1Military Medical Academy, Multiprofile Hospital for Active Treatment, Bulgaria
2Military Medical Academy, Department of Aviation and Marine Medicine, Bulgaria
3Paraskev Stoyanov Medical University Varna, Department of Clinical Laboratory, Bulgaria
*Corresponding author: Yordanova Mariana, Military Medical Academy, Multiprofile Hospital for Active Treatment, Head Clinical laboratiory and immunology, Bulgaria
Submission: July 13, 2022;Published: July 29, 2022
Introduction: A high level of physiological stress characterizes diving. Serum cortisol and Salivary Alpha-
Amylase (sAA) values are markers closely related to dynamics and adaptation under different stress
conditions.
The aim is to determine serum cortisol and salivary alpha-amylase levels as stress markers affected by
diving and hyperbaric conditions.
Material and methods: Twenty-two military divers with an average age of 34.4±4.1 years were studied,
with more than five years of diving experience, conducting 42-meter dives into the hyperbaric chamber
with a bottom time of 35 minutes. Serum levels of cortisol and sAA were determined twice (before and
15min after decompression).
Results and discussion: Contrary to expectations, the mean values of cortisol before compression in the
chamber were higher than after surfacing, and the difference was statistically significant (11.82±4.42μg/
dl, respectively 9.09±2.73μg/dl; p=0.0377). After decompression, the salivary values of sAA increased
compared to the pre-chamber, but they were not statistically significant (77.01±54.28, respectively,
54.69±36.27 U/ml; p=0.1817).
We hypothesize that subjects have adapted in the stress response during dive into the chamber and that
cortisol levels paradoxically do not increase after the descent. Increased sAA levels are most likely due
to the effects of hyperbaric oxygenation and dehydration, decreased salivary secretion, and to a lesser
extent, stress.
Conclusion: The conditions in the chamber are not adequate to the extreme stress conditions of the
actual underwater descent, where the stress factor is hypothermia, fatigue, anxiety, poor visibility and
more. A real-sea study will provide more accurate information on the occurrence of diving stress.
Keywords:Divers; Stress; Cortisol; Alpha-amylase; Saliva