A pilot study of sleep, cognition, and respiration under 4 weeks of intermittent nocturnal hypoxia in adult humans

Study objectivesA pilot study to examine the effects of intermittent nocturnal hypoxia on sleep, respiration and cognition in healthy adult humans.MethodsParticipants were eight healthy, non-smoking subjects (four male, four female), mean age of 26.4 ± 5.2 years, and BMI 22.3 ± 2.6 kg/m2, exposed to 9 h of intermittent hypoxia between the hours of 10 P.M. and 7 A.M. for 28 consecutive nights. At a simulated altitude of 13,000 feet (FIO2 0.13), intermittent hypoxia was achieved by administering nasal nitrogen, alternating with brief (approximately 5 s) boluses of nasal oxygen. Pre- and post-exposure assessments included polysomnography, attention (20-min Psychomotor Vigilance Test), working memory (10-min verbal 2 and 3-back), Multiple Sleep Latency Test, and the Rey Auditory Verbal Learning Test. Obstructive and non-obstructive respiratory events were scored.ResultsOverall sleep quality showed worsening trends but no statistically significant change following exposure. There was no difference after hypoxia in sleepiness, encoding, attention or working memory. Hyperoxic central apneas and post-hyperoxic respiratory instability were noted as special features of disturbed respiratory control induced by intermittent nocturnal hypoxia.ConclusionsIn this model, exposure to nocturnal intermittent hypoxia for 4 weeks caused no significant deficits in subjective or objective alertness, vigilance, or working memory.