Combination with temperature changes

Exposure to hypoxic stress alone is rare within real-world contexts and is usually concomitant with cold and/or hot environments. Yet limited evidence exists pertaining to human responses to the combination of hypoxia with cold or heat. The aim of this chapter is to describe the combined impact of hypoxia-and-cold and hypoxia-and-heat on exercise and health. Passive and exercise responses to singular stressors will be described briefly before providing a detailed overview of exposure to combined stressors. Hypoxia, heat, and cold alone can all elicit positive and detrimental health and exercise responses. Therefore, it is plausible that the combination of stressors may exacerbate or enhance the effects of individual stressors. In acute hypoxic/cold environments, additive to modest synergistic decrements in exercise performance or capacity are typically observed. Hypoxic/hot induces antagonistic decrements on endurance exercise but positive antagonistic effects during repeated sprint exercise. Exercise performance after chronic hypoxic/cold exposure is yet to be studied. Following chronic hypoxic/hot exposure, there does not appear to be any ergogenic effects within subsequent single stressor environmental exposures. Collectively, these observations are based on a small number of studies, predominantly in able-bodied males, with limited sample sizes. Considerably more research is required to fully elucidate the impact of combined hypoxia and temperature stress on exercise and health, particularly within female and people with a disability/para-athlete populations.