Circadian patterns of peak expiratory flow in healthy male individuals from different age groups

Bhagvat V. Shinde; Farahanaz B. Irani; Prema Joshi

doi:10.18203/2320-6012.ijrms20253605

Authors

Bhagvat V. Shinde Department of Physiology, MVP’s Dr. Vasantrao Pawar Medical College, Adgaon, Maharashtra, India
Farahanaz B. Irani Department of Physiology, MGM Medical College, Chhatrapati Sambhajingar, Maharashtra, India
Prema Joshi Department of Physiology, MVP’s Dr. Vasantrao Pawar Medical College, Adgaon, Maharashtra,

DOI:

https://doi.org/10.18203/2320-6012.ijrms20253605

Keywords:

Aging, Diurnal variation, Peak expiratory flow rate, Pulmonary function

Abstract

Background: The human respiratory system exhibits circadian variation, with peak expiratory flow rate (PEFR) typically lowest in the early morning and highest in the evening. This study aimed to assess diurnal variations in PEFR across different age groups and evaluate the influence of aging on this physiological rhythm.

Methods: A cross-sectional study was conducted on 145 healthy male volunteers aged 18–50 years, divided into two groups: 18-30 years (n=78) and 31-50 years (n=67). PEFR was recorded at four time points (7:00 AM, 12:00 PM, 7:00 PM, and 10:00 PM) over two days using mini-Wright’s peak flow meters. Data were analyzed using unpaired t-test, ANOVA, and Tukey’s post hoc test.

Results: Both groups exhibited significant diurnal variation in PEFR (p<0.0001), with morning troughs and evening peaks. The younger group consistently showed higher PEFR values at all-time points (p<0.0001) and a greater amplitude of variation. The largest increase occurred between 7 AM and 7 PM. No significant differences were observed between 12 pm and 10 pm in either group, indicating a plateau after the evening peak. BMI was comparable between groups, ruling it out as a confounder.

Conclusions: PEFR demonstrates a clear circadian pattern in healthy adult males, with aging associated with reduced values and diminished amplitude of variation. These findings underscore the importance of considering time-of-day and age in pulmonary function assessment. Clinically, they support time-based monitoring and interventions, particularly in conditions like asthma, where diurnal variation is exaggerated.

Metrics

Metrics Loading ...

References

Aggarwal AN, Gupta D, Jindal SK. Diurnal variation in peak expiratory flow in healthy young adults. Indian J Chest Dis Allied Sci. 2000;42(1):15-19.

Jena SK, Mohanty A, Mania RN, Pal A. Diurnal variation of peak expiratory flow rate in healthy young adults: A gender-based study. J Medi Soci. 2017;31(2):104-8.

Jahan W, Bhuyan P, Bharali R. Diurnal Variation of Peak Expiratory Flow Rate in Healthy Young Adults of North East of India. J Med Sci Clin Res. 2016;4(3):9676-81. DOI: https://doi.org/10.18535/jmscr/v4i3.31

Jena SK, Mohanty A, Mania RN, Pal A. Diurnal variation of peak expiratory flow rate in healthy young adults: A gender-based study. Journal of Medical Society. 2017;31(2):104-108. DOI: https://doi.org/10.4103/jms.jms_50_16

Teramoto S. Influence of age on diurnal variability in measurements of spirometric indices and respiratory pressures. J Asthma. 1999;36(6):487-492. DOI: https://doi.org/10.3109/02770909909054554

Zhang X. Age-related circadian rhythm and variability of large- and small-airway function in healthy non-smoking adults: Data from 7-day diurnal and nocturnal home monitoring using an electronic portable spirometer. Front Public Health. 2022;10:946988. DOI: https://doi.org/10.3389/fpubh.2022.946988

Barnes PJ. Circadian variation in airway function. The Am J Medi. 1985;79(6):5-9. DOI: https://doi.org/10.1016/0002-9343(85)90080-4

Monk TH, Buysse DJ, Reynolds CF, Berga SL, Jarrett DB, Begley AE, et al. Circadian rhythms in human performance and mood under constant conditions. J Sleep Res. 1997;6(1):9-18. DOI: https://doi.org/10.1046/j.1365-2869.1997.00023.x

Scheer FAJL, Hilton MF, Mantzoros CS, Shea SA. Adverse metabolic and cardiovascular consequences of circadian misalignment. PNAS. 2009;106(11):4453-8. DOI: https://doi.org/10.1073/pnas.0808180106

Janssens JP, Pache JC, Nicod LP. Physiological changes in respiratory function associated with ageing. Eur Respir J. 1999;13(1):197-205. DOI: https://doi.org/10.1034/j.1399-3003.1999.13a36.x

Sharma G, Goodwin J. Effect of aging on respiratory system physiology and immunology. Clin Interv Aging. 2006;1(3):253-60. DOI: https://doi.org/10.2147/ciia.2006.1.3.253

Knudson RJ, Lebowitz MD, Holberg CJ, Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis. 1983;127(6):725-34.

Mortola JP. Breathing around the clock: an overview of the circadian pattern of respiration. Eur J Appl Physiol. 2004;91(2-3):119-29. DOI: https://doi.org/10.1007/s00421-003-0978-0

Hetzel MR, Clark TJH. Comparison of normal and asthmatic circadian rhythms in peak expiratory flow rate. Thorax. 1980;35(10):732-8. DOI: https://doi.org/10.1136/thx.35.10.732

Spengler CM, Shea SA. Endogenous circadian rhythm of pulmonary function in healthy humans. Am J Respir Crit Care Med. 2000;162(3 Pt 1):1038-46. DOI: https://doi.org/10.1164/ajrccm.162.3.9911107

Turner-Warwick M. Epidemiology of nocturnal asthma. Am J Med. 1988;85(1B):6-8. DOI: https://doi.org/10.1016/0002-9343(88)90231-8

Kraft M, Martin RJ. Chronobiology and chronotherapy in asthma. Clin Chest Med. 1995;16(4):699-713. DOI: https://doi.org/10.1016/S0272-5231(21)01172-2