of 5 to 7 minutes is always followed by a shorter Hyperoxia phase of 2 to 4 minutes. The cycle of Hypoxia-Hyperoxia is repeated 3 to 5 times in total. Your exact programme will be created for you after an initial assessment.
We recommend a minimum of 5 (but ideally 10) sessions to feel the benefits. These should be taken with 1-3 days break in between, because this is stress on your body, which it needs to recover from. After having 5-10 sessions we recommend to continue with 'maintenance' sessions, every 1-2 weeks, but this is optional, you can speak to staff for other options and recommendations.
Costs
The cost of IHHT therapy can vary significantly. Costs in Zurich typically range from 100-120CHF / session. Thanks to the potential benefits for all people, our goal is to make IHHT therapy more accessible.
What are the benefits of IHHT at a biological level?
IHHT can lead to various physical adaptations in the longer term. Depending on the mechanism, this can take a few hours, days or even week³.
Regeneration of Mitochondria
The focus of IHHT is mitochondrial health. In simple terms, the mitochondria are responsible for generating the energy in your cells that are critical for all life.
Mitochondria replicate by direct-division (i.e. one becomes two)⁴. When the mitochondria become damaged, they become dysfunctional, and no longer function properly. When these dysfunctional mitochondria replicate, they create more dysfunctional mitochondria limiting your supply of energy⁵.
How do Mitochondria get damaged? Mitochondria can become damaged simply due to aging, but also made worse by various lifestyle factors such as: lack of sleep, poor diet, excess stress, lack of exercise, environmental toxins, medications and illness.
IHHT's impact on mitochondria and energy
The exposure of mitochondria to stress, from IHHT kills the dysfunctional mitochondria, and at the same time promotes the generation of new young, healthy mitochondria ¹,⁶,⁷,⁸
Further adaption mechanisms
Hypoxia, triggers a number of other mechanisms in the body through the regulatory protein HIF (hypoxia-induced factor)³. In order to maintain oxygen balance, HIF triggers changes to increase oxygen uptake. This happens by, first, making more oxygen available by producing more red blood cells that carry oxygen to cells, and creating new blood vessels through which the blood can flow with oxygen.
Second, HIF reduces oxygen consumption by switching from oxidative metabolism to other ways of producing energy that do not require oxygen.
Other potential benefits of IHHT may include improvement in the fitness of your cardiovascular system, LDL cholesterol, body fat percentage, cognitive abilities, and your subjective well-being¹,⁵,⁷,⁹.
Who can use IHHT?
Thanks to the adaptability of IHHT, it can be given to almost anyone², whether young or old, healthy or exhausted.
Since IHHT is not a sport (i.e. no movement and no sweating), the training can also be a therapeutic approach for various diseases and indications. Examples are burn out, anxiety, permanent fatigue and lack of energy, chronic diseases and lipometabolic disorders.
Of course, IHHT can, and is, also used to enhance performance in sports¹⁰ as well as in older age, to improve cognitive performance⁵,⁶.
Link to Nobel prize awarded for 'their discoveries of how cells sense and adapt to oxygen availability', the science which is behind Hypoxia Recovery.
Bibliography
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2 Glazachev, O. S. (2013). Optimization of Clinical Application of Interval Hypoxic Training. Biomedical Engineering, 47(3), 134–137. https://doi.org/10.1007/s10527-013-9352-7
3 Prabhakar, N. R., & Semenza, G. L. (2015). Oxygen Sensing and Homeostasis. Physiology, 30(5), 340–348. https://doi.org/10.1152/physiol.00022.2015
4 Meyer, J. N., Leuthner, T. C., & Luz, A. L. (2017). Mitochondrial fusion, fission, and mitochondrial toxicity. Toxicology, 391, 42–53. https://doi.org/10.1016/j.tox.2017.07.019
5 Han, R., Liang, J., & Zhou, B. (2021). Glucose Metabolic Dysfunction in Neurodegenerative Diseases—New Mechanistic Insights and the Potential of Hypoxia as a Prospective Therapy Targeting Metabolic Reprogramming. International Journal of Molecular Sciences, 22(11), 5887. https://doi.org/10.3390/ijms22115887
6 Bayer, U., Likar, R., Pinter, G., Stettner, H., Demschar, S., Trummer, B., Neuwersch, S., Glazachev, O., & Burtscher, M. (2017). Intermittent hypoxic-hyperoxic training on cognitive performance in geriatric patients. Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 3(1), 114–122. https://doi.org/10.1016/j.trci.2017.01.002
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8 Voronina, T., Grechko, N., Shikhlyarova, A., & Bobkova, N. (2017). Intermittent hypoxic training as an effective method of activation therapy. Cardiometry, 10, 93–99. https://doi.org/10.12710/cardiometry.2017.9399
9 Glazachev, O., Kopylov, P., Susta, D., Dudnik, E., & Zagaynaya, E. (2017). Adaptations following an intermittent hypoxia-hyperoxia training in coronary artery disease patients: A controlled study: Cardiopulmonary and metabolic adaptations after intermittent hypoxia-hyperoxia training. Clinical Cardiology, 40(6), 370–376. https://doi.org/10.1002/clc.22670
10 Susta, D., Dudnik, E., & Glazachev, O. S. (2017). A programme based on repeated hypoxia–hyperoxia exposure and light exercise enhances performance in athletes with overtraining syndrome: A pilot study. Clinical Physiology and Functional Imaging, 37(3), 276–281. https://doi.org/10.1111/cpf.12296