title: The breathing route dependence of ventilatory responses to hypercapnia and exercise is modulated by upper airway resistance.
abstract: OBJECTIVE
  The ventilatory response to hypercapnia is greater breathing orally than nasally.
  
  
  METHODS
  We hypothesize that this is due to higher nasal resistance to airflow compared with oral resistance. Seven normal male subjects were studied during both progressive hyperoxic hypercapnia (HC) and exercise (EX) until ventilation exceeded 40 L/min. Under each condition, subjects breathed via the nose only or the mouth only. For each breathing route, ventilation and pathway resistance were calculated simultaneously at the highest common exercise workload (140 +/- 20 watt; mean +/- SE) or the same end-tidal CO2 level (8.0 +/- 0.5%).
  
  
  RESULTS
  The ventilatory response breathing nasally was decreased by a similar amount for both EX and HC when compared with the oral route. The difference between nasal and oral ventilation was highly correlated with the difference between nasal resistance and oral resistance for both EX and HC (linear regression analysis; r = 0.91 for EX and r = 0.86 for HC; both P < 0.01).
  
  
  CONCLUSIONS
  We conclude that the breathing route dependence of ventilatory responses to respiratory stimuli in normal subjects is independent of the method of stimulation and is substantially determined by the added resistance of nasal breathing.
authors.affiliation: Department of Respiratory Medicine, University of Sydney, Westmead Hospital, New South Wales, Australia.
authors.forename: Y X
authors.initials: YX
authors.lastname: Shi
authors.forename: M
authors.initials: M
authors.lastname: Seto-Poon
authors.forename: J R
authors.initials: JR
authors.lastname: Wheatley
mesh_terms: D000328:Adult; D000403:Airway Resistance / Q000502:physiology*; D000704:Analysis of Variance; D005080:Exercise Test; D006801:Humans; D006935:Hypercapnia; D016014:Linear Models; D008297:Male; D009058:Mouth Breathing / Q000503:physiopathology; D009296:Nasal Cavity / Q000502:physiology*; D012016:Reference Values; D012119:Respiration; D015656:Respiratory Mechanics; D012680:Sensitivity and Specificity