Sex comparisons in physiological and cognitive performance during hypoxic challenge

Vento, Kaila A.; Borden, Cammi K.; Blacker, Kara J.

doi:10.3389/fphys.2022.1062397

Sex comparisons in physiological and cognitive performance during hypoxic challenge

Journal Article · Tue Nov 22 00:00:00 EST 2022 · Frontiers in Physiology

DOI:https://doi.org/10.3389/fphys.2022.1062397· OSTI ID:2425796

Vento, Kaila A. ^[1]; Borden, Cammi K. ^[1]; Blacker, Kara J. ^[2]

Naval Medical Research Unit-Dayton Wright-Patterson Air Force Base, Dayton, OH (United States); Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN (United States)
Naval Medical Research Unit-Dayton Wright-Patterson Air Force Base, Dayton, OH (United States)

Within the tactical aviation community, human performance research lags in considering potential psychophysiological differences between male and female aviators due to little inclusion of females during the design and development of aircraft systems. A poor understanding of how male and female aviators differ with respect to human performance results in unknown potential sex differences on aeromedically relevant environmental stressors, perchance leading to suboptimal performance, safety, and health guidelines. For example, previous hypoxia studies have excluded female participants or lacked a sizeable sample to examine sex comparisons. As such, progress toward sensor development and improving hypoxia familiarization training are stunted due to limited knowledge of how individual differences, including sex, may or may not underlie hypoxia symptoms and performance impairment. Investigating sex differences bridges the gap between aerospace medicine and operational health, and addressing hypoxia is one of many facets yet to be studied. In the current study, we retrospectively examined N = 6 hypoxia studies with male-female participant samples (total, N = 189; male, n = 118; female, n = 71). We explored sex as a predictor of physiological response, sensory deficits, the severity of cognitive performance declines, and symptom manifestation via linear and binary logistic regression models. We found that the female sex predicted lower peripheral oxygen saturation and the likelihood of headache reporting in response to hypoxic challenge, yet explained little variance when combined with age and body mass index. The sensory and cognitive performance models did not converge, suggesting high intra-individual variability. Together, sex, age, and body mass index were not the most robust predictors in responses to hypoxic challenge; we cannot infer this for sensory deficits and cognitive performance within an experimentally induced hypoxic environment. The findings have implications for improving hypoxia familiarization training, monitoring sensor development, and emergency response and recovery protocols in case of a hypoxia occurrence suitable for all aircrew. We recommend continuing to elucidate the impact of sex and intrapersonal differences in hypoxia and other aeromedically relevant stressors in tactical aviation.

View Accepted Manuscript (DOE)

Research Organization:: Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN (United States)

Sponsoring Organization:: USDOE Office of Science (SC)

Grant/Contract Number:: SC0014664

OSTI ID:: 2425796

Journal Information:: Frontiers in Physiology, Journal Name: Frontiers in Physiology Vol. 13; ISSN 1664-042X

Publisher:: Frontiers Media S.A.Copyright Statement

Country of Publication:: United States

Language:: English

References (47)

