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Diurnal variation in bronchial responsiveness in asthmatic children

P D Sly, L I Landau

    Pediatric Pulmonology
    |November 1, 1986
    PubMed

    Insights

    Asthmatic children show diurnal variation in bronchial responsiveness. Airway sensitivity to histamine peaks at 4 AM, while cold air challenges show peak sensitivity at 4 PM, regardless of medication.

    Area of Science:

    • Pediatric Pulmonology
    • Circadian Rhythms in Respiratory Disease
    • Asthma Pathophysiology

    Background:

    • Asthma symptoms often exhibit diurnal variations, impacting quality of life.
    • Understanding bronchial responsiveness rhythms is crucial for optimizing asthma management.

    Purpose of the Study:

    • To investigate diurnal variations in bronchial responsiveness in children with asthma.
    • To assess bronchodilator responsiveness and airway sensitivity to stimuli throughout the day.

    Main Methods:

    • Assessed peak expiratory flow rate (PEFR) changes after sympathomimetic inhalation over four weeks.
    • Performed bronchial provocation tests (histamine and cold air) every six hours for 24 hours.

    Main Results:

    • Diurnal variation in bronchodilator responsiveness observed in 55% of patients.
    • Bronchodilation was significantly greater in the morning.
    • Airway sensitivity to histamine peaked at 4 AM, and to cold air at 4 PM.

    Conclusions:

    • A clear diurnal variation exists in bronchial responsiveness in asthmatic children.
    • This variation is independent of baseline airway caliber and consistent medication use.
    • Timing of airway hyperresponsiveness differs based on the provocative stimulus.

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