A hierarchical logistic regression predicting rapid respiratory rates from post-exertional malaise. Jason et al. 2020

John Mac

Senior Member (Voting Rights)
ABSTRACT
Background
Past research has found high rates of hyperventilation in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), but hyperventilation can be influenced by psychological factors. Clinical respiratory rates have been less frequently assessed.

Aim
This study aimed to identify the predictors of rapid respiratory rates in patients referred an outpatient clinic specializing in ME/CFS.

Methods
Adults (n = 216) referred to an outpatient clinic specializing in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) participated in a two-day cardiopulmonary exercise test.
As part of that evaluation, subjects had resting respiratory rates measured on two consecutive days.
The current study used questionnaires to assess the relationship between tachypnea (rapid respiratory rates) and a variety of domains including post-exertional malaise (PEM), a common complaint in patients with ME/CFS, and psychiatric/somatic symptoms, using hierarchical logistic regression analysis.

Results
PEM was a significant predictor of tachypnea, while psychological/somatic assessments and sedentary behaviors were not significantly predictive of tachypnea.

Conclusions
These findings suggest that respiratory rate may be useful as an objective clinical metric of PEM, and potentially ME/CFS.

https://www.tandfonline.com/doi/abs/10.1080/21641846.2020.1845287
 
Methods
Adults (n = 216) referred to an outpatient clinic specializing in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) participated in a two-day cardiopulmonary exercise test.
That potentially makes it the largest ever sample of mecfs peeps who have had a CPET. I would love to see The results for such a large sample. So far we’ve had a lot of small studies: what we need are large studies, or good meta analyses of small ones.
 
That potentially makes it the largest ever sample of mecfs peeps who have had a CPET. I would love to see The results for such a large sample. So far we’ve had a lot of small studies: what we need are large studies, or good meta analyses of small ones.


This is from 12 May 2020, but I think I have seen it mentioned again in recent weeks (delayed due to Covid).

https://meassociation.org.uk/2020/0...-changes-in-daily-activity-in-me-12-may-2020/

In the ‘interview’ - Dr Clague-Baker of @PhysiosforME says that she hopes this feasibility study will proceed to a much larger study and that they can apply for funding from the NIHR.
 
This is from 12 May 2020, but I think I have seen it mentioned again in recent weeks (delayed due to Covid).

https://meassociation.org.uk/2020/0...-changes-in-daily-activity-in-me-12-may-2020/

In the ‘interview’ - Dr Clague-Baker of @PhysiosforME says that she hopes this feasibility study will proceed to a much larger study and that they can apply for funding from the NIHR.
Discussed here:
https://www.s4me.info/threads/uk-pl...ly-activity-2020-21-clague-baker-et-al.15110/
 

That looks like a different study.

The authors of this study are:

Notes on contributors
Joseph Cotler is a project director of ME/CFS research at the Center for Community Research at DePaul university. He has been conducting research on ME/CFS since 2018.

Dr Ben Z. Katz is a Professor of Pediatrics at the Northwestern University Feinberg School of Medicine and an Attending Physician in the Division of Infectious Diseases at the Ann & Robert H Lurie Children’s Hospital of Chicago. He has been studying chronic fatigue syndrome with the group from DePaul since 2002.

Corine Reurts-Post is a doctor’s research assistant at the CVS/ME Medisch Centrum in Amsterdam, specializing in the treatment of patients with chronic fatigue.

Ruud Vermeulen heads the Research department and the research and treatment of chronic fatigue and exercise physiology at the CVS/ME Medisch Centrum.

Leonard A. Jason has been the principle investigator of ME/CFS research at DePaul university and the Center for Community Research for 25 years.
 
This study looks pretty interesting as it addresses the psychiatric/biological cause with a large group of adult patients (as Simon noted). I don't know when I'll be able to read it, but I got a little confused by the prepositional phrase regarded PEM which can be easily misread as PEM is a symptom of me/cfs *and* psychiatric/somatic symptoms.

The current study used questionnaires to assess the relationship between tachypnea (rapid respiratory rates) and a variety of domains including post-exertional malaise (PEM), a common complaint in patients with ME/CFS, and psychiatric/somatic symptoms, using hierarchical logistic regression analysis.

Although, I must admit I can't remember ever hyperventilating. It seems possible I might cross the thresshold of 20 breaths in minute when it's driven by tachycardia, a more common symptom of mine.
 
I haven't read the study yet, but assuming the finding is correct, there's faster breathing in PEM

Factors that affect breathing rate: age, gender, size and weight, exercise, anxiety, pain, the effect of some medicines, smoking habits and excitement level, infections, sepsis

The pain of PEM could possibly be the cause of the finding of faster breathing. But might be more that the body is under stress somehow - it thinks it is exercising when we are just lying down, or it thinks it is fighting an infection.

Although, I must admit I can't remember ever hyperventilating. It seems possible I might cross the thresshold of 20 breaths in minute when it's driven by tachycardia, a more common symptom of mine.
Same. I'm pretty sure an elevated resting heart rate is correlated with PEM.

Both exercise and infections can increase both breathing rate and heart rate.
 
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