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African Journal of Biomedical Research, Vol.

11 (2008); 39 - 46 39
ISSN 1119 – 5096 © Ibadan Biomedical Communications Group

Full Length Research Article
Thirst Perception and Dryness of Mouth in
Healthy Young Adults Nigerians
1,2
Igbokwe, V.U. and 2Obika, L.F.O.
1
Full-text available at Department of Physiology, College of Health Sciences,
http://www.ajbrui.com
http://www.bioline.br/md
Usmanu Danfodiyo University P.M.B 02254, Sokoto, Nigeria
http://www.ajol.com
2
Department of Physiology, College of Medicine,
P.M.B 1154, University of Benin, Benin City, Nigeria.

ABSTRACT
This study examined the threshold for thirst perception (TP) using the
visual analogue scale (VAS). Thirst perception (TP) and dryness of
mouth (DM) were studied in normal subjects, (n = 137; 78 males of
height, 1.72 ± 0.01, age, 23 ± 0.26, body mass index, 21.11 ± 0.29, and
59 females of height, 1.65 ± 0.01, age, 21 ± 0.23, body mass index,
21.0 ± 0.27). The results showed that (i) TP and DM in males, (1.21 ±
Received: 0.15 cm and 1.14 ± 0.16cm respectively) and in females, (1.10 ±
August 2007 0.16cm and 1.04 ± 0.17cm respectively) were similar. (ii) The
relationship, Thirst (cm) = 0.75 (plasma arginine vasopressin ± 1.2)
Accepted (Revised):
November 2007
exists and has a mean of not thirsty of 1.2cm at the lower end of the
scale. (iii) The plasma osmolality of 281mOsm/kg cannot be the
Published threshold for TP and the plasma osmolality of 285mOsm/kg or
January 2008 284.3mOsm/kg cannot be the threshold for plasma arginine vasopressin
secretion but rather the mean of the lower set point of the scales for TP
and plasma arginine vasopressin [PAVP] secretion. (iv) The threshold for
TP using the VAS is between 1.50 - 1.575cm markings, and plasma
osmolality of 286.0 - 286.25 mOsm/kg. PAVP of 0.4 – 0.5 pmol/l
being the sensitivity of the osmoregulatory unit.

(Afr. J. Biomed. Res. 11: 39 - 46)

Key Words; Thirst perception, Dryness of mouth, plasma osmolality, osmotic threshold,
Visual Analogue Scale

*Address for Correspondence : vigbokwe5@yahoo.com

Abstracted by:
African Index Medicus (WHO), CAB Abstracts, Index Copernicus, Global Health Abstracts, Asian Science Index, Index
Veterinarius, Bioline International , African Journals online

