Arterial oxygen desaturation during apnea in humans

We studied the effect of the human diving response, defined as bradycardia and reduced peripheral blood flow, on arterial hemoglobin desaturation. We induced a diving response of different magnitudes by using apnea in air and apnea with face immersion. Each of 21 subjects performed five apneas in air and five apneas with face immersion in 10 degrees C water. Periods of apnea in both conditions were of the same duration in any individual subject (average: 126.4 s) and the order of air and water was equally distributed among subjects. Heart rate, skin capillary blood flow, arterial blood pressure, arterial hemoglobin oxygen saturation during apneas, and end-tidal fractions of CO2 after apneas were recorded with non-invasive methods. The bradycardia and capillary blood flow reduction during apnea in air (7.8 and 37.7% change from control, respectively) were significantly potentiated by face immersion (13.6 and 55.9%, respectively). Arterial hemoglobin desaturated more during apnea in air (2.7%) compared to during apnea with face immersion (1.4%). We conclude that the potentiation of the human diving response with face immersion in cold water leads to a smaller decrease in arterial hemoglobin saturation, which may reflect an oxygen-conserving effect

Effects of lung volume and involuntary breathing movements on the human diving response

The effects of lung volume and involuntary breathing movements on the human diving response were studied in 17 breath-hold divers. Each subject performed maximal effort apnoeas and simulated dives by apnoea and cold water face immersion, at lung volumes of 60%, 85%, and 100% of prone vital capacity (VC). Time of apnoea, blood pressure, heart rate, skin capillary blood flow, and fractions of end-expiratory CO2 and O2 were measured. The length of the simulated dives was the shortest at 60% of VC, probably because at this level the build up of alveolar CO2 was fastest. Apnoeas with face immersion at 100% of VC gave a marked drop in arterial pressure during the initial 20 s, probably due to high intrathoracic pressure mechanically reducing venous return. The diving response was most pronounced at 60% of VC. We concluded that at the two larger lung volumes both mechanical factors and input from pulmonary stretch receptors influenced the bradycardia and vasoconstriction, resulting in a nonlinear relationship between the breath-hold lung volume and magnitude of the diving response in the near-VC range. Furthermore, the involuntary breathing movements that appeared during the struggle phase of the apnoeas were too small to affect the diving response

Diving response and apneic time in humans

The aim of this study was to compare apneic time with the human diving response, defined as heart rate (HR) reduction and reduced skin blood flow, in groups with varying degrees of breath-hold diving experience. Apneic time and HR reduction at apneas in air and apneas with face immersion in cold water were thus recorded in nine groups. Skin capillary blood flow was recorded in six of the groups. All subjects received the same information on maximizing apneic duration, and no information about their progress during the apneas. The longest apneas and the most pronounced cardiovascular adjustments were found in the young, trained divers. It was found that apneic time was significantly correlated to HR reduction among the nine groups (r = 0.94, P < 0.001), and to skin capillary blood flow reduction among the six groups where the parameter was measured (r = 0.82, P < 0.05). The correlation between HR reduction and skin capillary blood flow reduction was also significant (r = 0.85, P < 0.05). When the difference in HR reduction and apneic time between apneas in air and apneas with face immersion were compared in the nine groups, it was found that all groups reacted with a more pronounced HR reduction during apneas with face immersion. All groups without prior breath-hold diving experience were found to perform shorter apneas with face immersion than apneas in air, or apneas of the same duration in both conditions, which has been reported in other studies. However, in all groups with diving experience, the apneic time was prolonged during apneas with face immersion. The results of this study suggest an oxygen-conserving effect of the diving response in trained apneic divers

Effects of repeated apneas on apneic time and diving response in non-divers

Human breath-hold divers usually perform a series of dives with short intervals. Repeated apneas prolong apneic time, and an accentuated diving response has been suggested to be the cause. The aim of this study was to investigate the effect of repeated apneas on apneic time and diving response in humans. Forty-one subjects performed a series of five apneas with face immersion in water of 10 degrees C, separated by 2-min intervals. Apneas were performed at rest and to individual maximal duration. Heart rate, mean arterial pressure, skin capillary blood flow, and respiratory movements were recorded. Thirty-eight of the subjects were used for analysis of cardiovascular parameters, and in 23 subjects the physiologic breaking point could be detected by the involuntary breathing movements. Heart rate reduction and blood pressure increase were most prominent during the first apneic face immersion, whereas skin capillary blood flow reduction was most intense in the second apneic face immersion. Blood pressure and skin capillary blood flow during recovery from apneic episodes also changed throughout the series. Repetition increased apneic time by 55% and postponed the occurrence of involuntary breathing movements by 27% in subjects passing the physiologic breaking point. We conclude that both physiologic factors, associated with the accumulation of CO2, and psychologic factors, related to the capacity to withstand the respiratory drive, contribute to the prolongation of apneic time whereas an increased diving response does not contribute