Performing at altitude

This chapter summarizes our current understanding of how to prepare for performance at altitude and provide guidance for the safe ascent to higher elevations. The ability to accurately predict who will retain performance at high altitude is highly desirable. The majority of approaches developed thus far require exposing an individual to simulated altitude and examining the magnitude of arterial oxygen desaturation. Predictive tests have previously been developed to estimate the likelihood of severe illness associated with high altitude exposure in mountaineers, and these have recently been applied to athletic cohorts. Athletes who experience exercise-induced hypoxemia in normoxia have consistently been shown to demonstrate a reduced ventilatory drive during exercise and in response to hypoxia at rest. The magnitude of the decrement in performance is highly variable between individuals, but exercise physiologists have a number of tests available to identify more susceptible athletes.