2) Thirst perception (TP) rises desire for water’. thirst as ‘a generalized deep-seated feeling of a Robertson. 1980). Baylis & Robertson. pharyngeal) or et al. 1972).001. African Journal of Biomedical Research 2008 (Vol.4 (Posm . 1984).966. r = Subjects 0.285) . (3) changes in thirst in controlled experimental Determine whether there are differences between settings.001 and PAVP ( pmol/l ) = 0. 1972). thirst is not in a progressive fashion throughout a wide range synonymous with drinking. According to their analysis the osmotic Healthy young volunteer males (n = 78. defined (Robertson et al.92. 1976. 1980. they defined the functions: essential component of thirst. of Benin. As thus defined. r = + 0. All the subjects were active but none was athletically trained as 40 Threshold for thirst perception . because drinking can of plasma osmolalities and that the osmolar be affected positively or negatively by a variety of threshold for thirst onset (281 mOsm/kg) was factors such as personal and cultural factors. Using this method the sexes in the responses above and (4) determine (Robertson.5). to quantify acute using the equations of Thompson et al (1986). The result MATERIALS AND METHODS showed the function.96. studies as animals cannot report the sensation of In the works of Robertson (1984) and thirst.281). Estimates of range for normal not thirsty markings on the VAS thirst and DM rely solely on the subject’s ability to as currently used for the estimation of TP? This perceive and to report the sensation. P AVP = 1. and some have gone so far as to examined. assessed the effects of osmotic the range for normal not thirsty markings on the stimuli on thirst mechanism and vasopressin VAS. P < that we drink when we are thirsty solely to abolish 0. what exactly is the objective methods of quantification.7). Robertson (1984). where subjects defined Definition of thirst has been the subject of much their own thirst ratings before the experiment debate. similar to the theoretical osmolar threshold for this terminology is only appropriate for human vasopressin release (285 mOsm/kg). using the VAS (2) investigate whether a linear A geometric rating scale was devised by relationship also exists between TP and P AVP Thompson and Campbell (1977).48(P osm . which is approximately 10 mOsm/Kg were used in this study following approval by the above the osmotic threshold for vasopressin local Research Ethics committee of the University release.977 and Thirst = 9.3 (Posm .284. (1) determine normal TP and one can check such information by observing the DM in young healthy male and female adults amount of water drunk spontaneously.5 17-30years) and females (n = 59.06(Posm . secretion at various times during the infusion of hypertonic solution in healthy adults. 1984). but very few claim Thirst (cm) = 0. The evidence being that the (281 mOsm/Kg) is at the lower end of the sensation of thirst and the sensation of dryness of physiological range of plasma osmolality and was the mouth could be dissociated from each other much lower than that quoted in previous studies (Fitzsimons. Dryness of osmotically induced thirst throughout a wider the mouth (DM) and throat region is a striking range of plasma osmolalities than previously feature in thirst. r = the disagreeable sensations that arise in the mouth + 0. r = 0. explored the characteristics of general sensation (Fitzsimons. with major disagreement focusing on rather than be assigned to zero thirst ratings (Rolls whether it is a local (for example. 11) / Igbokwe and Obika INTRODUCTION Thompson et al (1986) employing a visual analogue scale (VAS). age threshold for the onset of thirst was 293. age 18-29years) mOsm/Kg. Also. College of Medicine. Sometimes study therefore is to. Thompson et al (1986) it was not clear whether a Studies of thirst mechanism and dryness of linear relationship also exists between thirst (cm) mouth have been hampered by the lack of and P AVP. From linear regression analysis of their say that this feeling of dryness of mouth is an results. P < 0. Also not clear is. They concluded that (1) the when salivation is insufficient to keep the mouth osmolar threshold for thirst onset thus defined and pharynx moist.293.

1982) which we have exercise programme during the last six months not measured in this work.04 ± 0. were obtained using the visual analogue scale Scatter gram showing the relationship between Thirst (VAS) (Thompson et al. BMI. hypertension and current use of significant when p < 0. Body surface area was perception and dryness of mouth. Thirst perception and dryness of mouth male group.respiratory disease. paired t-test.16 and 1. p < 0. was used for blood pressure and heart 4 Th irs t Pe rc e p tio n rate measurements. Model 93). 1991. The subject’s anthropometric data also done for possible correlation between thirst then were obtained. -1 0 1 2 3 4 5 6 7 Dryness of Mouth Thirst Perception = .14 ± 0. Measurements were made by digital blood pressure and HR monitor 3 (Walgreen’s. Data are presented as means ± SEM. The 5 right arm supported at the heart level (Frohlich et al 1988). 1996).15 and 1. R^2 = . Procedure and BP between the groups were analysed using Each subject came to the laboratory on the day the unpaired students’t-test. The sensations of of the experiment. Base-line (resting) blood pressure (BP) and heart rate (HR) were measured with the subject in the Scattergram 6 seated position and after fifteen minutes of rest in the laboratory at a room temperature of 29oC. Differences in TP. Age. The regression equation given by the ratings were defined for statistical purposes as the straight line and defining the relationship between distance in centimeters of the mark from the “Not Thirst perception and Dryness of Mouth is: thirsty” or ‘Not dry’ extreme. African Journal of Biomedical Research 2008 (Vol. 1995). personal and family history of diabetes.16 H2 (cm) respectively.248 Thirst and Dryness of Mouth Rating Thirst perception and dryness of the mouth Figure 1. Mean arterial blood pressure (MABP) was calculated 0 from the formular MABP = ⅓ systolic blood pressure + ⅔ Diastolic blood pressure (Zappe et -1 al. DM. Changes were considered statistically heart disease. WT.486 DM (r = 0.17 respectively.486 * Dryness of Mouth. Three basal readings 2 were obtained on each subject at 3-minutes interval and the mean of these readings recorded 1 as the normal blood pressure and heart rate. Exclusion criteria for this study were any history Statistical Analysis of diabetes and cardio . HT. HR.10 ± 0. scale is an indirect approximation of the plasma Threshold for thirst perception 41 .498. and the body mass index RESULTS (BMI). 11) / Igbokwe and Obika defined by the absence of a regular physical osmolality (Robertson et al.21 ± 0. calculated from height [H (cm)] and weight [W (kg)] with the formular of Dubois and Dubois (Peyreigne et al 1998). while the dryness of mouth was 1. calculated from The male and female groups studied showed thirst BMI = Wt(kg)/ perceptions of 1. The visual analogue TP = 0. before the experiment (Kokkinos et al.622 + 0.622 + . Takamata et al. Participants completed a thirst and dryness of mouth within the groups were general health questionnaire to determine physical also analysed for possible difference using the fitness. Perception (TP) and Dryness of Mouth (DM) in the 1994).0001). Regression plot was medication.05.

