Skip to main content
Thorax logoLink to Thorax
. 1981 Aug;36(8):618–621. doi: 10.1136/thx.36.8.618

Diurnal variation in airflow obstruction in chronic bronchitis.

K D Dawkins, M F Muers
PMCID: PMC471650  PMID: 6458922

Abstract

Twelve patients fulfilling strict criteria for chronic obstructive bronchitis recorded serial peak expiratory flow rates (PEFR) five times daily for a two-week period. Despite a 9.2% improvement in forced expiratory volume in one second (FEV1) with ipratropium bromide, and an 11.3% improvement with ipratropium bromide plus salbutamol, the inherent diurnal variation in PEFR while on no medication was greater than the improvement caused by either bronchodilator. In the group as a whole, the difference between the highest and the lowest daily PEFR over the two weeks was 24% of the mean daily value. Using cosinor analysis, 10 of the 12 patients showed a significant rhythm in PEFR with a computed mean amplitude between highest and lowest readings of 8.6% of the mean daily value. This is no greater than that found in normal subjects, but is considerably less than the variation in PEFR in patients with bronchial asthma.

Full text

PDF
618

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Benson M. K. Bronchial hyperreactivity. Br J Dis Chest. 1975 Oct;69(0):227–239. doi: 10.1016/0007-0971(75)90090-x. [DOI] [PubMed] [Google Scholar]
  2. Clark T. J., Hetzel M. R. Diurnal variation of asthma. Br J Dis Chest. 1977 Apr;71(2):87–92. doi: 10.1016/0007-0971(77)90087-0. [DOI] [PubMed] [Google Scholar]
  3. Cochrane G. M., Clark J. H. A survey of asthma mortality in patients between ages 35 and 64 in the Greater London hospitals in 1971. Thorax. 1975 Jun;30(3):300–305. doi: 10.1136/thx.30.3.300. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Connolly C. K. Diurnal rhythms in airway obstruction. Br J Dis Chest. 1979 Oct;73(4):357–366. [PubMed] [Google Scholar]
  5. Guberan E., Williams M. K., Walford J., Smith M. M. Circadian variation of F.E.V. in shift workers. Br J Ind Med. 1969 Apr;26(2):121–125. doi: 10.1136/oem.26.2.121. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hetzel M. R., Clark T. J., Branthwaite M. A. Asthma: analysis of sudden deaths and ventilatory arrests in hospital. Br Med J. 1977 Mar 26;1(6064):808–811. doi: 10.1136/bmj.1.6064.808. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hetzel M. R., Clark T. J. Comparison of normal and asthmatic circadian rhythms in peak expiratory flow rate. Thorax. 1980 Oct;35(10):732–738. doi: 10.1136/thx.35.10.732. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hetzel M. R., Clark T. J. Does sleep cause nocturnal asthma? Thorax. 1979 Dec;34(6):749–754. doi: 10.1136/thx.34.6.749. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hetzel M. R., Clark T. J., Houston K. Physiological patterns in early morning asthma. Thorax. 1977 Aug;32(4):418–423. doi: 10.1136/thx.32.4.418. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hetzel M. R., Williams I. P., Shakespeare R. M. Can patients keep their own peak-flow records reliably? Lancet. 1979 Mar 17;1(8116):597–599. doi: 10.1016/s0140-6736(79)91019-5. [DOI] [PubMed] [Google Scholar]
  11. LEWINSOHN H. C., CAPEL L. H., SMART J. Changes in forced expiratory volumes throughout the day. Br Med J. 1960 Feb 13;1(5171):462–464. doi: 10.1136/bmj.1.5171.462. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Perks W. H., Tams I. P., Thompson D. A., Prowse K. An evaluation of the mini-Wright peak flow meter. Thorax. 1979 Feb;34(1):79–81. doi: 10.1136/thx.34.1.79. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Soutar C. A., Costello J., Ijaduola O., Turner-Warwick M. Nocturnal and morning asthma. Relationship to plasma corticosteroids and response to cortisol infusion. Thorax. 1975 Aug;30(4):436–440. doi: 10.1136/thx.30.4.436. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Walford J., Lammers B., Schilling R. S., Hoven van Genderen D., van der Veen Y. G. Diurnal variation in ventilatory capacity. An epidemiological study of cotton and other factory workers employed on shift work. Br J Ind Med. 1966 Apr;23(2):142–148. doi: 10.1136/oem.23.2.142. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Wright B. M. A miniature Wright peak-flow meter. Br Med J. 1978 Dec 9;2(6152):1627–1628. doi: 10.1136/bmj.2.6152.1627. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Zedda S., Sartorelli E. Variability of plethysmographic measurements of airway resistance during the day in normal subjects and in patients with bronchial asthma and chronic bronchitis. Respiration. 1971;28(2):158–166. doi: 10.1159/000192812. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES