Breath-Hold Diving.

Published on Mar 25, 2018in Comprehensive Physiology6.604
· DOI :10.1002/CPHY.C160008
John R. Fitz-Clarke4
Estimated H-index: 4
(Dal: Dalhousie University)
: Breath-hold diving is practiced by recreational divers, seafood divers, military divers, and competitive athletes. It involves highly integrated physiology and extreme responses. This article reviews human breath-hold diving physiology beginning with an historical overview followed by a summary of foundational research and a survey of some contemporary issues. Immersion and cardiovascular adjustments promote a blood shift into the heart and chest vasculature. Autonomic responses include diving bradycardia, peripheral vasoconstriction, and splenic contraction, which help conserve oxygen. Competitive divers use a technique of lung hyperinflation that raises initial volume and airway pressure to facilitate longer apnea times and greater depths. Gas compression at depth leads to sequential alveolar collapse. Airway pressure decreases with depth and becomes negative relative to ambient due to limited chest compliance at low lung volumes, raising the risk of pulmonary injury called "squeeze," characterized by postdive coughing, wheezing, and hemoptysis. Hypoxia and hypercapnia influence the terminal breakpoint beyond which voluntary apnea cannot be sustained. Ascent blackout due to hypoxia is a danger during long breath-holds, and has become common amongst high-level competitors who can suppress their urge to breathe. Decompression sickness due to nitrogen accumulation causing bubble formation can occur after multiple repetitive dives, or after single deep dives during depth record attempts. Humans experience responses similar to those seen in diving mammals, but to a lesser degree. The deepest sled-assisted breath-hold dive was to 214 m. Factors that might determine ultimate human depth capabilities are discussed. © 2018 American Physiological Society. Compr Physiol 8:585-630, 2018.
📖 Papers frequently viewed together
42 Citations
10 Citations
#1Thomas KjeldH-Index: 5
#2T. JattuH-Index: 1
Last. Niels Vidiendal Olsen (UCPH: University of Copenhagen)H-Index: 31
view all 6 authors...
Free diving is associated with extreme hypoxia. This study evaluated the combined effect of maximal static breath holding and underwater swimming on plasma biomarkers of tissue hypoxemia: erythropoietin, neuron-specific enolase and S100B, C-reactive protein, pro-atrial natriuretic peptide, and troponin T. Venous blood samples were obtained from 17 competing free divers before and 3 h after sessions of static apnea and underwater swimming. The heart was evaluated by echocardiography. Static apnea...
15 CitationsSource
#1Andrea Sivieri (University of Brescia)H-Index: 4
#2Nazzareno Fagoni (University of Brescia)H-Index: 10
Last. Guido Ferretti (University of Brescia)H-Index: 33
view all 6 authors...
Purpose Cardiovascular responses during resting apnoea include three phases: (1) a dynamic phase of rapid changes, lasting at most 30 s; (2) a subsequent steady phase; and (3) a further dynamic phase, with a continuous decrease in heart rate (HR) and an increase in blood pressure. The interpretation was that the end of the steady phase corresponds to the physiological apnoea breaking point. This being so, during exercise apnoeas, the steady phase would be shorter, and the rate of cardiovascular ...
17 CitationsSource
#1Guillaume Costalat (University of Rouen)H-Index: 7
#2Aurélien Pichon (University of Paris)H-Index: 23
Last. Frédéric Lemaître (University of Rouen)H-Index: 17
view all 5 authors...
Abstract Trained breath-hold divers (BHDs) are exposed to repeated bouts of intermittent hypoxia and hypercapnia during prolonged breath-holding. It has thus been hypothesized that their specific training may develop enhanced chemo-responsiveness to hypoxia associated with reduced ventilatory response to hypercapnia. Hypercapnic ventilatory responses (HCVR) and hypoxic ventilatory responses at rest (HVR r ) and exercise (HVR e ) were assessed in BHDs ( n = 7) and a control group of non-divers (N...
7 CitationsSource
7 Citations
#1Emmanuel GemppH-Index: 16
#2Fabrice SbardellaH-Index: 1
Last. Pierre LougeH-Index: 10
view all 4 authors...
Haemoptysis and pulmonary oedema following deep breath-hold diving have been described in recent years. We describe the case of a 33-year-old healthy military diver who presented symptoms suggestive of pulmonary oedema after two breathhold dives, the first lasting 0.5-1 min and the second 1-2 min, to 6 metres' depth in the sea. The diagnosis was promptly confirmed with chest computed tomography showing bilateral interstitial infiltrates in the upper regions of the lungs. To our knowledge, this i...
1 Citations
#1Ornella PiazzaH-Index: 20
#2Rosalba Romano (UNISA: University of Salerno)H-Index: 8
Last. Edoardo De RobertisH-Index: 17
view all 5 authors...
summary Donation after cardiac death is defined as organ donation once death is declared after irreversible cessation of circulatory and respiratory functions. The aim of this subjective review is to evaluate the outcome of grafts and recipients in consideration of the length of ischaemia and individuating those who can be considered suitable donors after cardiac arrest. Our main conclusion is that graft and patient survival are comparable either if the organs come from non-heart-beating-donors ...
7 CitationsSource
#1Tomas A. Schiffer (KI: Karolinska Institutet)H-Index: 12
#2Peter Lindholm (KI: Karolinska Institutet)H-Index: 19
Breath-hold divers report transient, severe neurological symptoms that could be caused by arterial gas embolism after glossopharyngeal insufflation. This technique is often used to overinflate the lungs and stretch the chest prior to breath-holding and can increase the transpulmonary pressure to around 7–8 kPa, so introducing risk of pulmonary barotrauma. Airway pressure, blood pressure and static spirometry (nitrogen dilution) were measured simultaneously in ten subjects attempting to identify ...
7 CitationsSource
#1George E. Billman (OSU: Ohio State University)H-Index: 53
Power spectral analysis of the beat-to-beat variations of heart rate or the heart period (R–R interval) has become widely used to quantify cardiac autonomic regulation (Appel et al., 1989; Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology, 1996; Berntson et al., 1997; Denver et al., 2007; Thayler et al., 2010; Billman, 2011). This technique partitions the total variance (the “power”) of a continuous series of beats into its frequency ...
600 CitationsSource
#1BR Raghavendra (Swami Vivekananda Yoga Anusandhana Samsthana)H-Index: 6
#2S. Telles (Swami Vivekananda Yoga Anusandhana Samsthana)H-Index: 1
Last. Pailoor Subramanya (Swami Vivekananda Yoga Anusandhana Samsthana)H-Index: 9
view all 6 authors...
Background/Aims: One month of yoga training has been shown to reduce the pulse rate voluntarily without using external cues. Hence, the present study was designed to understand the strategies used by yoga practitioners and autonomic changes associated with voluntary heart rate reduction. Materials and Methods: Fifty volunteers (group mean age ± S.D., 25.4 ± 4.8 years; 25 males) were assessed in two trials on separate days. Each trial was for 12 minutes, with a 'pre' state and 'during' state of 6...
7 CitationsSource
#1Rachael Brown (University of Western Sydney)H-Index: 11
#2Cheree James (University of Western Sydney)H-Index: 11
Last. Vaughan G. Macefield (University of Western Sydney)H-Index: 51
view all 4 authors...
The sympathetic innervation of the skin primarily subserves thermoregulation, but the system has also been commandeered as a means of expressing emotion. While it is known that the level of skin sympathetic nerve activity (SSNA) is affected by anxiety, the majority of emotional studies have utilized the galvanic skin response as a means of inferring increases in SSNA. The purpose of the present study was to characterize the changes in SSNA when showing subjects neutral or emotionally-charged ima...
701 CitationsSource
Cited By32
#1Xavier Woorons (Artois University)H-Index: 13
#2François Billaut (Laval University)H-Index: 23
Last. Christine Lamberto (University of Paris)H-Index: 15
view all 3 authors...
The goal of this study was to assess the effects of repeated running bouts with end-expiratory breath holding (EEBH) up to the breaking point on muscle oxygenation. Eight male runners participated in three randomised sessions each including two exercises on a motorised treadmill. The first exercise consisted in performing 10–12 running bouts with EEBH of maximum duration either (separate sessions) at 60% (active recovery), 80% (passive recovery) or 100% (passive recovery) of the maximal aerobic ...
#1J. Chris McKnight (St And: University of St Andrews)H-Index: 2
#2Eric Mulder (Mid Sweden University)H-Index: 4
Last. Frank Pernett (Mid Sweden University)H-Index: 1
view all 14 authors...
