Repeated breathlessness experiences induced by hypercapnia: differential effects on intensity and unpleasantness

Chest. 2009 Feb;135(2):455-461. doi: 10.1378/chest.08-1226.

Abstract

Background: The present study investigated the effect of repeated hypercapnic challenges on the sensory (intensity [I]) and affective (unpleasantness [U]) dimensions of breathlessness.

Methods: Three subsequent rebreathing trials (Read, 1968) were administered to healthy men and women (n = 39). The I and U of breathlessness were rated every 20 s during the baseline, rebreathing, and recovery phases. Breathing behavior (fractional end-tidal CO(2) [Fetco(2)] and minute ventilation [Ve]) was monitored continuously. Intraindividual linear regression slopes for Fetco(2) and Ve] were calculated and standardized, separately for both rating dimensions.

Results: Both the absolute magnitude and the slope of the I of breathlessness were higher compared to U (p < 0.05). Across-trial habituation of the peak I and U of breathlessness occurred in both genders (p < 0.001), but habituation was larger for the U than for the I (p = 0.05).

Conclusions: The findings show that the sensory and affective dimensions of breathlessness can meaningfully be distinguished during hypercapnic challenges and that repeated exposures have different effects on both dimensions.

MeSH terms

  • Adolescent
  • Blood Gas Analysis
  • Carbon Dioxide / blood*
  • Dyspnea / etiology
  • Dyspnea / physiopathology*
  • Female
  • Humans
  • Hypercapnia / complications
  • Hypercapnia / physiopathology
  • Hypercapnia / psychology*
  • Illness Behavior
  • Inhalation / physiology
  • Male
  • Reference Values
  • Risk Assessment
  • Sampling Studies
  • Sensitivity and Specificity
  • Sensory Thresholds
  • Sex Factors
  • Young Adult

Substances

  • Carbon Dioxide