Does aspiration of saliva trigger nocturnal asthma?
Five adult asthmatics with nocturnal symptoms (mean FEV1 2.31 1; 2 mean PD20 histamine 1.5 unmoles), 5 asthmatics with no nocturnal symptoms (mean FEV1 l 2.97 l; mean PD20 Histamine 3.7 unmoles) and 5 non-asthmatic control subjects (mean FEV1 3.63 l; mean PD20 histamine 78 unmoles) were challenged with nebulised solutions of their own saliva or isotonic saline in a double blind crossover study to investigate whether the inhalation of saliva during sleep could cause nocturnal asthma. The maximum % fall in FEV1 with saliva was -26.6, -6.5 and -4.1 for the nocturnal, non-nocturnal and control groups respectively. The corresponding values for the maximum % fall in FEV1 with saline was -12.4, -5.5 and -3.6. The difference in maximum % fall in FEV1 with both saliva and saline was significant (p < 0.01) for the nocturnal asthmatics when compared to the non-nocturnal asthmatics. These results lend support to the hypothesis that nocturnal symptoms in asthmatic patients may be triggered by inhalation of saliva during sleep.
Javaid
A
A
Chest Research Institute, Birmingham Heartlands Hospital.
Sykes
A P
AP
Ayres
J G
JG
D000328:Adult; D000403:Airway Resistance / Q000502:physiology; D001249:Asthma / Q000503:physiopathology*; D001980:Bronchi / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D001239:Inhalation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012463:Saliva / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000503:physiopathology*