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The effects of sodium oxybate on core body and skin temperature regulation in narcolepsy.
van der Heide, A, Donjacour, CE, Pijl, H, Reijntjes, RH, Overeem, S, Lammers, GJ, Van Someren, EJ, Fronczek, R
Journal of sleep research. 2015;(5):566-75
Abstract
Patients suffering from narcolepsy type 1 show altered skin temperatures, resembling the profile that is related to sleep onset in healthy controls. The aim of the present study is to investigate the effects of sodium oxybate, a widely used drug to treat narcolepsy, on the 24-h profiles of temperature and sleep-wakefulness in patients with narcolepsy and controls. Eight hypocretin-deficient male narcolepsy type 1 patients and eight healthy matched controls underwent temperature measurement of core body and proximal and distal skin twice, and the sleep-wake state for 24 h. After the baseline assessment, 2 × 3 g of sodium oxybate was administered for 5 nights, immediately followed by the second assessment. At baseline, daytime core body temperature and proximal skin temperature were significantly lower in patients with narcolepsy (core: 36.8 ± 0.05 °C versus 37.0 ± 0.05 °C, F = 8.31, P = 0.01; proximal: 33.4 ± 0.26 °C versus 34.3 ± 0.26 °C, F = 5.66, P = 0.03). In patients, sodium oxybate administration increased proximal skin temperature during the day (F = 6.46, P = 0.04) to a level similar as in controls, but did not affect core body temperature, distal temperature or distal-proximal temperature gradient. Sodium oxybate administration normalised the predictive value of distal skin temperature and distal-proximal temperature gradient for the onset of daytime naps (P < 0.01). In conclusion, sodium oxybate administration resulted in a partial normalisation of the skin temperature profile, by increasing daytime proximal skin temperature, and by strengthening the known relationship between skin temperature and daytime sleep propensity. These changes seem to be related to the clinical improvement induced by sodium oxybate treatment. A causal relationship is not proven.
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Availability of self-recorded axillary temperature for assessment of thermic effects of food: relationship between HDL-cholesterol level and postprandial thermoregulation in type 2 diabetic patients.
Suzuki, S, Nishio, SI, Ishii, H, Sato, A, Takeda, T, Komatsu, M
Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association. 2012;(2):96-100
Abstract
AIMS: The present study was performed to develop a simple procedure for assessment of body temperature and to determine whether postprandial thermoregulation is related to metabolic regulation in diabetic patients. METHODS We examined 101 male and female subjects with diabetes. Axillary temperature was measured prior to and after all meals (3 meals per day) and self-recorded for 1 week. The averages were calculated. Positive postprandial thermoregulation (PPT) was defined as a pattern in which each of 3 average postprandial temperatures was higher than the corresponding 3 preprandial temperatures. Negative postprandial thermoregulation (NPT) was defined as the pattern except for PPT. RESULTS A significant increase in postprandial temperature was observed. With the exception of high-density lipoprotein (HDL)-cholesterol levels, there were no relationships between the categorized postprandial thermoregulation and other factors, including age, sex, body mass index, thyroid function, HbA1c, diabetic complications, lipid metabolism, and calorie intake. Logistic analysis indicated an independent positive relation between HDL-cholesterol and PPT. CONCLUSION A simple method for measurement of body temperature indicated that HDL-cholesterol level was predominantly associated with thermic effects of food in diabetic patients, while other metabolic factors showed no such relations. HDL-cholesterol may affect the postprandial regulation of body temperature in diabetic patients.
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Marginal effects of a large caffeine dose on heat balance during exercise-heat stress.
