Elevation Masks: Uses, Benefits, Risks, and Scientific Evidence

What are Elevation Masks Used For?

Elevation masks, often marketed as "altitude training masks," are primarily used to restrict airflow during exercise, aiming to strengthen respiratory muscles and increase the perceived effort of a workout, rather than truly simulating high-altitude conditions.

Introduction to Elevation Training Masks

Elevation masks are devices worn over the mouth and nose during physical activity, featuring adjustable valves designed to regulate the amount of air inhaled and exhaled. They gained popularity with the claim of replicating the physiological benefits of training at high altitudes, where the air contains less oxygen (hypoxia). The masks create resistance, making breathing more challenging, which proponents suggest can lead to improved athletic performance and endurance.

The Theory: Simulating Hypoxia

The concept behind altitude training, or hypoxic training, is well-established in sports science. When athletes train at high altitudes, the lower atmospheric pressure means less oxygen is available for the body to absorb. In response, the body undergoes several adaptations to improve oxygen delivery and utilization, including:

• Increased Erythropoietin (EPO) production: This hormone stimulates red blood cell production, enhancing the blood's oxygen-carrying capacity.
• Improved capillary density: More capillaries mean better oxygen delivery to muscles.
• Mitochondrial efficiency: Muscles become more efficient at using oxygen.

These adaptations, developed over weeks of consistent exposure to true altitude, can lead to significant improvements in endurance performance upon returning to sea level. Elevation masks claim to induce similar hypoxic conditions and adaptations by reducing the amount of air an individual can inhale.

How Elevation Masks Actually Work (or Don't)

Despite their marketing, elevation masks do not simulate true high-altitude conditions or hypoxia. Here's why:

• Air Composition Remains Unchanged: The masks do not alter the percentage of oxygen in the ambient air. You are still breathing air with approximately 21% oxygen.
• Airflow Restriction, Not Oxygen Deprivation: Instead of reducing oxygen intake, the masks primarily create resistance to airflow. This means you have to work harder to inhale and exhale.
• Respiratory Muscle Training: The increased effort required to breathe strengthens the diaphragm and intercostal muscles, which are crucial for respiration. This is akin to lifting weights for your breathing muscles.
• Increased CO2 Buildup (Hypercapnia): The restricted exhalation can lead to a buildup of carbon dioxide in the body (hypercapnia). This triggers a stronger urge to breathe and can create a sensation similar to being out of breath, but it is not the same as oxygen deprivation.

Therefore, while elevation masks make breathing more challenging, they fundamentally do not induce the systemic physiological adaptations associated with true hypoxic training.

Purported Benefits vs. Scientific Evidence

Many claims surround the use of elevation masks, but scientific evidence often paints a different picture.

• Increased Lung Capacity and Respiratory Muscle Strength: This is the most consistently supported benefit. By forcing the respiratory muscles to work harder, the masks can lead to an increase in their strength and endurance. However, dedicated inspiratory muscle training (IMT) devices are often more targeted and effective for this purpose.
• Improved VO2 Max and Endurance Performance: The evidence for masks improving maximal oxygen uptake (VO2 max) or overall endurance beyond what can be achieved through regular training is largely inconclusive or negative. Studies often find no significant difference in these metrics compared to training without a mask. True altitude training, with its systemic adaptations, remains the gold standard for this.
• Enhanced Speed and Power: There is no credible scientific evidence to suggest that elevation masks directly improve short-burst speed or power outputs.
• Mental Toughness: Some users report an increase in mental fortitude due to the added challenge and discomfort of training with a mask. While subjective, pushing through discomfort can certainly build mental resilience.
• Weight Loss: While the increased effort might slightly increase calorie expenditure during a workout, there's no unique mechanism by which masks directly promote weight loss more effectively than any other form of intense exercise.

Potential Risks and Considerations

While generally safe for healthy individuals, there are several considerations and potential risks associated with elevation mask use:

• Discomfort and Anxiety: The feeling of restricted breathing can be uncomfortable, distracting, and even anxiety-inducing for some, potentially detracting from workout quality.
• Hypercapnia Symptoms: Excessive CO2 buildup can lead to symptoms like dizziness, lightheadedness, nausea, or headache, especially during high-intensity exercise.
• Reduced Training Intensity: The added breathing resistance can make it harder to maintain a high level of intensity or complete as many repetitions, potentially compromising the overall training stimulus for muscles other than respiratory ones.
• Not for Individuals with Respiratory or Cardiovascular Conditions: People with asthma, COPD, heart conditions, or other respiratory/cardiovascular issues should avoid using these masks without explicit medical clearance, as they can significantly increase strain.
• False Sense of Security: Relying on a mask for "altitude training" can give athletes a false sense of achieving true hypoxic adaptations, potentially leading to misguided training strategies.

Who Might Benefit (and How)?

Given the scientific understanding, elevation masks are not a magic bullet for performance, nor do they replace true altitude training. However, certain individuals might find specific, limited benefits:

• Athletes Focused on Respiratory Muscle Training: If the primary goal is to specifically strengthen the breathing muscles, an elevation mask can contribute to this. However, dedicated inspiratory muscle training (IMT) devices, which provide calibrated resistance, are often more precise and effective for this purpose.
• Individuals Seeking a Novel Training Stimulus: For those looking to add a new challenge or vary their workouts, the mask can provide a different type of resistance.
• For Mental Toughness: The added challenge can serve as a mental training tool, helping individuals push through discomfort.

Conclusion: Evidence-Based Perspective

Elevation masks are primarily tools for respiratory muscle training, making breathing more challenging and potentially strengthening the diaphragm and intercostal muscles. They do not replicate the physiological effects of true high-altitude training, as they do not reduce the oxygen concentration of inhaled air.

For athletes seeking to improve endurance, VO2 max, or systemic adaptations, evidence-backed strategies such as consistent progressive overload in training, interval training, and, for elite athletes, genuine live-high, train-low altitude camps remain superior and scientifically validated. While elevation masks can add a novel challenge and potentially strengthen breathing muscles, users should approach them with realistic expectations, understanding their actual mechanism of action and limitations.