Ventilatory function in breath-hold divers: effect of glossopharyngeal insufflation

Lemaître, Frédéric; Clua, Éric; Andréani, Bernard; Castres, Ingrid; Chollet, Didier

doi:10.1007/s00421-009-1277-1

Cited by 17 publications

(19 citation statements)

References 34 publications

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“…Similarly to our findings, other studies have also found higher measured FVC [5,[8][9][10]19] and FEV 1 [5,19] in divers than those predicted using population data. There is a good correlation between higher measured than predicted FVC and diving depth and length of professional diving career, i.e., the greater the length of time practicing diving and the greater the depth, the greater the difference between the measured values and the predicted values [9].…”

Section: Discussionsupporting

confidence: 92%

“…Some authors suggest that the increase in lung volume found in competitive free divers may be a result of an increase in the number of alveoli or the alveolar size by the virtue of training [20,21]. Others, have attributed the increase in lung volumes to the improved performance of the respiratory muscles gained from free diving or from GI [19,22,23]. This condition may be related to our findings, since the free-diving fishermen, who participated in this study, perform repetitive apneas for three to five hours on a daily basis in hyperbaric conditions at depths ranging from 8 to 15 m deep according to the tide (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

“…Increases in FVC and FEV 1 have been reported in competitive free divers. However, unlike the subjects in the present study, those individuals were trained in the glossopharyngeal insufflation (GI) technique [19].…”

Section: Lung Function In Breath-hold Diving Fishermen O R I G I N a mentioning

confidence: 99%

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Chronic adaptations of lung function in breath-hold diving fishermen

Diniz¹,

Farias²,

Pereira³

et al. 2014

International Journal of Occupational Medicine and Environmental Health

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Objectives: The aim of this study was to verify and analyze the existence of chronic adaptations of lung function in freediving fishermen whose occupation is artisanal fishing. Material and Methods: This was a cross-sectional study involving 11 breath-hold diving fishermen and 10 non-breath-hold diving fishermen (control) from the village of Bitupitá in the municipality of Barroquinha (Ceará -Brazil). Anthropometric measurements, chest and abdominal circumferences as well as spirometric and respiratory muscle strength tests were conducted according to the specifications of the American Thoracic Society/European Respiratory Society (ATS/ERS). In order to compare the measured values versus the predicted values, Student t test was used in the case of parametric test and Wilcoxon test in the case of nonparametric test. To compare the inter-group means Student t test was used for parametric test and Mann-Whitney test for the nonparametric one. The level of significance was set at α = 5%. Results: The forced vital capacity (FVC) (4.9±0.6 l vs. 4.3±0.4 l) and forced expiratory volume in 1 s (FEV 1 ) (4.0±0.5 l vs. 3.6±0.3 l) were, respectively, higher in the group of divers compared to the control group (p ≤ 0.05). Furthermore, in the group of free divers, the measured FVC, FEV 1 and FEV 1 /FVC ratios were significantly greater than the predicted ones. No differences were found between the measured respiratory pressures. Conclusions: These results indicate that breath-hold diving seems to produce chronic adaptations of the respiratory system, resulting in elevated lung volumes with no airway obstruction.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Chronic adaptations of lung function in breath-hold diving fishermen

Diniz¹,

Farias²,

Pereira³

et al. 2014

International Journal of Occupational Medicine and Environmental Health

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“…Such incongruence may happen physiologically and may be accentuated by several mechanisms, including in utero exposures such as tobacco smoke or vitamin D deficiency (34,35), although it is unclear whether these effects would persist later in childhood. Chronic hypoxemia has been associated with a higher risk of dysanaptic lung growth (36); dysanapsis may also be present in breathhold divers, who use glossopharyngeal insufflation to force their lung volumes above TLC (providing extra oxygen and preventing compression when diving) (37). Compensatory lung growth after pneumonectomy may also be dysanaptic (38).…”

