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Intermittent not continuous hypoxia provoked haematological adaptations in healthy seniors: hypoxic pattern may hold the key



The purpose of this single-blind, repeated measures study was to investigate the effect of two hypoxic patterns, continuous or intermittent on key markers of haematological adaptation, stress and cardiac damage in healthy senior participants.


Fifteen healthy senior participants each followed a three-phase protocol over 3 consecutive weeks: (1) 5 consecutive days of breathing room air without a mask (2) 5 days of normoxic mask breathing (sham, FiO2 = 21%) (3) 5 days of intermittent hypoxia (IH) tailored to achieve a mean peripheral oxygen saturation (SpO2) of 85% during ~ 70 min of cumulative exposure to hypoxia. After a 5-month washout period, participants were recalled to undertake continuous hypoxia (CH, SpO2 = 85%, ~ 70 min). The red blood cell count (RBCc), haemoglobin concentration ([Hb]), haematocrit (Hct), percentage of reticulocytes (% Retics), secretory immunoglobulin A (S-IgA), cortisol, cardiac troponin T (cTnT) and the OFF-score (i.e. \(\left[\mathrm{H}\mathrm{b}\right]\bullet 10-60\bullet \sqrt{\% \mathrm{R}\mathrm{e}\mathrm{t}\mathrm{i}\mathrm{c}\mathrm{s}}\)) were measured.


RBCc only increased by day 5 of IH treatment compared to day 5 baseline values (+ 7.7%, p < 0.01) and day 5 Sham values (+ 12.9%, p < 0.01). [Hb] only increased by day 5 of IH treatment compared to day 5 baseline values (+ 14.7%, p < 0.01) and day 5 Sham values (+ 14.3%, p < 0.01). Hct (+ 12.7%, p < 0.01) and the OFF-score (p < 0.05) increased only during the final day of IH treatment. No difference was observed in S-IgA, cortisol or cTnT following IH or CH.


These results revealed that inherent differences in the IH and CH hypoxic patterns could provide crucial components required to trigger hematological changes in senior individuals, without eliciting immunological stress responses or damaging the myocardium.

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Continuous hypoxia


Cardiac troponin T



FiO2 :

Fraction of inspired oxygen




Haemoglobin concentration


Hypoxia-inducible factors


Intermittent hypoxia

PiO2 :

Inspired oxygen partial pressure

RBCc :

Red blood cell count

% Retics:

Percentage of reticulocytes


Secretory immunoglobulin A

SpO2 :

Peripheral oxygen saturation


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The authors would like to thank Biomedtech Australia Pty. Ltd., the Heart Foundation Research Centre Griffith University, and the Griffith Health Institute for generously supporting this independent investigation. We greatly appreciated the opportunity to borrow hypoxicators from Oleg Bassovitch, Biomedtech (GO2Altitude®). We are grateful to the participants for their enthusiastic involvement in this study, to Taryn Mann for quantifying troponin T to Dr. Clare Minahan and Dr. Mike Steele for statistical advice as well as to Dr. Glenn Harrison for insightful comments on drafts of this manuscript.

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Correspondence to Gillian M. C. Renshaw.

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The authors declare that there was no conflict of interest and that the results of the present study do not constitute endorsement of any specific equipment for hypoxia delivery.

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Communicated by Susan Hopkins.

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Tobin, B., Costalat, G. & Renshaw, G.M.C. Intermittent not continuous hypoxia provoked haematological adaptations in healthy seniors: hypoxic pattern may hold the key. Eur J Appl Physiol 120, 707–718 (2020).

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  • Hypoxic pattern
  • Continuous hypoxia
  • Intermittent hypoxia
  • Haematology
  • Cardiac troponin T
  • S-IgA
  • Cortisol
  • Human
  • Seniors