TOPLINE:

Dysfunctional breathing and/or hyperventilation during cardiopulmonary exercise testing (CPET) is significantly more common in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) than in those without ME/CFS, a new study showed.

METHODOLOGY:

• Researchers used data from 2-day CPET on an upright bicycle ergometer to compare 57 adult patients with ME/CFS (mean age, 39 years; 81% female; mean BMI, 24) to 25 matched controls who did not have ME/CFS and did not exercise regularly. In addition to fatigue, ME/CFS symptoms include dyspnea and mental fog.
• All participants had a respiratory exchange ratio > 1.05 and comparable Godin Leisure-Time Exercise Questionnaire activity scores.
• Primary outcomes included the incidence of dysfunctional breathing, defined as ≥ 15% oscillations in ventilation for ≥ 60% of the exercise duration or an irregular pattern of respiratory rate, tidal volume, and ventilation; and the incidence of hyperventilation, defined as end-tidal CO₂ < 34 mm Hg persisting during low-intensity exercise.
• Secondary outcomes included peak oxygen consumption and ventilatory efficiency, assessed as the minute ventilation/ventilation CO₂ (VE/VCO₂) slope.

TAKEAWAY:

• Patients with ME/CFS were more likely than control individuals to have dysfunctional breathing (42% vs 16%; P < .02), hyperventilation (32% vs 4%; P < .01), or both dysfunctional breathing and hyperventilation (16% vs 0%).
• Mean peak oxygen consumption was similar between the groups at 22.3 mL/kg/min for patients with ME/CFS and 23.4 mL/kg/min for control individuals.
• Patients with ME/CFS and hyperventilation had significantly higher VE/VCO₂ ratios than those without hyperventilation (P < .001).
• About 58% of patients with ME/CFS had either hyperventilation or dysfunctional breathing compared with 16% of control individuals (P = .001). Among ME/CFS group members with hyperventilation, 50% also had dysfunctional breathing and 61% had elevated VE/VCO₂ slopes.

IN PRACTICE:

“Dysfunctional breathing and hyperventilation are common in patients with ME/CFS and could present a new therapeutic target for these patients,” the investigators of the study wrote.

“Future studies with breathing retraining techniques should be considered to reduce symptoms and improve exercise performance,” they added.

SOURCE:

The study was led by Donna M. Mancini, MD, Icahn School of Medicine at Mount Sinai, New York City. It was published online on November 10 in Frontiers in Medicine.

LIMITATIONS:

The study was limited by the absence of clear criteria for dysfunctional breathing. Because the mouthpiece often caused hyperventilation, a facemask would likely have been better tolerated. ME/CFS lacked a definitive biomarker and was diagnosed clinically over time.

DISCLOSURES:

The investigators of the study reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.