Temporary threshold shift after noise exposure in hypobaric hypoxia at high altitude: results of the ADEMED expedition 2011 Fehrenbacher, K.; Apel, C.; Bertsch, D. International Archives of Occupational and Environmental Health https://doi.org/10.1007/s00420-021-01715-w	journal	May 2021
Acute physiological response to a normobaric hypoxic exposure: sex differences Camacho-Cardenosa, Alba; Camacho-Cardenosa, Marta; Tomas-Carus, Pablo International Journal of Biometeorology, Vol. 66, Issue 7 https://doi.org/10.1007/s00484-022-02298-y	journal	May 2022
Gender-related differences in migraine Allais, Gianni; Chiarle, Giulia; Sinigaglia, Silvia Neurological Sciences, Vol. 41, Issue S2 https://doi.org/10.1007/s10072-020-04643-8	journal	August 2020
Comparison of anthropometry of Brazilian and US Military population for flight deck design da Silva, Gilvan V.; Gordon, Claire C.; Halpern, Manny International Journal of Industrial Ergonomics, Vol. 64 https://doi.org/10.1016/j.ergon.2018.01.016	journal	March 2018
Effect of acute hypoxia on cognition: A systematic review and meta-regression analysis McMorris, Terry; Hale, Beverley J.; Barwood, Martin Neuroscience & Biobehavioral Reviews, Vol. 74 https://doi.org/10.1016/j.neubiorev.2017.01.019	journal	March 2017
Is decision making in hypoxia affected by pre-acclimatisation? A randomized controlled trial Niedermeier, Martin; Weisleitner, Andreas; Lamm, Claus Physiology & Behavior, Vol. 173 https://doi.org/10.1016/j.physbeh.2017.02.018	journal	May 2017
Effect of different combat jet manoeuvres in the psychophysiological response of professional pilots Hormeño-Holgado, Alberto J.; Clemente-Suárez, Vicente J. Physiology & Behavior, Vol. 208 https://doi.org/10.1016/j.physbeh.2019.112559	journal	September 2019
Time course of recovery from acute hypoxia exposure as measured by vigilance and event-related potentials Blacker, Kara J.; McHail, Daniel G. Physiology & Behavior, Vol. 239 https://doi.org/10.1016/j.physbeh.2021.113508	journal	October 2021
Women slowly taking off: An investigation into female underrepresentation in commercial aviation Ferla, Martina; Graham, Anne Research in Transportation Business & Management, Vol. 31 https://doi.org/10.1016/j.rtbm.2019.100378	journal	June 2019
Factors influencing low female representation in pilot training recruitment Marintseva, Kristina; Mahanecs, Artjoms; Pandey, Mukesh Transport Policy, Vol. 115 https://doi.org/10.1016/j.tranpol.2021.11.010	journal	January 2022
Psychophysiological response of different aircrew in normobaric hypoxia training Bustamante-Sánchez, Álvaro; Delgado-Terán, Miguel; Clemente-Suárez, Vicente Javier Ergonomics, Vol. 62, Issue 2 https://doi.org/10.1080/00140139.2018.1510541	journal	October 2018
Normobaric hypoxia training in military aviation and subsequent hypoxia symptom recognition Leinonen, Antti; Varis, Nikke; Kokki, Hannu Ergonomics, Vol. 64, Issue 4 https://doi.org/10.1080/00140139.2020.1842514	journal	November 2020
A Retrospective, Epidemiological Review of Hemiplegic Migraines in a Military Population Moore, Brian A.; Hale, Willie J.; Nabity, Paul S. Military Medicine, Vol. 184, Issue 11-12 https://doi.org/10.1093/milmed/usz040	journal	March 2019
Sex differences in diaphragmatic fatigue: Effects of hypoxia during inspiratory loading Archiza, Bruno; Reinhard, Paige A.; Welch, Joseph F. The Journal of Physiology, Vol. 599, Issue 4 https://doi.org/10.1113/JP280704	journal	November 2020
Popliteal flow-mediated dilatory responses to an acute bout of prolonged sitting between earlier and later phases of natural menstrual and oral contraceptive pill cycles O’Brien, Myles W.; Johns, Jarrett A.; Al-Hinnawi, Amera Journal of Applied Physiology, Vol. 129, Issue 4 https://doi.org/10.1152/japplphysiol.00424.2020	journal	October 2020
Rapid Quantification of Color Vision: The Cone Contrast Test Rabin, Jeff; Gooch, John; Ivan, Douglas Investigative Opthalmology & Visual Science, Vol. 52, Issue 2 https://doi.org/10.1167/iovs.10-6283	journal	February 2011
