Dyspnea following Experimentally Induced Increased Nasal Airway Resistance

Abstract

Nasal resistance (NRZ) values for healthy adults range from 1.0 to 3.5 cm H2O/L/sec. Some oral breathing tends to occur at values above 3.5. The purpose of the present study was to determine at what level of NRZ individuals sense that nasal breathing is difficult. A diaphragm was used to add four different resistance loads in random to 15 adult subjects. These loads were 5, 8, and 15 cm H2O/L/sec and a value 40% above the individual's normal NRZ. Loads were added under four conditions: normal breathing, fixed flow rate, fixed breathing rate, and fixed flow and breathing rate. The pressure-flow technique was used to measure NRZ under all conditions. The study revealed that the sensation of breathing difficulty occurred at a median resistance of 5 cm H2O/L/sec and, as subjects were constrained to maintain fixed flow and breathing rates, the magnitude of RZ, at which the sensation of dyspnea was noted, decreased. The values observed in this study support previous findings suggesting that individuals switch to some oral breathing to maintain an adequate level of upper airway resistance at values between 3.5 and 4.5 cm H2/L/sec. The findings also show that individuals attempt to minimize increases in airway resistance by modifying breathing behaviors.