Ely, BR, Ely, MR, Cheuvront, SN
International journal of sport nutrition and exercise metabolism. 2011;(1):65-70
Abstract
UNLABELLED The use of caffeine supplements in athletic and military populations has increased in recent years. Excessive caffeine consumption in conjunction with exercise in a hot environment may predispose individuals to heat illness. PURPOSE To examine heat balance induced by a large dose of caffeine during exercise in a hot environment. METHODS Ten men, not heat acclimated and not habitual caffeine users, consumed either caffeine (CAF; 9 mg/kg) or placebo (PLA) before performing cycle-ergometer exercise for 30 min at 50% VO2peak in a 40 °C, 25% relative humidity environment while body temperature (core and skin) and ratings of thermal comfort (TC) were monitored. Heat-exchange variables were calculated using partitional calorimetry and thermometry. RESULTS Mean body temperature (Tb) was higher (p < .05) with CAF (37.18 ± 0.15 °C) than with PLA (36.93 ± 0.15 °C) at the start of exercise. Heat production was slightly higher (~8 W, p < .05) with CAF. There were no differences in heat storage, dry heat gains, TC, or Tb during exercise. CONCLUSIONS A caffeine dose of 9 mg/kg does not appreciably alter heat balance during work in a hot environment. The small increase in Tb observed with CAF was undetected by the participants and is unlikely to increase physiological strain sufficiently to affect endurance performance or risk of heat illness.
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Effects of encouraged water drinking on thermoregulatory responses after 20 days of head-down bed rest in humans.
Sato, M, Kanikowska, D, Iwase, S, Shimizu, Y, Inukai, Y, Nishimura, N, Sugenoya, J
International journal of biometeorology. 2009;(5):443-9
Abstract
We tested the hypothesis that encouraged water drinking according to urine output for 20 days could ameliorate impaired thermoregulatory function under microgravity conditions. Twelve healthy men, aged 24 +/- 1.5 years (mean +/- SE), underwent -6 degrees head-down bed rest (HDBR) for 20 days. During bed rest, subjects were encouraged to drink the same amount of water as the 24-h urine output volume of the previous day. A heat exposure test consisting of water immersion up to the knees at 42 degrees C for 45 min after a 10 min rest (baseline) in the sitting position was performed 2 days before the 20-day HDBR (PRE), and 2 days after the 20-day HDBR (POST). Core temperature (tympanic), skin temperature, skin blood flow and sweat rate were recorded continuously. We found that the -6 degrees HDBR did not increase the threshold temperature for onset of sweating under the encouraged water drinking regime. We conclude that encouraged water drinking could prevent impaired thermoregulatory responses after HDBR.
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Fluid intake during wheelchair exercise in the heat: effects of localized cooling garments.
Goosey-Tolfrey, VL, Diaper, NJ, Crosland, J, Tolfrey, K
International journal of sports physiology and performance. 2008;(2):145-56
Abstract
BACKGROUND Wheelchair tennis players, competing in hot and humid environments, are faced with an increased risk of heat-related illness and impaired performance. This study examined the effects of head and neck cooling garments on perceptions of exertion (RPE), thermal sensation (TS), and water consumption during wheelchair exercise at 30.4 +/- 0.6 degrees C. METHODS Eight highly trained wheelchair tennis players (1 amputee and 7 spinal cord injured) completed two 60-min, intermittent sprint trials; once with cooling (COOL) and once without cooling (CON) in a balanced cross-over design. Players could drink water ad libitum at five predetermined intervals during each trial. Heart rate, blood lactate concentration, peak speed, TS, and RPE were recorded during the trials. Body mass and water consumption were measured before and after each trial. RESULTS Water consumption was lower in COOL compared with CON (700 +/- 393 mL vs. 1198 +/- 675 mL respectively; P = 0.042). Trends in data suggested lower RPE and TS under COOL conditions (N.S.). Total sweat losses ranged from 200 to 1300 mL; this equated to approximately 1% dehydration after water consumption had been accounted for when averaged across all trials. The ad libitum drinking volumes matched and, in some cases, were greater than the total sweat losses. CONCLUSIONS These results suggest that there is a counterproductive effect of head and neck cooling garments on water consumption. However, despite consuming volumes of water at least equivalent to total sweat loss, changes in body mass suggest an incidence of mild dehydration during wheelchair tennis in the heat.
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Thermic effect of food and beta-adrenergic thermogenic responsiveness in habitually exercising and sedentary healthy adult humans.