Topography of Auditory and Visual P300 in Normal Adults Sangal, R. Bart; Sangal, Joanne M. Clinical Electroencephalography, Vol. 27, Issue 3 https://doi.org/10.1177/155005949602700307	journal	July 1996
Female versus male migraine: an event-related potential study of visual neurocognitive processing Guo, Yunliang; Xu, Song; Nie, Shanjing The Journal of Headache and Pain, Vol. 20, Issue 1 https://doi.org/10.1186/s10194-019-0995-y	journal	April 2019
Sex differences in electrophysiology: P200 event-related potential evidence Bourisly, Ali K.; Shuaib, Ali Translational Neuroscience, Vol. 9, Issue 1 https://doi.org/10.1515/tnsci-2018-0013	journal	June 2018
Aviation Culture: a ‘Glass Sky’ for Women Pilots - Literature Review Gorlin, Ivana; Bridges, Donna International Journal of Aviation, Aeronautics, and Aerospace https://doi.org/10.15394/ijaaa.2021.1587	journal	January 2021
Hypoxia signature: A useful tool for hypoxia recognition among aircrew Kasture, S.; Nataraja, Ms; Mohapatra, Ss Indian Journal of Aerospace Medicine, Vol. 65 https://doi.org/10.25259/IJASM_19_2021	journal	November 2021
Seeing sex, gender, and intersectionality in military, Veteran, and family health research Eichler, Maya Journal of Military, Veteran and Family Health, Vol. 7, Issue s1 https://doi.org/10.3138/jmvfh.7.s1_001	journal	September 2021
Hypoxia and Coriolis Illusion in Pilots During Simulated Flight Kowalczuk, Krzysztof P.; Gazdzinski, Stefan P.; Janewicz, Michał Aerospace Medicine and Human Performance, Vol. 87, Issue 2 https://doi.org/10.3357/AMHP.4412.2016	journal	February 2016
Hyperoxia and Hypoxic Hypoxia Effects on Simple and Choice Reaction Times Dart, Todd; Gallo, Megan; Beer, Jeremy Aerospace Medicine and Human Performance, Vol. 88, Issue 12 https://doi.org/10.3357/AMHP.4696.2017	journal	December 2017
Flight Performance During Exposure to Acute Hypobaric Hypoxia Steinman, Yuval; van den Oord, Marieke H. A. H.; Frings-Dresen, Monique H. W. Aerospace Medicine and Human Performance, Vol. 88, Issue 8 https://doi.org/10.3357/AMHP.4789.2017	journal	August 2017
Acute Mild Hypoxic Hypoxia Effects on Cognitive and Simulated Aircraft Pilot Performance Bouak, Fethi; Vartanian, Oshin; Hofer, Kevin Aerospace Medicine and Human Performance, Vol. 89, Issue 6 https://doi.org/10.3357/AMHP.5022.2018	journal	June 2018
Selective Auditory Attention and Spatial Disorientation Cues Effect on Flight Performance Lewkowicz, Rafał; Stróżak, Paweł; Bałaj, Bibianna Aerospace Medicine and Human Performance, Vol. 89, Issue 11 https://doi.org/10.3357/AMHP.5153.2018	journal	November 2018
Lack of Significant Audiometric Changes Under Hypobaric Hypoxia at 15,000 ft Lucertini, Marco; Lancia, Stefania; Sanjust, Filippo Aerospace Medicine and Human Performance, Vol. 91, Issue 1 https://doi.org/10.3357/AMHP.5421.2020	journal	January 2020
Retrospective Assessment of U.S. Army Aviator Anthropometric Screening Process Moczynski, Allison N.; Weisenbach, Charles A.; McGhee, James S. Aerospace Medicine and Human Performance, Vol. 91, Issue 9 https://doi.org/10.3357/AMHP.5462.2020	journal	September 2020
Migraine History and Recurrence in Military Pilot Applicants Hesselbrock, Roger R.; Haynes, Jared T. Aerospace Medicine and Human Performance, Vol. 91, Issue 1 https://doi.org/10.3357/AMHP.5491.2020	journal	January 2020
Deficits in Visual Processing During Hypoxia as Evidenced by Visual Mismatch Negativity Blacker, Kara J.; Seech, Todd R.; Funke, Matthew E. Aerospace Medicine and Human Performance, Vol. 92, Issue 5 https://doi.org/10.3357/AMHP.5735.2021	journal	May 2021
Hypoxia and Flight Performance of Military Instructor Pilots in a Flight Simulator Temme, Leonard A.; Still, David L.; Acromite, Michael T. Aviation, Space, and Environmental Medicine, Vol. 81, Issue 7 https://doi.org/10.3357/ASEM.2690.2010	journal	July 2010
Migraine History and Outcomes in Military Pilots and Flight Surgeons Hesselbrock, Roger R.; Haynes, Jared T. Aerospace Medicine and Human Performance, Vol. 93, Issue 1 https://doi.org/10.3357/amhp.5980.2022	journal	January 2022