05 42 Threshold for thirst perception .65 20. (1991) There was no significant difference in thirst reported a value of thirst perception (TP) of 1. It has been shown that -1 0 1 2 3 4 5 6 thirst ratings using the VAS are highly Dryness of mouth reproducible within individuals on repeated testing Thirst perception = 0 + 1 * Dryness of mouth.2 1.01 p<0.5 ± 0. African Journal of Biomedical Research 2008 (Vol.01 p < 0. The TP and DM observed in the Thirst perception and Dryness of Mouth is: TP = 0 + 1 male group did not show any significant difference DM (r = 1. p = 0). Thirst Dryness Weight Height Body Mass Body Age Heart Blood Perception Of Mouth (Kg) (M) Index Surface (Yrs) Rate Pressure (Tp)Cm (Dm) Cm (Bmi) (M2) (Bpm) (Mmhg) Male 1.17 0.4cm in experimental and and female groups.26 1.27 0.5 112 ± 1.3 103 ± 1.23 1. susceptible to distortion 1 by a variety of personal.05 p < 0. 1991). dryness of mouth (DM) of 1. This work shows a thirst perception (TP) and Figure 2.21 ± 0. They were also of comparable control male subjects respectively as ‘not thirsty’.11 1.69 69.10 1. though. might be.14 ± 0.01 p> 0.01 p < 0. and 1.05 p < 0.72 21. this method however provides the best available 0 description of the function of the thirst mechanism -1 so far. Burrell et al. from that of the female group. The regression equation given by the 1.04 Female 1.15cm and Scatter gram showing the relationship between Thirst Perception (TP) and Dryness of Mouth (DM) in the 1.05 p > 0. Thirst Perception and Dryness of Mouth.74 22.3 ± perception and dryness of mouth between the male 0.29 0.66 p > 0.8 1. body mass index (male = 21. 6 5 DISCUSSION 4 This work examined thirst perception and Thirs t perc eption dryness of mouth using the (VAS) visual analogue 3 scale in young male and female adults.00 0.70± 0.01 0.16cm in males.27).01 0. 1984).01 0.14 62.02 0. The 2 subjects were comparable in body mass index. R^2 = 1 (Thompson et al.16 1.15 0.10 ± 0.04 ± 0. (Robertson.05 p < 0. They were found to be similar to each other. in the male and female subjects.60 n = 78 ± ± ± ± ± ± ± ± 66 ± 1. The VAS.01 0.21 1.52 77.11± 0. with their data for thirst Scattergram perception and dryness of mouth.17cm in females as ‘not thirsty ‘ and ‘not straight line and defining the relationship between dry’ respectively.70 1.16 0. and cultural influences.16cm and female group.05 p > 0.04 56.57 0.8 0.29. female = 20. Table 1 gives a summary of their Table 1.4cm and 1. expressed as mean ± SEM.42 n = 66 ± ± ± ± ± ± ± ± 62 ± 1. 11) / Igbokwe and Obika anthropometric data.61 20.

