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Prevalence of Exercise-Induced Arterial Hypoxemia in Distance Runners at Sea Level


Medicine & Science in Sports & Exercise: May 2017 - Volume 49 - Issue 5 - p 948–954
doi: 10.1249/MSS.0000000000001193
Applied Sciences

Purpose It has been reported that ~50% of endurance-trained men demonstrate exercise-induced arterial hypoxemia (EIAH) during heavy exercise. However, this often-cited prevalence rate comes from a single study using a cohort of 25 highly trained men who completed maximal cycle ergometry. As arterial oxyhemoglobin saturation (SpO2) during maximal exercise is reported to be significantly lower during treadmill versus cycle ergometry in the same subjects, we hypothesized that the prevalence of EIAH would be greater than previously reported (and commonly referenced) in a larger cohort of highly endurance-trained men during maximal treadmill running.

Methods Data from 124 highly trained male distance runners (V˙O2max range = 60.3–84.7 mL·kg−1·min−1) were retrospectively examined from previously published studies completed in the Indiana University Human Performance Laboratory. Subjects completed a constant speed, progressive-grade treadmill exercise test to volitional exhaustion, and arterial oxyhemoglobin saturation (SaO2ear) in all subjects was estimated using the same oximeter (Hewlett Packard 47201A).

Results Using similar inclusion criteria as previously published for highly trained (V˙O2max > 68 mL·kg−1·min−1) and for EIAH (SaO2ear ≤ 91%), 55 of 79 subjects (70%) exhibited exercise-induced arterial desaturation. Across all 124 subjects, 104 (84%) demonstrated at least moderate EIAH (SaO2ear ≤ 93%) during maximal treadmill exercise. SaO2ear was significantly yet weakly correlated with V˙E/V˙O2 (P < 0.01, r = 0.28) and V˙E/V˙CO2 (P < 0.001, r = 0.33) but not with V˙O2max.

Conclusion These results indicate that the prevalence of EIAH in highly trained men during maximal treadmill exercise at sea level is greater compared with previously suggested data, with exercise mode perhaps playing a factor in the number of athletes who experience EIAH.

1HH Morris Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, IN; 2Department of Health and Kinesiology, Purdue University, West Lafayette, IN; and 3Department of Kinesiology, Kansas State University, Manhattan, KS

Address for correspondence: Robert F. Chapman, Ph.D., Department of Kinesiology, School of Public Health, Indiana University, 1025 E. 7th St., Bloomington, IN 47405; E-mail:

Submitted for publication October 2016.

Accepted for publication December 2016.

© 2017 American College of Sports Medicine