Enhanced air...does it help fatigue?

[Searcaigh]

Personally I use Nitrox for all of my rec dives deeper than 16M, primarily to give me longer bottom times as all of our local dives are square profile.

I always feel better after finding and photographing nudibranchs during a dive, perhaps that is the secret

Seriously though, irrespective of what gas I breath, my local diving is harder work than say diving Lembeh Straits, as locally like many of us, we have to haul all of our own gear from car to boat, which can mean a simple walk of a few hundred meters down onto a jetty or a swim out to a moored boat (not my preferred choice given all the gear I take with me). All of this in reverse after the dives, plus rinsing of gear etc, I always sleep well after a days diving.

 

[DevonDiver]

....I'm not aware of immune system responses to bubbles. ....

You might find this article enlightening, as an introduction:

DCS and the Immune Response | The Complement System and Diving

"Long thought to be a simple process of blockage of vessels and infarction, it has now been shown that there is a tripping of the complement system and the immune system (T- and B- leucocytes) when bubbles form from decompression. This immune response has a domino effect on blood chemistry that leads to marked changes in the tissues long after the bubbles are gone.

​

Work has also been done that shows the importance of early treatment. The longer the period of waiting after a decompression incident, the more blood chemistry changes occur and the greater the damage done,....

....This same process might be the explanation of the excessive fatigue that many divers describe after diving - the fatigue actually being the complement activation damage that is know to occur distant from local bubble sites and the hemoconcentration that occurs".​

The article illustrates that bubbles cause an immune-system response (with predicted damaging consequences in the long term), and also shows how individual tolerances can play a big role in the degree of immune-system (complement system) activation.

From my (very limited) medical understanding, the frequency (number) of bubbles would have a much more direct impact on an immune-system response. Therefore, sub-clinical DCS doesn't present the size of bubbles needed to provoke the symptoms (pain, rash etc) that justify chamber rides; but the quantity of (micro) bubbles can still bring about harmful changes in blood/brain chemistry. The symptoms of these changes is unusual post-dive fatigue, lethargy, sleepiness and decreased vitality.

Preventing the formation of microbubbles, or resolving them at the earliest possible opportunity, may have significant health impacts for divers. Nitrox is one of several important factors that can help reduce decompression stress and the complement/immune system activation that causes unusual fatigue.

More references from the article:

​

Shastri KA, Logue GL, Lundgren CE. Related Articles
In vitro activation of human complement by nitrogen bubbles.
Undersea Biomed Res. 1991 May;18(3):157-65.

Bergh K, Hjelde A, Iversen OJ, Brubakk AO.
Variability over time of complement activation induced by air bubbles in human and rabbit sera.
J Appl Physiol. 1993 Apr;74(4):1811-5.

Ward CA, McCullough D, Fraser WD.
Relation between complement activation and susceptibility to decompression sickness.
J Appl Physiol. 1987 Mar;62(3):1160-6.

Shastri KA, Logue GL, Lundgren CE, Logue CJ, Suggs DF.
Diving decompression fails to activate complement.
Undersea Hyperb Med. 1997 Jun;24(2):51-7.

Ward CA, McCullough D, Yee D, Stanga D, Fraser WD.
Complement activation involvement in decompression sickness of rabbits.
Undersea Biomed Res. 1990 Jan;17(1):51-66.

Pekna M, Ersson A.
Complement system response to decompression.
Undersea Hyperb Med. 1996 Mar;23(1):31-4.

Brook WH, Secombe J, Seychell D.
Complement levels and exposure in the hypobaric chamber.
Aviat Space Environ Med. 1995 May;66(5):415-7.

Hjelde A, Bergh K, Brubakk AO, Iversen OJ.
Complement activation in divers after repeated air/heliox dives and its possible relevance to DCS.
J Appl Physiol. 1995 Mar;78(3):1140-4.

Katuntsev VP, Kozlov LV, Shcherbakova MA, Ageev VP, Sizoi MN.
[Effect of decompression on the compliment system].
Aviakosm Ekolog Med. 1993 May-Jun;27(3):22-8. Russian.

Stevens DM, Gartner SL, Pearson RR, Flynn ET, Mink RB, Robinson DH, Dutka AJ.
Complement activation during saturation diving.
Undersea Hyperb Med. 1993 Dec;20(4):279-88.

Zhang J, Fife CE, Currie MS, Moon RE, Piantadosi CA, Vann RD.
Venous gas emboli and complement activation after deep repetitive air diving.
Undersea Biomed Res. 1991 Jul;18(4):293-302.

Huang KL, Lin YC.
Activation of complement and neutrophils increases vascular permeability during air embolism.
Aviat Space Environ Med. 1997 Apr;68(4):300-5.

 

[KenGordon]

The fifth paper you cite is about how the compliment system was not activated, contradicting the rest of the article. Also this line is about the immune response, even if it were the case you are then making a leap that that leads to tiredness. That is a hypothesis which has not been proven, indeed there is a reference in the 11 year old thread to a trial which tested it and failed to find a correlation.