Continuous measurements of haemodynamic and oxygenation changes in free living animals remain elusive. However, developments in biomedical technologies may help to fill this knowledge gap. One such technology is continuous-wave near-infrared spectroscopy (CW-NIRS)-a wearable and non-invasive optical technology. Here, we develop a marinized CW-NIRS system and deploy it on elite competition freedivers to test its capacity to function during deep freediving to 107 m depth. We use the oxyhaemoglobin...
7 CitationsSource
Many recreational divers suffer medical conditions, potentially jeopardizing their safety. To scale down risks, medical examinations are mandatory and overwhelmingly performed using bicycle ergometry, which overlooks some important aspects of diving. Searching ergometric systems that better address the underwater environment, a systematic literature search was conducted using the keywords ‘diving’, ‘fitness’, ‘ergometry’, and ‘exertion’. All presented alternative systems found convincingly descr...
#1Heng Peng (Waseda University)
#2Takuji Kawamura (Waseda University)H-Index: 13
Last. Isao Muraoka (Waseda University)H-Index: 15
view all 6 authors...
Abstract null null Purpose null The present study aimed to measure diving response, CO2 sensitivity and forced vital capacity in male and female breath-hold divers (BHDs), and to determine their effect on breath-hold diving performance. null null null Methods null This study included 8 non-divers (NDs, 4 males and 4 females) and 15 BHDs (7 males and 8 females). For NDs, diving response was measured during breath-holding with facial immersion, whereas for BHDs CO2 sensitivity was also measured. n...
#1Philipp Wolber (University of Cologne)H-Index: 3
#2Moritz F. Meyer (University of Duisburg-Essen)H-Index: 10
Last. Maria Grosheva (University of Cologne)H-Index: 19
view all 7 authors...
INTRODUCTION The Frenzel maneuver describes a technique for middle ear equalizing which is frequently used by apnea divers. It offers advantages compared to the most commonly used techniques such as the Valsalva or Toynbee maneuver. Until now, there is insufficient literature about the pressure dynamics and Eustachian tube (ET) function during the Frenzel maneuver. The aim of the present study was to characterize the ET function during the Frenzel maneuver. MATERIALS AND METHODS By means of an e...
#1Christian Paech (Leipzig University)H-Index: 7
#2Roman Gebauer (Leipzig University)H-Index: 21
view all 13 authors...
While swimming represents a popular recreational activity, the immersion of the human body into the water requires a complex physiologic adaption of the whole cardiopulmonary and circulatory system. While this sport is regarded as beneficial, especially in cardiovascular patients, current guidelines hypothesized a possible hazardous effect of swimming and especially diving in patients with univentricular hearts after Fontan palliation. Yet, actual data to underline or contradict these assumption...
#1Alexander Patrician (UBC: University of British Columbia)H-Index: 8
#2Željko Dujić (University of Split)H-Index: 6
Last. Philip N. Ainslie (UBC: University of British Columbia)H-Index: 65
view all 5 authors...
Breath-hold diving involves highly integrative physiology and extreme responses to both exercise and asphyxia during progressive elevations in hydrostatic pressure. With astonishing depth records exceeding 100 m, and up to 214 m on a single breath, the human capacity for deep breath-hold diving continues to refute expectations. The physiological challenges and responses occurring during a deep dive, highlight the coordinated interplay of oxygen conservation, exercise economy and hyperbaric manag...
1 CitationsSource
#1Alexander Patrician (UBC: University of British Columbia)H-Index: 8
#2Christopher Gasho (UBC: University of British Columbia)H-Index: 1
Last. Philip N. Ainslie (UBC: University of British Columbia)H-Index: 65
view all 9 authors...
In this case study, we evaluate the unique physiological profiles of two world-champion breath-hold divers. At close-to current world record depths, the extreme physiological responses to both exer...
1 CitationsSource
#1Alexander Patrician (UBC: University of British Columbia)H-Index: 8
#2Boris Spajić (University of Zagreb)H-Index: 1
Last. Philip N. Ainslie (UBC: University of British Columbia)H-Index: 65
view all 13 authors...
NEW FINDINGS What is the central question of this study? How does deep breath-hold diving impact cardiopulmonary function, both acutely and over the subsequent 2.5 hours post-dive? What is the main finding and its importance? Breath-hold diving to depths below residual volume are associated with acute impairments in pulmonary gas exchange, that typically resolve within 2.5 hours. These data provide new insight into the behavior of the lungs and pulmonary vasculature following deep diving. ABSTRA...
3 CitationsSource