Stob, NR, Bell, C, van Baak, MA, Seals, DR
Journal of applied physiology (Bethesda, Md. : 1985). 2007;(2):616-22
Abstract
The thermic effect of food (TEF) is an important physiological determinant of total daily energy expenditure (EE) and energy balance. TEF is believed to be mediated in part by sympathetic nervous system activation and consequent beta-adrenergic receptor (beta-AR) stimulation of metabolism. TEF is greater in habitually exercising than in sedentary adults, despite similar postprandial sympathetic nervous system activation. We determined whether augmented TEF in habitually exercising adults is associated with enhanced peripheral thermogenic responsiveness to beta-AR stimulation. In separate experiments in 22 sedentary and 29 habitually exercising adults, we measured the increase in EE (indirect calorimetry, ventilated hood) during beta-AR stimulation (intravenous isoproterenol: 6, 12, and 24 ng x kg fat-free mass(-1) x min(-1)) and EE before and after a liquid meal (40% of resting EE; 53% carbohydrate, 32% fat, 15% protein). The increase in EE during incremental isoproterenol administration was greater (P = 0.01) in habitual exercisers (0.34 +/- 0.03, 0.54 +/- 0.04, 0.81 +/- 0.05 kJ/min; means +/- SE) than in sedentary adults (0.26 +/- 0.03, 0.40 +/- 0.03, 0.64 +/- 0.04 kJ/min). The area under the TEF response curve was also greater (P = 0.04) in habitual exercisers (160 +/- 9 kJ) than in sedentary adults (130 +/- 11 kJ) and was positively related to beta-AR thermogenic responsiveness (r = 0.32, P = 0.02). We conclude that TEF is related to beta-AR thermogenic responsiveness and that the greater TEF in habitual exercisers is attributable in part to their augmented beta-AR thermogenic responsiveness. Our results also suggest that peripheral thermogenic responsiveness to beta-AR stimulation is a physiological determinant of TEF and hence energy balance in healthy adult humans.
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Sodium-facilitated hypervolemia, endurance performance, and thermoregulation.
Coles, MG, Luetkemeier, MJ
International journal of sports medicine. 2005;(3):182-7
Abstract
The purpose of this study was to investigate the effects of an immediate pre-exercise, orally ingested, sodium load (164 mEq Na+) (IPOSL), equivalent to 10 ml per kilogram of body weight, on plasma volume, endurance performance, and thermoregulation. Fourteen male participants consumed a nearly isotonic (255 mOsm . kg (-1)) IPOSL and a hypotonic (94 mOsm . kg (-1)), no-sodium, placebo beverage (Pl) equivalent to 10 ml . kg (-1) body weight in a randomized design. Subjects cycled at 70 % of maximal work rate, in a 21.0 - 23.3 degrees C lab, for 45 min while cardiovascular and thermoregulatory variables were measured. This was followed by a 15-min performance time trial. IPOSL and Pl ingestion lead to a 3.1 % expansion and a 4.7 % reduction in resting baseline plasma volume, respectively. IPOSL maintained plasma volume during exercise to a greater extent than the Pl at 15 and 30, but not 45 min. There was a significant improvement ( approximately 7.8 %; p < 0.05) in time trial performance following IPOSL. No significant differences were observed for heart rate, core temperature, rate of perceived exertion or total body sweat rate (p > 0.05). In conclusion, IPOSL ingestion increased pre-exercise plasma volumes, maintained 15- and 30-min exercise plasma volumes, and improved an endurance performance time trial better than the Pl with no apparent compromise in thermoregulation.
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Effect of amino acid infusion on central thermoregulatory control in humans.