Nitrox has proven benefits with regard to clinical DCI by reducing on gassing rate and increasing off gassing rate during the dive. Isn't that enough of a reason to use it without vague and possibly just wrong assertions about tiredness?

If tiredness is really an early symptom of DCI then perhaps an extra 10 minute stop whole help, or better hydration, or less heavy work just after the dive? Maybe Suunto should be the computer that refreshes the parts other computers never reach?

 

[Storker]

Andy, have you ever heard the expression "wall of text"? I think you'd get your point across better with a little less verbosity, we ARE in the New Divers forum. At least we were the last time I checked...


--
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Typos are a feature, not a bug

 

[KenGordon]

Andy, have you ever heard the expression "wall of text"? I think you'd get your point across better with a little less verbosity,

Wall of links more like. Reading them to refute his point takes time....

Actually it would be genuinely helpful if Andy could extract the particular points from each study which support his point in a logical order with why they matter such that we can be convinced. A list of (allegedly) true things does not make an argument.

 

[Johanan]

4 dives a day for a beginning diver is a tough program. Kitting up alone takes effort and stress. I think, it is normal to feel exhausted. I personally have not observed that use of enriched air nitrox (EAN) lessens tiredness after dives. Much more, what happens during the dive. Lack of experience increases the level of exertion. Level of exertion increases production of CO2 (carbon dioxide). John Chatterton teaches that CO2 is a major, if not the main culprit for fatigue. You can read it on his website. This is what I have really observed during dives.

 

[DevonDiver]

Andy, have you ever heard the expression "wall of text"? I think you'd get your point across better with a little less verbosity...

I wasn't making a point, as such. Simply pointing Diver0001 towards some interesting reading.

Immune response to bubbles is well known. That's why hyperbaric treatment includes immuno-surpressant drugs.

My suggestion is only that bubble frequency, not size, might be more critical in this specific aspect of DCS. That means decompression stress (high microbubble frequency) resulting from too high gas differential (fast tissues - recreational dives) could be leading divers into an immune system reaction that presents as unusual fatigue.

Nitrox use is one aspect that can positively influence decompression stress. If used to that end, it would eliminate the fatigue that some divers associate with diving.

As the article states, individuals will have varying levels of immune system response. And, of course, not every diver would routinely suffer decompression stress in the first place... their routine diving precautions insulate against it.

I'm not trying to 'prove' anything, I'm neither a medical nor decompression physics researcher. I'm merely suggesting a hypothesis based on the varied research already completed in different fields. Tying strands together, if you like.

The issue compares with other immune system linked ailments; like chronic fatigue syndrome or ME, at present a lot is still not understood or sufficiently researched. That, however, does not mean it isn't a very real issue...

What remains essential is that divers (especially new divers) understand there ARE repercussions to fast ascents, saw-tooth profiles, limited stops and aggressive, multi-day repetitive diving. Those repercussions extend beyond the simplistic notion of 'the bends' and should be thought applicable to every diver on every dive... Luckily, there are also safeguards; ascent strategies, extended stops and the use of nitrox.

---------- Post added December 15th, 2015 at 05:01 PM ----------

I think, it is normal to feel exausted.

The issue is unusual fatigue.

That's relative to the diver and their lifestyle, fitness, diet, diving experience, diving conditions etc etc...

I think divers have either experienced this symptom, or not. I've referenced a possible reason/s why. Those who haven't are most likely: (1) divers who refute that nitrox reduces fatigue and (2) divers who cannot differentiate between expected fatigue and unusual fatigue.

Those who suffer allergies, or immune system ailments, will understand the sort of fatigue sensations being discussed. So will many technical divers...

 

[Diver0001]

Andy, have you ever heard the expression "wall of text"? I think you'd get your point across better with a little less verbosity, we ARE in the New Divers forum. At least we were the last time I checked...

Andy referred to a concept that I hadn't heard about before and I am grateful for his bibliography. I know it's the new divers forum but we took a little side step into technical diving and for the first time in a while I learned something that I didn't already know.

R..

 

[DevonDiver]

I know it's the new divers forum but...

New divers are the ones highly likely to suffer depression stress. Experienced divers tend to refine their buoyancy, ascents, stops, gasses etc... so less likely to encounter the fast-tissue issues routinely...

Yes, there's some science and medicine debated here... But it's a "new divers" forum, not "dumb divers"...

Storker and Ken seem to have appointed themselves in a position to keep everything in the thread dumbed-down and fruitless..

.... Or should we go back to the inane "yes, it does "..." I never noticed it"... "I think not"...." I swear by it" type of subjective posts that do nothing to further insight into the topic and have persisted for pointless decades? Just because 'new divers' can't read long posts, or might nosebleed over an actual, meaty, concept?

 

[cooter383]

I am a long time diver and while diving my first time on Nitrox in Coron, Palawan I noticed other divers younger than myself and dive buddy were completely exhausted and sleeping on deck, while we were fully alert. I dive on Nitrox whenever I can and come out feeling way better than on normal air.