The effect of inhaled menthol on upper airway resistance in humans: A randomized controlled crossover study

Abstract

BACKGROUND: Menthol (l-menthol) is a naturally-occurring cold receptor agonist commonly used to provide symptomatic relief for upper airway congestion. Menthol can also reduce the sensation of dyspnea. It is unclear whether the physiological action of menthol in dyspnea reduction is through its cold receptor agonist effect or whether associated mechanical changes occur in the upper airway.OBJECTIVE: To determine whether menthol inhalation alters upper airway resistance in humans.METHODS: A randomized, sham-controlled, single-blinded crossover study of inhaled menthol on upper airway resistance during semirecumbent quiet breathing in healthy subjects was conducted. Ten healthy participants (eight female) with a mean (± SD) age of 21±1.6 years completed the study.RESULTS: Nasal resistance before testing was similar on both occasions. No differences were found in respiratory frequency (mean ± SEM) (menthol 17.0±1.1 cmH₂O/L/s; sham 16.9±0.9 cmH₂O/L/s), minute ventilation (menthol 7.7±0.5 cmH₂O/L/s; sham 7.9±0.5 cmH₂O/L/s) or total inspiratory time/total breath time (menthol 0.4±0.1 cmH₂O/L/s; sham 0.4±0.1 cmH₂O/L/s). The upper airway resistance was similar during menthol (3.47±0.32 cmH₂O/L/s) and sham (3.27±0.28 cmH₂O/L/s) (P=0.33) inhalation.CONCLUSION: Inhalation of menthol does not alter upper airway resistance in awake human subjects.