attributed this threshold for thirst onset (281 mOsm/Kg) is at the sensation to a deficiency of mucus and saliva.5 ± 0. 1931. When P(osm) = T + 0. and Plasma arginine vasopressin (PAVP) The idea that thirst is related to the relative Secretion. the could be a dissociation between DM and TP relationship between thirst and plasma osmolality (Montgomery.3(281) = 10T + 281 ……………. Studies linear relationship between plasma osmolality and of the effect on thirst of altering oral sensations or thirst. it however was silent on whether a dry mouth theory (Adolph. Sham drinking had also work therefore is found to correlate very well with been seen clinically in 1925 by Gairdner when in the findings of Burrell et al. It is The role of dryness of mouth in thirst. (1980) have suggested that the mouth’. The observation of this study therefore conforms with the reports of Relationship between thirst perception (TP) the above two groups of workers. against this local arginine vasopressin and thirst. correlated with thirst (r = 0. This theory cannot be correct. 1958. as seen in ‘normally the subjective sensation of thirst has a humans. female group or between the groups. and between plasma osmolality and arginine blocking them have shown results consistent with vasopressin. relieved by dryness of mouth in the subjects were analysed for placing water into the lower half of the possible correlation using the t-test.5cm in control young drinking). Figaro and Mack (1997). not his arteries or veins. 1947. but all the water he drank Correlation between DM and TP ran straight out of the oesophagus and produced no In this study the sensations of thirst and relief of thirst. However. P(osm) can be expressed as Claude Bernard in (1856) prepared horses and dogs with an oesophageal or gastric fistula. Thirst was. Stachenfeld et al (1996) also showed that oropharynx may have a role in the initiation. in spite of the mouth being bathed with subjects as ‘not thirsty. (1991) and Figaro and attempting suicide a man cut his oesophagus. are experiments demonstrating that there From Thompson’s et al equations (1986). should not be completely disregarded. therefore concluded that using the visual analogue (although shown not a be an essential thirst scale (VAS). African Journal of Biomedical Research 2008 (Vol. dryness of the mouth dates back to the Greeks Thompson et al (1986) reported that the osmolar (Grossman. These evidence indicate that dry did not show any significant difference between mouth and thirst can be dissociated and therefore TP and DM either in the respective male and there must be some other explanation for thirst. there was a linear relationship between plasma Epstein et al. Rolls et al. 1964). Bellows (1939) also in their work in dehydrated humans showed confirmed Bernard’s early experiments in dogs ratings of perceived thirst and mouth dryness of and observed that during persistent sham-drinking 1. Wolf. theory. very strong oral component described as a dry Rolls et al. There is the need to look into.6cm and 0. but Mack (1997). if there is any. 1967).’ Figaro and Mack (1997) large quantities of water. Steggerda.5 ± 0.96). the local discomfort and unpleasantness mOsm/Kg). (1996) in their work on kolanut the animals were tested with open fistula. subjective ratings of mouth dryness were highly termination and maintenance of drinking. After several days he became intensely thirsty.(1) 0.3 3 Threshold for thirst perception 43 . The analysis oesophagus. 11) / Igbokwe and Obika Obika et al. what exactly is the (1980) on studies of thirst in humans showed that role of dryness of mouth in thirst. associated with dryness of the mouth. lower end of the physiological range of plasma Canon (1919) stated that when the salivary glands osmolality and it is similar to the theoretical fail to provide sufficient fluids to moisten the osmolar threshold for vasopressin release (285 mouth. 1941). the sensation of thirst is closely stimulus). Haller (1764).9 ± 0. however. While their work showed a clear which result constitute the feeling of thirst.2cm as ‘not thirsty’ and water wets the mouth and therefore the dry mouth ‘not dry’ respectively in control subjects. they activity in young dehydrated subjects reported drank enormous quantities of water (sham- thirst rating of 2.

