Mitchell Reid A, Hind Alanna S, Ferguson Olivia N, Flynn Morgan, Arnold Jem I, Dhillon Satvir S, Eves Neil D, Sheel A William, Guenette Jordan A
Centre for Heart Lung Innovation, Providence Research, The University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada.
Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
J Appl Physiol (1985). 2025 Jan 1;138(1):73-88. doi: 10.1152/japplphysiol.00420.2024. Epub 2024 Dec 3.
Historically, it was thought that healthy humans predominantly described their breathing as a sense of increased work or effort (W/E) during maximal exercise. However, emerging data show that many healthy adults select unpleasant dyspnea descriptors such as "unsatisfied inspiration" (UI), with relatively more females selecting UI than males. We hypothesized that males and females who select UI would report higher dyspnea intensity ratings during exercise, select more distressing dyspnea qualities post exercise, and have greater inspiratory constraints than those who do not. Sixty-four healthy, nonsmokers (32 males:32 females; 23 ± 5 yr) completed questionnaires, pulmonary function tests, and maximal incremental cycling with detailed dyspnea evaluation. Males in UI and non-UI subgroups reported similar Borg 0-10 dyspnea intensity ratings of W/E, UI, and unsatisfied expiration (UE) (all > 0.05). Females in the UI subgroup reported significantly higher UI and UE ratings than females in the non-UI subgroup (both < 0.01). Both UI subgroups reported greater air hunger, chest tightness, and mental breathing effort than non-UI participants (all < 0.05). In males only, masculine gender was negatively correlated (ρ = -0.402, = 0.02) and anxiety positively correlated (ρ = 0.363, = 0.04) with submaximal UI ratings. Females with UI had smaller peak tidal volume (Vt) [1.74 (0.32) vs. 2.06 (0.33) L, = 0.03] than non-UI females; and Vt was negatively correlated with submaximal (ρ = -0.496, = 0.004) and peak (ρ = -0.495, = 0.004) UI ratings in all females. There were no differences in Vt or correlations between Vt and dyspnea in male subgroups. Absolute lung volumes and psychosocial factors appear important in understanding sex differences in the perception of UI during exercise. The mechanisms of sex-based differences in the sensation of unsatisfied inspiration (UI) in healthy humans during exercise are poorly understood. We found that females who selected UI at peak exercise had worse dyspnea intensity ratings throughout exercise. Both sexes who selected UI at peak exercise also reported more distressing dyspnea qualities post exercise. Psychosocial factors appeared to influence male dyspnea perception, whereas smaller absolute lung volumes correlated with worse UI ratings in females.
从历史上看，人们认为健康人在最大运动时主要将呼吸描述为工作或努力增加的感觉（W/E）。然而，新出现的数据表明，许多健康成年人会选择不愉快的呼吸困难描述词，如“吸气不满足”（UI），选择UI的女性相对多于男性。我们假设，选择UI的男性和女性在运动期间报告的呼吸困难强度评分会更高，运动后选择更痛苦的呼吸困难特征，并且比不选择UI的人有更大的吸气限制。64名健康的非吸烟者（32名男性：32名女性；23±5岁）完成了问卷调查、肺功能测试以及带有详细呼吸困难评估的最大递增自行车运动。UI和非UI亚组中的男性报告的W/E、UI和呼气不满足（UE）的Borg 0 - 10呼吸困难强度评分相似（均>0.05）。UI亚组中的女性报告的UI和UE评分显著高于非UI亚组中的女性（均<0.01）。两个UI亚组报告的气促、胸闷和心理呼吸努力程度均高于非UI参与者（均<0.05）。仅在男性中，男性性别与亚最大UI评分呈负相关（ρ = -0.402，P = 0.02），焦虑与亚最大UI评分呈正相关（ρ = 0.363，P = 0.04）。有UI的女性的潮气量峰值（Vt）[1.74（0.32）L vs. 2.06（0.33）L，P = 0.03]小于无UI的女性；并且在所有女性中，Vt与亚最大（ρ = -0.496, P =0.004）和峰值（ρ = -0.495, P =0.004）UI评分呈负相关。男性亚组中Vt或Vt与呼吸困难之间的相关性没有差异。绝对肺容量和社会心理因素似乎对理解运动期间UI感知的性别差异很重要。健康人运动期间吸气不满足（UI）感觉的性别差异机制尚不清楚。我们发现，在运动峰值时选择UI的女性在整个运动过程中的呼吸困难强度评分更差。在运动峰值时选择UI的男女在运动后也报告了更痛苦的呼吸困难特征。社会心理因素似乎影响男性的呼吸困难感知，而较小的绝对肺容量与女性较差的UI评分相关。
