Does breath-hold training help runners?
- Training
Thomas Solomon, PhD.
March 31, 2020Updated on
In my recent 3-part series on cold exposure (here, here, and here), I touched on the dive response and breath-holding. A couple of weeks ago, Alex Hutchinson released an article describing how sea divers and people who have used breath-hold methods fared well on long-duration, multi-day, slow-moving, very high-altitude ascents — they seemingly acclimated rapidly to the high-altitude exposure.
At that time, I wanted to follow up on his article because this summer some of my athletes were to be heading to various parts of Europe to compete in long-distance trail races and obstacle course races (OCR) at moderate to high altitudes. Consequently, a few people asked me, “Should I start breath-hold training?”.
Unfortunately, in the face of the COVID-19-induced interruption, as well as the postponement of all races, this issue was not at the top of my agenda. Alas, finally, here are my thoughts…
Let’s dive in...
What Is Breath-Hold Training?
Breath-holding, medically known as apnea, has been vastly studied in humans and comparatively with other species. Marine mammals have phenomenal capacities for breath-holding underwater. Fun-loving dolphins can dive underwater and be active for up to 10 minutes, while sperm whales can dive for over an hour! Yes, elite apneists have been documented to hold their breath on land at rest for over 11 minutes, but, on average, we humans, even of the Phelps variety, are a little deficient underwater.
Why Runners Are Interested in the Dive Response
The reason breath-hold training might be of interest to endurance athletes is that apnea (e.g., 3-5 maximal breath holds with 2-min intervals of recovery), when combined with face immersion in cold water, decreases arterial oxygen levels causing the spleen to contract. This rapidly increases blood levels of haemoglobin, the oxygen-carrying protein, and erythropoietin (EPO), which stimulates the production of our haemoglobin-carrying red blood cells. These effects characterise what we call the dive response. While the effects of the dive response are seen in trained divers, apneists, and untrained regular folk, they are short-lived, and levels of haemoglobin and EPO return to normal within minutes.
Because repeated apneas in cold conditions cause splenic contraction and increase oxygen availability to tissues, it is of great interest as to whether breath-hold training can improve exercise performance. Yes, breath-hold training can increase haemoglobin levels and, therefore, your blood might then be able to carry more oxygen and deliver it to tissues more efficiently. To then speculate that breath-hold training will improve your running performance is appealing, but this would be a nonsensical wild leap because it has not been systematically studied.
Can Breath-Hold Training Improve Running Performance?
At present, research on breath-hold training in relation to exercise performance is sparse. Firstly, 4 maximal bouts of breath-holding immediately prior to a 4 km time trial were not found to change performance in seven cyclists. While 3 months of breath-hold training in 4 swimmers increased lung capacity and VO2peak during cycling (yes, cycling, not swimming), but did not improve front crawl swimming performance in a 50-metre time trial (although this was done while subjects held their breath). This limited data does not show promise for the utility of breath-hold training in endurance athletes, but the studies are very small and unusually designed.
Fortunately, in 2022, we got a randomised controlled trial from scientists in Belgium who recruited healthy folks to complete 6 weeks of 5 daily maximal breath holds.
The outcome?
Breath-hold training did not increase resting blood EPO concentrations, haemoglobin mass, VO2max, or time trial performance.
At this time, the evidence shows that breath-hold training may increase your ability to hold your breath and that cyclic hyperventilation combined with breath-holding may increase your ability to withstand cold exposure. Breath-hold training does not, however, appear to manifest improved endurance exercise performance. Consequently, breath-hold training is not likely to be a good time investment if you are seeking to improve your running performance. If you are fortunate enough to have 10 minutes spare a day to dedicate to additional training, I would strongly encourage favouring an extra 10 minutes a day of EASY-effort running instead of toying with methods that have an uncertain outcome.
In other words:
Extra Easy Running Is Probably a Better Use of Time than Breath-Hold Training
Why?
Well, quite simply, because boosting your volume of low-intensity work is pretty much guaranteed to increase your endurance capacity with minimal stress, helping to shuttle more oxygen to your muscles to facilitate greater fuel oxidation and ATP synthesis for when you need it during prolonged, high-intensity efforts. Yes, you may have heard about how Jon Albon used to practise Wim Hof breathing every morning, but remember that he was already a multiple world champion before starting that practice. If you are not at the pinnacle of world-class human performance, focus on optimising all of your training ingredients that will have benefit before reaching for the unknowns that, at best, might exert a marginal gain or, at worst, do bugger all and waste your time.
Until next time, stay nerdy and keep empowering yourself to be the best athlete you can be by training smart.
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Who is Thomas Solomon?
My knowledge has been honed following 20+ years of running, cycling, hiking, cross-country skiing, lifting, and climbing, 15+ years of academic research at world-leading universities and hospitals, and 10+ years advising and coaching in athletic performance and lifestyle change.
I have a BSc in Biochemistry, a PhD in Exercise Science, and over 90 peer-reviewed publications in medical journals.
I'm also an ACSM-certified Exercise Physiologist (ACSM-EP), an ACSM-certified Personal Trainer (ACSM-CPT), a VDOT-certified Distance Running Coach, and a UKVRN Registered Nutritionist (RNutr).
Since 2002, I’ve conducted biomedical research in exercise and nutrition and have taught and led university courses in exercise physiology, nutrition, biochemistry, and molecular medicine.
And, with my personal experience of competing on the track (800m to 10,000m), the road (5 k to marathon), on the trails, and in the mountains, by foot, bicycle, cross-country ski, and during obstacle course races (OCR), I deeply understand what it's like to train and compete — I've been there, done it, and gotten sweat, mud, and tears on my t-shirt.
Disclaimer: I occasionally mention brands and products, but it is important to know that I don't sell recovery products, supplements, or ad space, and I'm not affiliated with / sponsored by / an ambassador for / receiving advertisement royalties from any brands. I have conducted biomedical research for which I’ve received research money from publicly-funded national research councils and medical charities, and also from private companies, including Novo Nordisk Foundation, AstraZeneca, Amylin, the A.P. Møller Foundation, and the Augustinus Foundation. I’ve also consulted for Boost Treadmills and Gu Energy on R&D grant applications, and I provide research and scientific writing services for Examine.com. Some of my articles contain links to information provided by Examine.com, but I do not receive any royalties or bonuses from those links. Importantly, none of the companies described above have had any control over the research design, data analysis, or publication outcomes of my work. I research and write my content using state-of-the-art, consensus, peer-reviewed, and published scientific evidence, combined with my empirical evidence observed in practice and feedback from athletes. My advice is, and always will be, based on my own views and opinions shaped by the scientific evidence available. The information I provide is not medical advice. Before making any changes to your habits of daily living based on any information I provide, always ensure it is safe for you to do so and consult your doctor if you are unsure.
