The effect of diurnal variation in exercise-induced bronchoconstriction

Abstract

Objective: Exercise-induced bronchoconstriction (EIB) is an acute, transient narrowing of the airway as a result of exercise. Diurnal variation in asthma is well-established, however, few studies have investigated diurnal variability in EIB; no study has used eucapnic voluntary hyperpnea (EVH). The aim of this study was to examine circadian variability in EIB using EVH.

Methods: Fourteen recreationally-active males with mild to moderate asthma and nine healthy controls were randomized to first complete either an AM (07:00–08:00) or PM (17:00–18:00) EVH challenge, followed by the alternate test 34 h to 7 days later. The EVH protocol comprised of six-minutes of hyperventilation of a 5% CO₂ gas at a minimum ventilation rate of 21 × FEV₁ min⁻¹. The primary outcome measure was FEV₁ pre- and post-EVH.

Results: We observed no diurnal effect on EIB in the asthma group. The minimum observed post-EVH FEV₁ in the asthma cohort was 3.58 ± 0.95 L in AM and 3.62 ± 0.87 L in PM tests, corresponding to a 15.0 ± 15.3% vs. 14.9 ± 14.7% reduction from baseline, respectively. The asthma group showed similar baseline FEV₁ before AM (4.21 ± 0.79 L) and PM (4.25 ± 0.65 L) tests. No difference was observed in minute ventilation between AM (26.1 ± 3.4 × FEV₁ min⁻¹) and PM (25.6 ± 3.8 × FEV₁ min⁻¹) tests for the asthma cohort. Controls displayed no significant changes in FEV₁ or minute ventilation between tests.

Conclusions: When baseline pulmonary function is similar, this study suggests that time-of-day has no effect on EIB in mild to moderate asthma.

Keywords:

• Asthma
• circadian rhythm
• eucapnic voluntary hyperpnea
• exercise-induced asthma
• exercise-induced bronchospasm
• time-of-day

Acknowledgements

We would like to extend our gratitude to all participants in this study; without their commitment and generosity this study would not have been possible.

Declaration of interest

The authors report no conflicts of interest.