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About the method

Normobaric hypoxic training is based on breathing air with a reduced oxygen content at sea level atmospheric pressure, while the person is comfortable. The healing properties of the altitude air in the mountains have been well known for many centuries. The beneficial effect is explained by the reduced oxygen content in the mountain air, i.e. moderate hypoxia, however, staying in the mountains is not always available and may cause excessive stress in some people.
Scientific studies of the last decades have clarified the molecular – biological mechanisms of the effect of hypoxia on the body and laid the foundations for its therapeutic use. With a reduced oxygen content in the inhaled air, the body oxygen delivery system is activated, the level of hemoglobin in the blood increases, its binding and transport capacity increases, oxygen metabolism in cells improves, and the number of capillaries per unit volume of tissue increases. Hypoxic training affects the activity of about 500 genes that control metabolism and the body’s adaptation to the environment.

In 2019, the Nobel Prize in Medicine and Physiology was awarded to Greg Semense et al. for the “Research on molecular switches that act in cells under hypoxic conditions.” Semenza discovered these signaling molecules (hypoxia-induced factors: HiF-1alpha) in 1995. However, the practical application of controlled normobaric hypoxia for prevention and treatment in humans began in the 1970s in the USSR thanks to the pioneering research of R.B. Strelkov and A.Ya. Chizhov.
Intermittent hypoxia and constant hypoxia, what is their difference
A very low level of oxygen in the uterus is necessary for the normal development of embryos in all vertebrates, and of course mammals, including humans. This is explained by the biological evolution, during which the oxygen level in the Earth’s atmosphere slowly, over hundreds of millions of years, increased from very low, extremely hypoxic values, of the order of 1%, to the current normoxic level of 21% O2.
A low level of oxygen in the uterus is needed in the embryonic period for the full formation and development of tissues and organs. Its increase occurs gradually, as the physiological systems of the fetus mature. With the approach of the end of pregnancy, the level of oxygen in the tissues of the fetus approaches 10%, which is only half of its content in the atmospheric air. At the same time, throughout the entire period of pregnancy, regular impulse fluctuations in the oxygen content in the uterus and fetal tissues have been observed and measured. It was found that it is precisely the fluctuations in the oxygen content that are the mechanism guiding the development and maturation of the cellular, tissue and organ systems of the fetus. In an adult organism, these fluctuations are either low, or practically absent. But they can be recreated at the cellular level by means of physical activity, or systemically, by breathing hypoxic air.
Applying precisely controlled periods of respiratory hypoxia, it is possible to stimulate and support the development and self-repair of the body’s cellular structures at any age, just as it happens in embryogenesis. Dosed hypoxic training, controlled alternation of hypoxic, normoxic and hyperoxic intervals helps the body’s adaptation to environmental conditions, which often become extreme. Interval hypoxic training is proven to be a universal means of creating and maintaining a high degree of adaptation of the body to a variety of extreme environmental factors, such as excessive physical exertion, lack of food and oxygen deficiency, temperature fluctuations, increased radiation, etc. An organism trained, prepared by repetitive hypoxic episodes, has a better chance of avoiding diseases, infections and ultimately, leaving more healthy offspring than an untrained one.
The duration of hypoxic intervals plays a very important role. The ideal combination of the duration of hypoxic and normoxic intervals (in the range from 1 to 10 minutes for each) creates a supercompensation effect. At the same time, in the hypoxic phase, the cells maximally activate the mechanisms of energy production, and in the normoxic phase, they restore their resources to values ​​that exceed the initial ones. The action of physical training is based on the same principle, allowing building up muscle strength, increase in the speed and duration of running and swimming.
But too long hypoxic breathing intervals (hours, days, weeks) do not allow the body to compensate for the hypoxic stress, therefore, a long stay in the highlands leads to a pathologic weight loss, decreased immunity, poor health, accelerated aging and reduced life expectancy.
As a result of fundamental scientific research conducted since the middle of the 20th century, it was found that normobaric interval hypoxic training by intermittent hypoxic-normoxic or hyperoxic breathing at sea level is significantly more effective and much more convenient than prolonged stay in the mountains or imitation of this in hypobaric chambers. This was confirmed by numerous clinical trials conducted in the 1980s-2000s.
The method of normobaric interval hypoxic therapy was born in the 1970s in the USSR. It was created by an intensive care physician, prof. A.Ya. Chizhov and radiologist prof. A.R. Strelkov and was originally developed, patented and successfully applied to increase the effectiveness of anticancer treatment – radiotherapy. Currently, the method is successfully used in many clinics in Europe, Russia, Ukraine, America, Australia, China and Japan.

There are various uses for this method. So, for therapeutic purposes, individualized protocols of interval hypoxic therapy are used in clinics, sanatoriums and other medical institutions. When used for prophylaxis, as well as for training athletes, it is often referred to as interval hypoxic training. The method is well known exactly where excellent health, high efficiency and reliability are required: among top managers, military men, pilots, cosmonauts and saturation divers.
For the technical support of the method, modern devices were created – hypoxicators.
Interval normobaric hypoxic training is one of the most effective methods used in modern medical practice for the prevention and treatment of a number of diseases of the cardiovascular, respiratory, endocrine and immune systems, as well as for increasing physical endurance and adaptive capabilities of the body.

According to numerous studies, as a result of hypoxic training, there is an improvement in general well-being, a decrease in fatigue, an increase in productivity and performance, and a pronounced anti-stress effect is observed. Patients note an increase in vitality, in memory and the speed of thought processes improvement. There is an increase in the body’s resistance to unfavorable environmental factors, normalization of the immune system, optimization of blood circulation and tissue nutrition, improvement of tracheobronchial patency and ultimately, prevention of premature aging. Such a reaction of the human body to the effects of interval hypoxia is programmed at the genetic level, since exactly these mechanisms operate during the intrauterine development of the fetus.

