Effect of hyperoxia on the arousal response to airway occlusion during sleep in normal subjects

The effect of hyperoxia on the arousal response to airway occlusion during non-rapid eye movement (NREM) sleep was studied in six normal male subjects with a mean age (+/- SD) of 23.5 +/- 8.7 yr by testing the response to the occlusion of a face mask covering the nose and mouth. Occlusion trials while the subjects breathed room air (room air condition) were alternated with trials in which subjects breathed a mixture of room air and oxygen adjusted to maintain a sleeping baseline arterial oxygen saturation of 98% (hyperoxic condition). The time to arousal (mean +/- SEM) was significantly longer during oxygen administration (4.1 +/- 4.5 versus 28.9 +/- 4.6 s; p < 0.002). The maximal deflections in airway pressure were measured at a supraglottic location during airway occlusion to reflect the degree of inspiratory effort. The maximal airway suction pressure preceding arousal did not differ between the room air (27.4 +/- 5.4 cm H2O) and hyperoxic conditions (26.6 +/- 5.9 cm H2O). Conversely, the rate of increase in inspiratory effort (maximal pressure) during occlusion was decreased by oxygen administration. We conclude that hyperoxia prolongs the time to arousal after airway occlusion by decreasing the rate of increase in the magnitude of inspiratory efforts, but it does not change the arousal threshold.