Sex differences in the intensity and qualitative dimensions of exertional dyspnea in physically active young adults.
Understanding sex differences in the qualitative dimensions of exertional dyspnea may provide insight into why women are more affected by this symptom than men. This study explored the evolution of the qualitative dimensions of dyspnea in 70 healthy, young, physically active adults (35 M and 35 F). Participants rated the intensity of their breathing discomfort (Borg 0-10 scale) and selected phrases that best described their breathing from a standardized list (work/effort, unsatisfied inspiration, and unsatisfied expiration) throughout each stage of a symptom-limited incremental-cycle exercise test. Following exercise, participants selected phrases that described their breathing at maximal exercise from a list of 15 standardized phrases. Intensity of breathing discomfort was significantly higher in women for a given ventilation, but differences disappeared when ventilation was expressed as a percentage of maximum voluntary ventilation. The dominant qualitative descriptor in both sexes throughout exercise was increased work/effort of breathing. At peak exercise, women were significantly more likely to select the following phrases: "my breathing feels shallow," "I cannot get enough air in," "I cannot take a deep breath in," and "my breath does not go in all the way." Women adopted a more rapid and shallow breathing pattern and had significantly higher end-inspiratory lung volumes relative to total lung capacity throughout exercise relative to men. These findings suggest that men and women do not differ in their perceived quality of dyspnea during submaximal exercise, but subjective differences appear at maximal exercise and may be related, at least in part, to underlying sex differences in breathing patterns and operating lung volumes during exercise.
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada;
Julia M
JM
Cory
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada;
Michele R
MR
Schaeffer
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada;
Sabrina S
SS
Wilkie
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada;
Andrew H
AH
Ramsook
Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada;
Joseph H
JH
Puyat
Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada;
Brandon
B
Arbour
Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada;
Robbi
R
Basran
Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada;
Michael
M
Lam
Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada;
Christian
C
Les
Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada;
Benjamin
B
MacDonald
Department of Kinesiology and Physical Education, McGill University, Montréal, Québec, Canada.
Dennis
D
Jensen
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; jordan.guenette@hli.ubc.ca.
Jordan A
JA
Guenette
D000328:Adult; D004417:Dyspnea; D015444:Exercise / Q000502:physiology*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D012123:Pulmonary Ventilation; D012727:Sex Characteristics; D055815:Young Adult
dyspnea; exercise; sex