575) = Posm (286.33). African Journal of Biomedical Research 2008 (Vol.3 mOsm/kg cannot be the T (1.3mOsm/kg in healthy man 0.2) exists. the T (1) = Posm (284. 1. PAVP (1) = Posm (287.2cm as ‘not having a desire to drink and the relationship between plasma osmolality water’ or ‘not thirsty’. PAVP (0.281). and also corresponding appreciation of thirst and there is no marked plasma arginine vasopressin (PAVP) in pmol/l are arginine vasopressin secretion. desire to drink.3 (Posm . Thompson et al.75 PAVP + 1. the sensation of thirst is should be a sensation of thirst or a desire to drink closely associated with a dry mouth. It is T (1.16cm for females. and the lower set point of females as ‘not having a desire to drink water’ or “not thirsty” on the VAS has a mean value of ‘not thirsty’ and our derived equation shows a 44 Threshold for thirst perception .15cm for males and 1. the plasma osmolality is not yet high enough to give a sensation of thirst and subsequent plasma T (cm) = 0.5) = Posm (286).75) important factor in stimulating thirst is increase plasma osmolality. PAVP (0.. 1998). Variations of individual markings on the lower end of the VAS could be due to T (cm) = 0. P AVP (0) = Posm (285) fluid.21 ± al. 1986) or 284. which means that shown below in their respective equations.. from the derived equation.16cm for vasopressin +1.10 ± 0. From the values From Thompson’s et al equations (1986).15 cm for males and 1..1. Markings of 1986).2) = Posm (285). at a plasma values of some plasma osmolality (Posm) and their osmolality of 285mOsm/kg there is no corresponding thirst (cm).25). PAVP = 0. the shown in the equations above.4(285) = 10(PAVP)+ 28….25 mOsm/kg. the 0cm mark on the VAS cannot be said to P(osm) = (PAVP) + 0. PAVP (0. Our analysis shows that given plasma osmolality.21 ± 0.5) perception and the plasma osmolality of 285 mOsm/kg or 284.25) therefore concluded that the plasma osmolality of 281 mOsm/kg cannot be the threshold for thirst T (1.2cm.50 . which points on the scales for thirst perception and Thompson and his colleagues (1986) reported plasma arginine vasopressin secretion. Table 1 shows a mean of 1.575cm marking on the VAS.285) arginine vasopressin secretion to conserve body T (0) = Posm (281). It was also reported that plasma arginine The result of this work shows that the above vasopressin release is dependent on plasma equation relating thirst perception and plasma osmolality and that the osmotic threshold of arginine vasopressin exists and has a mean lower vasopressin secretion into the circulation is a set point of ‘not thirsty’ or ‘not having a desire to plasma osmolality of 285mOsm/kg.75 (plasma arginine of 1.0 . The observed data of this study shows a TP relationship: Thirst (cm) = 0.95) = Posm (287. Since ‘threshold’ means the and plasma arginine vasopressin (PAVP) can be adequate stimulus required to cause an impulse or expressed as: sensation.4 4 point of the scale for thirst perception.3) = Posm (285. lies between a TP of (McKenna and Thompson.10 ± 0. equations (1) and (2) relating plasma 0. but rather the lower set 0.5) threshold for plasma arginine vasopressin secretion but rather the mean of the lower set The osmotic threshold for thirst.150cm on the visual analogue scale therefore osmolality can be solved. 1998.0 . The water. The since their work was within the same range of threshold for TP on the VAS. 11) / Igbokwe and Obika value of 1.5) = Posm (286. arginine vasopressin and thirst. in this case to actually want to drink water. (Thompson et drink’ of 1.320 mOsm/kg. from this study and plasma osmolality.4(POSM . Solving these two are normal range for “not thirsty” or not having a equations yield the equation. (Thompson & Mckenna.4) = Posm (286) ‘not thirsty’ between 280.0-286. means that after 0cm mark on the VAS there In summary. 280 .285mOsm/kg with a threshold of 286. and it has a normal range of T (1.(2) be the threshold for thirst.2 differences in volume status of the subject.

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