Section: Discussionmentioning

confidence: 99%

Obesity and Airway Dysanapsis in Children with and without Asthma

Forno

Weiner

Mullen

et al. 2017

Am J Respir Crit Care Med

204

137

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Rationale: For unclear reasons, obese children with asthma have higher morbidity and reduced response to inhaled corticosteroids.Objectives: To assess whether childhood obesity is associated with airway dysanapsis (an incongruence between the growth of the lungs and the airways) and whether dysanapsis is associated with asthma morbidity.Methods: We examined the relationship between obesity and dysanapsis in six cohorts of children with and without asthma, as well as the relationship between dysanapsis and clinical outcomes in children with asthma. Adjusted odds ratios (ORs) were calculated for each cohort and in a combined analysis of all cohorts; longitudinal analyses were also performed for cohorts with available data. Hazard ratios (HRs) for clinical outcomes were calculated for children with asthma in the Childhood Asthma Management Program.Measurements and Main Results: Being overweight or obese was associated with dysanapsis in both the cross-sectional (OR, 1.95; 95% confidence interval [CI], 1.62-2.35 [for overweight/obese compared with normal weight children]) and the longitudinal (OR, 4.31; 95% CI, 2.99-6.22 [for children who were overweight/obese at all visits compared with normal weight children]) analyses. Dysanapsis was associated with greater lung volumes (FVC, vital capacity, and total lung capacity) and lesser flows (FEV 1 and forced expiratory flow, midexpiratory phase), and with indicators of ventilation inhomogeneity and anisotropic lung and airway growth. Among overweight/obese children with asthma, dysanapsis was associated with severe disease exacerbations (HR, 1.95; 95% CI, 1.38-2.75) and use of systemic steroids (HR, 3.22; 95% CI, 2.02-5.14).Conclusions: Obesity is associated with airway dysanapsis in children. Dysanapsis is associated with increased morbidity among obese children with asthma and may partly explain their reduced response to inhaled corticosteroids.

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“…58 Furthermore, the FEV1/FVC ratio was normal, and identical in the two groups, indicating no increase in airway resistance and lack of signs of airway obstruction in divers. Nevertheless, even higher static and dynamic lung volumes were reached in subjects who performed glossopharyngeal breathing manoeuvres [13,22,23]. However, it was recently demonstrated that this practice may indeed lead to traumatic lung lesions, eventually resulting in pneumomediastinum or pneumothorax [24].…”

Section: Discussionmentioning

confidence: 99%

Lung volumes of extreme breath-hold divers

Ferretti

Costa

Moroni³

et al. 2012

Sport Sci Health

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Achievements in breath-hold diving depend, amongst others, on body oxygen stores at start of dive. A diver with very high lung volumes could increase dive's duration, and attain deeper depths for a given speed. Thus, we hypothesized that extreme breath-hold divers have very high lung volumes. On eight extreme breathhold divers (age 35 + 4 years, height 179 + 7 cm, body mass 76 + 6 kg) and 9 non-diving controls (age 37 + 6 years, height 177 + 4 cm, body mass 81 + 9 kg) residual volume, vital capacity and total lung capacity (TLC) were measured with a body plethysmograph. Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV 1 ) were measured with a spirometer. Peak expiratory flow and flow-volume loops were measured with a pneumotachograph. In divers, but not in controls, volumes and capacities were systematically and significantly (p<0.01, paired t-test) higher than predicted from their body size. Consistently, volumes and capacities were significantly higher in divers than in controls, except for residual volume. Divers' TLC was 22% higher than predicted, and 21% higher than in controls. All divers' TLC was higher than 8 L, two had it higher than 9 L. FVC and FEV 1 were significantly higher in divers than in controls. The FEV 1 /FVC ratio was the same in both groups. We conclude that extreme breath-hold divers may constitute a niche population with physiological characteristics different from those of normal individuals, facilitating the achievement of excellent diving performances.

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Ventilatory function in breath-hold divers: effect of glossopharyngeal insufflation

Cited by 17 publications

References 34 publications

Chronic adaptations of lung function in breath-hold diving fishermen

Chronic adaptations of lung function in breath-hold diving fishermen

Obesity and Airway Dysanapsis in Children with and without Asthma

Lung volumes of extreme breath-hold divers

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