Hyperventilation during rest and exercise in orthostatic intolerance and Spiky-Leaky Syndrome.

This study explores the phenomenon of hyperventilation in patients with orthostatic intolerance dysautonomia syndromes (OIDS), such as POTS, particularly in those with associated conditions referred to as Spiky-Leaky Syndrome (SLS). SLS includes craniocervical instability, mast cell activation syndrome, hypermobility spectrum disorder, and issues with cerebrospinal fluid dynamics. Researchers conducted a retrospective review of exercise stress tests, comparing metabolic indicators of young patients with SLS to those with OIDS and healthy controls. Results indicated that patients with OIDS, and especially those with SLS, displayed reduced metabolic parameters during exercise, such as a lower peak oxygen pulse and end-tidal carbon dioxide levels, highlighting significant exercise intolerance and altered respiratory dynamics.