Hypoxic Hypoxia at Moderate Altitudes: Review of the State of the Science Petrassi, Frank A.; Hodkinson, Peter D.; Walters, P. Lynne Aviation, Space, and Environmental Medicine, Vol. 83, Issue 10 https://doi.org/10.3357/asem.3315.2012	journal	October 2012
The Number of X Chromosomes Influences Inflammatory Cytokine Production Following Toll-Like Receptor Stimulation Lefèvre, Nicolas; Corazza, Francis; Valsamis, Joseph Frontiers in Immunology, Vol. 10 https://doi.org/10.3389/fimmu.2019.01052	journal	May 2019
Effects of Acute Hypoxia on Early Visual and Auditory Evoked Potentials Blacker, Kara J.; McHail, Daniel G. Frontiers in Neuroscience, Vol. 16 https://doi.org/10.3389/fnins.2022.846001	journal	April 2022
Sex differences during a cold-stress test in normobaric and hypobaric hypoxia: A randomized controlled crossover study Hohenauer, Erich; Taube, Wolfgang; Freitag, Livia Frontiers in Physiology, Vol. 13 https://doi.org/10.3389/fphys.2022.998665	journal	September 2022
Impaired Sensory Processing During Low-Oxygen Exposure: A Noninvasive Approach to Detecting Changes in Cognitive States Seech, Todd R.; Funke, Matthew E.; Sharp, Richard F. Frontiers in Psychiatry, Vol. 11 https://doi.org/10.3389/fpsyt.2020.00012	journal	January 2020
The Acute Effects of Normobaric Hypoxia on Strength, Muscular Endurance and Cognitive Function: Influence of Dose and Sex Karayigit, Raci; Eser, Mustafa Can; Sahin, Fatma Nese Biology, Vol. 11, Issue 2 https://doi.org/10.3390/biology11020309	journal	February 2022
A Cardiac Force Index Applied to the G Tolerance Test and Surveillance among Male Military Aircrew Chiang, Kwo-Tsao; Tu, Min-Yu; Lin, You-Jin International Journal of Environmental Research and Public Health, Vol. 18, Issue 16 https://doi.org/10.3390/ijerph18168832	journal	August 2021
Effects of Acute Hypobaric Hypoxia Exposure on Cardiovascular Function in Unacclimatized Healthy Subjects: A “Rapid Ascent” Hypobaric Chamber Study Theunissen, Sigrid; Balestra, Costantino; Bolognési, Sébastien International Journal of Environmental Research and Public Health, Vol. 19, Issue 9 https://doi.org/10.3390/ijerph19095394	journal	April 2022
Microcomputer analyses of performance on a portable, simple visual RT task during sustained operations Dinges, David F.; Powell, John W. Behavior Research Methods, Instruments, & Computers, Vol. 17, Issue 6 https://doi.org/10.3758/bf03200977	journal	November 1985
How to Calculate Sample Size and Why Kim, Jeehyoung; Seo, Bong Soo Clinics in Orthopedic Surgery, Vol. 5, Issue 3 https://doi.org/10.4055/cios.2013.5.3.235	journal	January 2013
Evaluation of Workload and Performance during Primary Flight Training with Motion Cueing Seat in an Advanced Aviation Training Device Belt, Stephen; Gururajan, Srikanth; Wu, Xiaoyu SAE International Journal of Aerospace, Vol. 13, Issue 1 https://doi.org/10.4271/01-13-01-0006	journal	May 2020
Female versus male migraine: an event-related potential study of visual neurocognitive processing Guo, Yunliang; Xu, Song; Nie, Shanjing figshare https://doi.org/10.6084/m9.figshare.c.4481318	collection	January 2019
Research on U.S. Military Women: Recruitment and Retention Challenges and Strategies Braun, Lisa A.; Kennedy, Holly P.; Sadler, Lois S. Military Medicine, Vol. 180, Issue 12 https://doi.org/10.7205/MILMED-D-14-00601	journal	December 2015
Female Relief Systems in U.S. Military Fighter Ejection Seat Aircraft Schultz, Marian C.; Schultz, James T.; Schultz, Joshua J. Journal of Aviation Technology and Engineering, Vol. 10, Issue 2 https://doi.org/10.7771/2159-6670.1220	journal	January 2022

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60 APPLIED LIFE SCIENCES
Physiology
female aviators
human performance
hypoxia
sex differences
unexplained physiological events

Sex comparisons in physiological and cognitive performance during hypoxic challenge

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References (47)

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