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At altitude there is a decrease in oxygen hemoglobin saturation. In order to compensate for this, Erythropoietin (EPO), a hormone secreted by the kidneys, stimulates red blood cell production from bone marrow in order to increase hemoglobin saturation and oxygen delivery
Before diving, performance-oriented freedivers hyperventilate to a certain degree, resulting in a lower level of CO2 in their lungs and bloodstream. This postpones the start of stimulation to the breathing centre of the brain, and thus delays the warning signals of running out of air. As the oxygen level of the blood is not increased by hyperventilation, this is very dangerous and may contribute to shallow water blackout and deep water blackout