Nakajima, Y, Takamata, A, Matsukawa, T, Sessler, DI, Kitamura, Y, Ueno, H, Tanaka, Y, Mizobe, T
Anesthesiology. 2004;(3):634-9
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Abstract
BACKGROUND Administration of protein or amino acids enhances thermogenesis, presumably by stimulating oxidative metabolism. However, hyperthermia results even when thermoregulatory responses are intact, suggesting that amino acids also alter central thermoregulatory control. Therefore, the authors tested the hypothesis that amino acid infusion increases the thermoregulatory set point. METHODS Nine male volunteers each participated on 4 study days in randomized order: (1) intravenous amino acids infused at 4 kJ x kg(-1) x h(-1) for 2.5 h combined with skin-surface warming, (2) amino acid infusion combined with cutaneous cooling, (3) saline infusion combined with skin-surface warming, and (4) saline infusion combined with cutaneous cooling. RESULTS Amino acid infusion increased resting core temperature by 0.3 +/- 0.1 degrees C (mean +/- SD) and oxygen consumption by 18 +/- 12%. Furthermore, amino acid infusion increased the calculated core temperature threshold (triggering core temperature at a designated mean skin temperature of 34 degrees C) for active cutaneous vasodilation by 0.3 +/- 0.3 degrees C, for sweating by 0.2 +/- 0.2 degrees C, for thermoregulatory vasoconstriction by 0.3 +/- 0.3 degrees C, and for thermogenesis by 0.4 +/- 0.5 degrees C. Amino acid infusion did not alter the incremental response intensity (i.e., gain) of thermoregulatory defenses. CONCLUSIONS Amino acid infusion increased the metabolic rate and the resting core temperature. However, amino acids also produced a synchronous increase in all major autonomic thermoregulatory defense thresholds; the increase in core temperature was identical to the set point increase, even in a cold environment with amble potential to dissipate heat. In subjects with intact thermoregulatory defenses, amino acid-induced hyperthermia seems to result from an increased set point rather than increased metabolic rate per se.
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Hypohydration effects on thermoregulation during moderate exercise in the cold.
Kenefick, RW, Mahood, NV, Hazzard, MP, Quinn, TJ, Castellani, JW
European journal of applied physiology. 2004;(4-5):565-70
Abstract
Hyperosmotic hypovolemia impairs vasoconstriction during sedentary cold exposure. The purpose of this study was to determine whether hypohydration alters thermoregulation and cardiovascular responses to exercise in cold air. On four occasions, eight males [35.1 (2.7) years, 175.5 (3.1) cm, 73.3 (2.6) kg, 57.2 (2.6) ml kg(-1) min(-1) maximal oxygen uptake (VO(2max)), 19.6 (2.4)% fat] walked, in t-shirt, shorts, and shoes, at 50% VO(2max), for 60 min in either a 4 degrees C (Cold) or a 25 degrees C (Temperate) environment in both hypohydrated state (HYPO, -4% body mass) and euhydrated state (EU). During exercise-cold stress, rectal temperature ( T(re)), mean weighted skin temperature, heart rate (HR), cardiac output (CO), and stroke volume (SV) were measured every 20 min. Mean weighted skin temperature values were not different between HYPO and EU but were lower ( P<0.05) in Cold versus Temperate trials. T(re) was not different ( P>0.05) between HYPO-Cold and EU-Cold. CO and SV were not different within hydration states and were not different between Cold and Temperate trials ( P<0.05). HR was not different between HYPO-Cold and EU-Cold. These data demonstrate that moderate intensity exercise in the cold while hypohydrated does not alter metabolic heat production, skin temperatures and heat loss, nor does it increase thermoregulatory and cardiovascular strain.
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Effects of hyperoxia on thermoregulatory responses during feet immersion to hot water in humans.
Yamashita, K, Tochihara, Y
Journal of physiological anthropology and applied human science. 2003;(4):181-5
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Abstract
This study examined effects of hyperoxia on thermoregulatory responses. Eight healthy male students (23.5+/-1.8 yrs) were involved in this study. They immersed their legs in a hot water bath (42 degrees C) for 60 minutes in a climate chamber. The conditions of oxygen concentration of a chamber were set at 21% (control), 25% (25%O(2)), and 30% (30%O(2)). Ambient temperature and relative humidity was maintained at 25 degrees C and 50% in every condition, respectively. Measurements included rectal temperature (Tre), skin temperature at 7 sites, laser Doppler flowmeter (LDF) on the back and forearm as an index of skin blood flow, heart rate, local sweat rate (Msw) on the back and forearm, and total body weight loss (BWL). Increases of Tre at 25%O(2) and 30%O(2) tended to be lower during the immersion than in the control. Mean skin temperature (Tsk) of the control increased gradually after the onset of sweating, while the Tsks at 25%O(2) and 30%O(2) maintained a constant level during sweating. LDFs on the forearm at 25%O(2) and 30%O(2) showed lower increases compared with the control. No significant differences in Msw on the back and the forearm and BWL were seen among the conditions. These results suggested that hyperoxia could not affect sweating responses but elicit an inhibitory effect on thermoregulatory skin blood flow.