A controlled hypoxic stimulation of cells leads to the gradual development of hypoxic adaptation, in other words, the hypoxic preconditioning.
Hypoxic preconditioning is a general physiological feature of vertebrates, including mammals. In response to a decrease in oxygen supply to tissues, the organism gradually adapts to new conditions, compensating for disturbances at all levels. Following the complete restoration of the impaired function, the so-called over-recovery, or supercompensation occurs, and with each subsequent exposure to this factor, the body’s resistance to hypoxia increases.

For example, in older people with long-term coronary heart disease, hypoxic preconditioning of the myocardium develops over time, in which the number of collateral (bypass) vessels in the myocardium increases, and therefore, unlike heart attacks in young people, in older people they are smaller in volume and leave less severe consequences. It has been established that hypoxytraining is able to prevent myocardial infarction, and, if it occurs, to accelerate recovery.
Hypoxic training has been successfully used to treat the following diseases:
Coronary artery disease
Arterial hypertension
Respiratory diseases
Chronic inflammatory diseases of various etiology and localization
Neuroses, neurosis-like, asthenic and depressive states, epilepsy
Periodontal disease
Premature aging
Secondary immunodeficiency states
Bronchial asthma

But there are some contraindications:
Acute infectious diseases
Stage of acute exacerbation of a chronic inflammatory processes
Fever-associated illnesses
Acute somatic diseases:
Myocardial infarction, acute cerebrovascular accident, exacerbation of blood pressure, pneumothorax, acute asthma attack, etc.
Chronic diseases at the stage of decompensation (chronic renal failure requiring hemodialysis, anasarca, etc.); hypertension stage III with high blood pressure; angina pectoris and COPD, etc .;
Congenital anomalies of the heart and large vessels
Individual intolerance to oxygen deficiency

Physiological Effects of Hypoxic Training
As a result of hypoxic training, the following effects occure:
An increase in the surface of ​​the alveoli, on which gas exchange occurs in the lungs
An increase in the oxygen – carrying capacity of the blood
Increase in the number of capillaries per unit volume in the heart, brain, muscles, lungs and liver
Oxygen utilization efficiency improvement: increasing the ability of tissues to extract and use oxygen from the blood at its reduced concentrations
Increase in the activity of enzymes involved in the synthesis of ATP
Increase in the activity of enzymes involved in the hormonal synthesis
Increasing the number and improving the quality of the energy stations of cells (mitochondria)
Increased activity of enzymes of oxidative phosphorylation
Strengthening immunity against a variety of infections
Increasing the general adaptive capabilities of the body

Hypoxic training in sports and for better health
It’s no secret that nearly all elite athletes use hypoxic training to improve their performance.

But how can you personally benefit from hypoxic training?

Everyone knows that physical exercise is not only useful, but also essential for health maintenance of people at any age, without exception. However, exercising intensity, quantity, and frequency must be strictly individualised. Besides, many of us simply do not have enough time for this. Especially today, during pandemic when many people stay in forced self-isolation, some simply do not have any experience of physical training. What to do in this case, is there any shortcuts possible, is there a full-fledged replacement for physical exercise?
Let’s take a close look at what happens in the body (in the muscles, in the heart, in the brain) during exercise, what exactly makes it so beneficial for our health?

During physical exertion, muscle cells consume oxygen and produce many cytokines – intercellular signaling molecules that enter the bloodstream and, at the end of the exercise, stimulate recovery not only in working muscles, but also in all distant organs, tissues and cells, such as neurons and liver cells, myocardium and immune organs, joints, ligaments and bones, etc.
The most important physiological mechanism that stimulates the release of cytokines and determines the benefits of exercise is short-term interruption of blood flow, because strong cyclical tension and muscle contraction periodically block blood flow and lead to intermittent ischemia, in other words, to intermittent hypoxia (intermittent oxygen deficiency). At the same time, hypoxia compensation mechanisms are gradually activated in cells, such as the accumulation of the oxygen-binding protein myoglobin and cellular “fuel” – glycogen.

Okay, so let’s try to create intermittent hypoxia throughout the body, but without strenuous exercise. This can be done by supplying low-oxygen air for breathing, alternating with oxygen-enriched air. For this purpose, special apparatuses, computer-controlled hypoxicators devices have been created, supplying alternately hypoxic and hyperoxic air to the breathing mask in accordance with an individual program controlled by feedback from the changing physiological parameters of the user.

This technology is called intermittent normobaric hypoxic-hyperoxic training (IHHT), or in short – hypoxic training. The method exists since the early 1970s and in various modifications is widely used today in clinical practice, high-performance sports and for training special contingents. The IHHT is well known where the robust health, high efficiency and reliability of the body is required: among top managers, military men, pilots, astronauts and deep divers. According to numerous scientific studies, IHHT significantly increases the effectiveness of physical training, and in many cases it can even serve as a full-fledged replacement for them. Molecular – biological mechanisms of hypoxic therapy, biochemical ways of adaptation to hypoxia have been well studied over the past decades.

It is very important that hypoxytherapy is a unique method that improves the quality of mitochondria in all cells. Today it is known that it is the high quality of mitochondria that is the basis of lasting health at any age. Mitochondrial health is a prerequisite for the prevention, treatment and rehabilitation of almost all chronic diseases, as well as for slowing the rate of aging.

Finally, since hypoxic training sessions are most effective in a completely relaxing state, this technology brings to life the age-old dream of all lazy people: to get all the benefits of physical training without getting off the couch!


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