IntroductionTechnical diving is very popular in Finland throughout the year despite diving conditions being challenging, especially due to arctic water and poor visibility. Cold water, immersion, submersion, hyperoxia, as well as psychological and physiological stress, all have an effect on the autonomic nervous system (ANS).Materials and methodsTo evaluate divers’ ANS responses, short-term (5 min) heart rate variability (HRV) during dives in 2–4°C water was measured. HRV resting values were evaluated from separate measurements before and after the dives. Twenty-six experienced closed circuit rebreather (CCR) divers performed an identical 45-meter decompression dive with a non-physical task requiring concentration at the bottom depth.ResultsActivity of the ANS branches was evaluated with the parasympathetic (PNS) and sympathetic (SNS) indexes of the Kubios HRV Standard program. Compared to resting values, PNS activity decreased significantly on immersion with face out of water. From immersion, it increased significantly with facial immersion, just before decompression and just before surfacing. Compared to resting values, SNS activity increased significantly on immersion with face out of water. Face in water and submersion measures did not differ from the immersion measure. After these measurements, SNS activity decreased significantly over time.ConclusionOur study indicates that the trigeminocardiac part of the diving reflex causes the strong initial PNS activation at the beginning of the dive but the reaction seems to decrease quickly. After this initial activation, cold seemed to be the most prominent promoter of PNS activity – not pressure. Also, our study showed a concurrent increase in both SNS and PNS branches, which has been associated with an elevated risk for arrhythmia. Therefore, we recommend a short adaptation phase at the beginning of cold-water diving before physical activity.
Blood-borne extracellular vesicles and inflammatory mediators were evaluated in divers using a closed circuit rebreathing apparatus and custom-mixed gases to diminish some diving risks. “Deep” divers (n = 8) dove once to mean (±SD) 102.5 ± 1.2 m of sea water (msw) for 167.3 ± 11.5 min. “Shallow” divers (n = 6) dove 3 times on day 1, and then repetitively over 7 days to 16.4 ± 3.7 msw, for 49.9 ± 11.9 min. There were statistically significant elevations of microparticles (MPs) in deep divers (day 1) and shallow divers at day 7 that expressed proteins specific to microglia, neutrophils, platelets, and endothelial cells, as well as thrombospondin (TSP)-1 and filamentous (F-) actin. Intra-MP IL-1β increased by 7.5-fold (p < 0.001) after day 1 and 41-fold (p = 0.003) at day 7. Intra-MP nitric oxide synthase-2 (NOS2) increased 17-fold (p < 0.001) after day 1 and 19-fold (p = 0.002) at day 7. Plasma gelsolin (pGSN) levels decreased by 73% (p < 0.001) in deep divers (day 1) and 37% in shallow divers by day 7. Plasma samples containing exosomes and other lipophilic particles increased from 186% to 490% among the divers but contained no IL-1β or NOS2. We conclude that diving triggers inflammatory events, even when controlling for hyperoxia, and many are not proportional to the depth of diving.
Introduction: Cold water imposes many risks to the diver. These risks include decompression illness, physical and cognitive impairment, and hypothermia. Cognitive impairment can be estimated using a critical flicker fusion frequency (CFFF) test, but this method has only been used in a few studies conducted in an open water environment. We studied the effect of the cold and a helium-containing mixed breathing gas on the cognition of closed circuit rebreather (CCR) divers.Materials and Methods: Twenty-three divers performed an identical dive with controlled trimix gas with a CCR device in an ice-covered quarry. They assessed their thermal comfort at four time points during the dive. In addition, their skin temperature was measured at 5-min intervals throughout the dive. The divers performed the CFFF test before the dive, at target depth, and after the dive.Results: A statistically significant increase of 111.7% in CFFF values was recorded during the dive compared to the pre-dive values (p < 0.0001). The values returned to the baseline after surfacing. There was a significant drop in the divers’ skin temperature of 0.48°C every 10 min during the dive (p < 0.001). The divers’ subjectively assessed thermal comfort also decreased during the dive (p = 0.01).Conclusion: Our findings showed that neither extreme cold water nor helium-containing mixed breathing gas had any influence on the general CFFF profile described in the previous studies from warmer water and where divers used other breathing gases. We hypothesize that cold-water diving and helium-containing breathing gases do not in these diving conditions cause clinically relevant cerebral impairment. Therefore, we conclude that CCR diving in these conditions is safe from the perspective of alertness and cognitive performance.
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