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Related Experiment Video

Updated: Jul 7, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

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Published on: December 6, 2016

Trazodone increases arousal threshold in obstructive sleep apnoea.

R C Heinzer¹, D P White, A S Jordan

¹Sleep Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. rheinzer@post.harvard.edu

The European Respiratory Journal

|February 8, 2008

Summary

Trazodone, a sleep aid, increased the arousal threshold in obstructive sleep apnea (OSA) patients. This means patients could tolerate higher carbon dioxide levels before waking up during sleep.

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Area of Science:

Sleep Medicine
Respiratory Physiology

Background:

A low arousal threshold is linked to breathing instability during sleep.
Obstructive sleep apnea (OSA) is characterized by breathing disruptions during sleep.

Purpose of the Study:

To investigate if trazodone, a sleep-promoting agent, can raise the effort-related arousal threshold in OSA patients.
To assess the impact of trazodone on arousal responses to hypercapnia and CPAP reduction in OSA.

Main Methods:

A double-blind, randomized study involving nine OSA patients.
Patients received either 100 mg trazodone or a placebo on separate nights while on CPAP.
Arousals were induced by increasing inspired CO2 or decreasing CPAP levels, with respiratory effort and end-tidal CO2 monitored.

Main Results:

Trazodone significantly increased the arousal threshold, with arousals occurring at higher P(ET,CO2) levels compared to placebo.
During CO2 challenges, trazodone led to greater esophageal pressure swings, indicating increased respiratory effort before arousal.
No significant difference in arousal threshold was observed when induced by CPAP drops.

Conclusions:

Trazodone (100 mg) effectively increases the effort-related arousal threshold in OSA patients, particularly in response to hypercapnia.
This suggests trazodone may help improve breathing stability during sleep in OSA by allowing higher CO2 tolerance.