Dr. Artour Rakhimov: It is clear that breathing and breath holding time are not the same for all of us. Many things are different. For example, stress and oxygen air modulation. Now sleep in an other way to defer. In fact, for most people breath holding time is smallest during morning hours. Even in healthy people breath holding time is smallest and breathing is heaviest during these times.
Now let’s look. During the evening sessions, most of the BHT/Delta P ACO2 ratios were higher than the corresponding morning values. Bosco G. Ionadi. Voluntary breath-holding in the morning and in the evening. Clinical science, 2004.
Reason that the call of breath-holding time and increased breathing in even strong in sick people, consider that people with asthma.
There was a little study about 30 years ago. The goal of the study was to explain the sudden nature of some asthma deaths as these often occur in the early morning. Title of the study, physiological patterns in the early morning asthma, Thorax 1977.
Consider a wider health problem, COPD; chronic obstructive pulmonary disease. Symptoms related to sleep disturbances are common in individuals with moderate to severe COPD, particularly in the elderly, which is commonly manifested as morning fatigue and the early awakenings. One major cause of morbidity in this population is abnormalities in gas exchange and the resultant hypoxemia as they can lead to elevated pulmonary pressures, dyspnea and in severe cases right ventricular overload and failure. Sleep has profound adverse effects on the respiration and gas exchange in patients with COPD. Title of the study, chronic obstructive pulmonary disease and sleep: the interaction, Panminerva Medicina 2006.
Another study done by American researchers, published, told that COPD patients are most likely to die during the early morning hours. Epidemiologic investigation has revealed that patients with pulmonary disease are at increased risk of dying during the early morning hours. Title of the study, myocardial stress. Exercise verus sleep in patients with COPD, Chest 1984.
Now equation with pulmonary disease have problems and in fact in this study they found that breathing is so heavier than the similar amount of muscle exercise. What about cardiac patients? Coronary spasm occurs most often from midnight to early morning when the patient is at rest. Title of the study coronary spasm, clinical features and pathogenesis, published in the Internal Medicine 1997.
Trying to explain is this, two cardiologists conducted their own research trying to find out what was the cause. Background: Several studies related to cardiac events including sudden death have shown a peak incidence in the early morning hours. Title of the study, circadian variations in QTc dispersion; is it a clue to the morning increase of sudden cardiac death, published in Clinical Cardiology 1999.
Just one year ago, Australian medical professionals published a research about what was going on in the brain of healthy people during morning hours. They found that the connection with the throat, these data indicate that normal diurnal changes in the cerebrovascular response to CO(2) influence the hypercapnic ventilatory response as well as the level of cerebral oxygenation during changes in arterial Pco(2); this may be a contributing factor for diurnal changes in breathing stability and the high incidence of stroke in the morning. Title of the study is, morning attenuation in cerebrovascular CO2 reactivity in healthy humans is associated with a lowered cerebral oxygenation and an augmented ventilatory response to CO2, Journal of Applied Physiology 2007.
Though they found people have high risk of dying from stroke during the early morning hours. The neurologists found the same results. This reduced morning response to hypercapnia suggests diminished vasodilator reserve during this period, and may be related to the increased stroke risk during the morning hours. Title of the study is Morning reduction of cerebral vasomotor reactivity, Neurology 1994.
Now there is another thing that you should wish, it’s not as severe as those one, but people feel that they have various complications. I talk to people on a day basis. Let’s have a look at this and try to get we should all get and other parameters, black parameters of patients on a day basis. Circadian rhythms of tissue oxygen balance and blood rheological properties were investigated in 40 patients with insulin dependent diabetes mellitus. Preserve blood hyperviscosity and increasing tissue hypoxia at night indicated stable disturbance of hemorheological properties and tissue oxygen balance. Title of the study is, desynchronization of circadian rhythms of the oxygen balance in the tissues and rheological properties of the blood in type 1 diabetes mellitus, published in Therapy Archives 1988.
A group of Japanese scientists done one investigation and they concluded that it’s very important to take good care about this patients especially during the early morning hours. This is what they wrote. S-w paroxysms combined with clinical symptoms and continuing for more than four seconds were fewer during the afternoon than the morning and, moreover, during sleep. Therefore, the observation of typical absence seizures during the morning should be regarded as important. The title of this study is, The circadian rhythm of typical absence seizures – the frequency and duration of paroxysmal discharges, published in the Neuropediatrics 1990.
There is even a special health condition, which is called morning sickness. It affect of all two-thirds of women during the first three months of their pregnancy. They experience nausea and they are weakened. What I found with my own students that breath-holding time for most of them is much less during the early morning hours. I will say that only probably 10% of people who have less the same breath-holding time and same breathing as in the evening.
Now about half of the people have very big reductions. So morning breath-holding time, two times, about three times less than in the evening. Thus You knew that people breath two, three times heavier during the morning early hours and definitely there hidden the cause of death. Imagine a person with heart disease or asthma, during week times, but of course time of such person as found before, it’ll be about 15 seconds, quite reasonable time. It’s not very good but people can function, people can walk. But in the morning hours, if it drops three times, you got only five seconds, and this is the time when cardiac arrest, heart attack, strokes, and heart’s problems are very, very likely, breathing-holding time is too short, breathing period is very, very heavy.
Now that can also can develop doctor thoroughly investigates sick patients and when sick patients arrive, they can be and doctor trying to find the disease, they can not find it because breathing is more great but it’s also to the norm, but during the early morning hours, patient is much heated and this is the time when the most damage done to their body.
Now take upon the patients with asthma. What happens during early morning hours? Do you think -- conditions some pathogens, in formation it’ll increase, while more and more disease produced, later they might go to the hospital, well they can’t find he is on the right. Consider a heart patient. The situation is the same. During the day time, breathing is more or less good. Cardiac professionals said,-- trying to find the disease, they do not see it. Now people with other conditions, for example tumors. Let tumors have the role. Tumors -- type of heal but rated and these examples during the early morning hours. Let’s say a patient can go to the hospital to research, they’ve been trying to find something but nothing, the tumor is not growing. It’s a misleading diseases which comes in vigorously.
In some treacherous way, for just for two, three, four hours, and produce damage during the early morning hours. Now what that causes morning hypercapnic ventilatory? They are numerous. The changes, which do apply during -- for example, we go to bed, we sleep for long, we sleep on our back, we breathe through the mouth and during night, although windows are closed, air cooler is not good enough. There are many other factors like long blankets, big pillows, distract you throughout your sleep. We can investigate this topic in more details in the section, give all into the importance of hyperventilation.
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