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This study specifically aims to elucidate the effects of IEK on sleep and recuperation in hypoxia, after training in normoxia. These conditions are in line with the widely applied live-high train-low strategy. Moreover, blood and tissue oxygenation status, as well as cerebral blood flow and cognitive function will be assessed.
During training stages in order to prepare for an important event, sleep and recuperation are almost equally important as the appropriate training strategy. This training strategy often consists of living-high (sleeping at -stimulated- altitude) and training low (training at sea level). A decreased oxygen availability, also known as hypoxia, however often disrupts sleep quality and thus compromises the overall training efficiency. Ketones are recently found to improve sleep quality, thus potentially playing a pivotal role in altitude training. Therefore, the investigators want to evaluate the effects of ketones on sleep in hypoxia, after training in normoxia. Moreover, the effect on a performance test, during a simulated 30 min time trial on the next morning, will be investigated. During this protocol, cerebral blood flow will be assessed, as well as ventilation, blood and tissue oxygen status, heart rate variability, and cognitive function.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Normoxia - placebo | Placebo Comparator | Both training and sleep in normoxia, supplemented with placebo |
|
| Hypoxia - placebo | Experimental | Training in normoxia and sleep in hypoxia, supplemented with placebo |
|
| Hypoxia - ketones | Experimental | Training in normoxia and sleep in hypoxia, supplemented with ketones |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Placebo | Dietary Supplement | Water, 5% collagen(w/w), octoacetate (1 mM) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Duration of different sleep stages | Measured using polysomnography | Throughout the entire duration of the night, up to 9 hours after individual bedtime |
| Exercise performance | Measured as the average power output (W) during a 30 minutes time trial | 30 minutes on the second morning of the protocol |
| Change in nocturnal oxygen saturation | Measured using pulse oximetry | Throughout the entire duration of the night, up to 9 hours after individual bedtime |
| Absolute amount of nocturnal urinary catecholamine excretion | Measured using ELISA of collected nocturnal urine | Subjects empty bladder before sleep and urine will be collected throughout the entire duration of the night, up to 9 hours after individual bedtime and in the morning immediately after waking up |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Chiel Poffé, Dr. | KU Leuven | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| KU Leuven | Leuven | Vlaams-Brabant | 3000 | Belgium |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39809236 | Derived | Stalmans M, Tominec D, Robberechts R, Lauriks W, Ramaekers M, Debevec T, Poffe C. A Single Night in Hypoxia Either with or without Ketone Ester Ingestion Reduces Sleep Quality without Impacting Next-Day Exercise Performance. Med Sci Sports Exerc. 2025 Apr 1;57(4):807-819. doi: 10.1249/MSS.0000000000003604. Epub 2024 Nov 18. |
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| ID | Term |
|---|---|
| D007662 | Ketosis |
| D000860 | Hypoxia |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D000138 | Acidosis |
| D000137 | Acid-Base Imbalance |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| C524675 | formic acid 4-(3-oxobutyl)phenyl ester |
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1 session with both training and sleep in normoxia, supplemented with placebo (NPL)
1 session with training in normoxia, sleep in hypoxia, supplemented with placebo (HPL)
1 session with training in normoxia, sleep in hypoxia, supplemented with ketones (HKE)
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| Ketone ester | Dietary Supplement | A total of 75g ketone ester supplementation will be administered in 3 bouts of 25g in order to establish intermittent exogenous ketosis: twice immediately after training, and one 30 minutes before sleep. The ketone ester used is (R)-3-hydroxybutyl (R)-3-hydroxybutyrate |
|
| D012818 |
| Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001519 | Behavior |