Effects of Intermittent Hypoxia Protocols on Physical Performance in Trained and Untrained Individuals: An Umbrella Review of Systematic Reviews and Meta-Analyses
Abstract
Background: Intermittent hypoxia (IH) has emerged as a promising strategy to enhance physical performance by eliciting adaptive responses across cardiovascular, respiratory, and muscular systems. Various IH protocols have been applied in both trained and untrained individuals to improve aerobic capacity, strength, and repeated sprint ability. However, the growing number of systematic reviews and meta-analyses (SRs/MAs) has led to heterogeneous conclusions due to variability in populations, protocols, and outcome measures. This umbrella review aimed to synthesize and critically appraise the available SRs/MAs on the effects of IH protocols on physical performance across different fitness levels.
Methods: A systematic search, aligned with the PRIOR (Preferred Reporting Items for Overviews of Reviews) guidelines, was conducted across seven electronic databases (PubMed/MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, Scopus, Embase, PsycINFO, and SciELO) from inception to June 2025. Eligible studies included systematic reviews (SRs) with or without meta-analyses (MAs) or network meta-analyses (NMAs) evaluating the effects of intermittent hypoxia protocols on physical performance. Methodological quality was assessed using the AMSTAR-2 tool.
Results: A total of 22 systematic reviews (14 with meta-analyses, 3 with network meta-analyses) analyzing 487 primary studies and 5,333 participants were included. Intermittent hypoxia (IH) protocols improved both aerobic and…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 5,333 participants or records.
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