Intermittent hypoxic therapy in the treatment of bronchial asthma patients with various chronotypes

The purpose of the paper is to identify the efficacy of normobaric interval hypoxic therapy in the treatment and rehabilitation of bronchial asthma patients, taking into account their individual characteristics of circadian rhythms. Materials and Methods. The authors examined the indicators of the functional respiratory system and oxygen regimes of the body, lipid peroxidation and antioxidant system and spirometric data in 145 patients with bronchial asthma. Patients' chronotypes were also determined. Bronchodilators were used to carry out individual peak flowmetry and to determine airway sensitivity, which made it possible to reveal the bronchial tree reactivity. In order to identify individual intolerance to the hypoxic factor and to select the optimal oxygen level in the gas mixture all patients underwent a hypoxic test before the hypoxic therapy. Results. The results obtained showed that morning hypoxic therapy sessions had the greatest effect in patients with bronchial asthma. A decrease in the malondialdehyde level indicated a decrease in lipid and protein peroxidation. An increase in the blood glutathione peroxidase and superoxide dismutase rates showed an increase in antioxidant protection. Intermittent normobaric hypoxic therapy improved the body oxygen supply during its transport and contributed to oxygen intake and a hypoxic decrease in the bronchopulmonary system. The hypoxic mixture was chosen individually, taking into account patient's chrono-type, in order to induce the subcompensated hypoxia. However, the morning hours turned out to be optimal for the greatest mobilization of compensatory mechanisms and adaptation to hypoxia in most patients. Conclusion. We consider it necessary to adjust recommendations for the use of intermittent normobaric hypoxic therapy in bronchial asthma patients, taking into account their circadian rhythms, and to recommend conducting hypoxic therapy in the morning and in the afternoon (from 8 a.m. to 3 p.m.).