DISTURBED SLEEP AND PROLONGED APNEA DURING NASAL OBSTRUCTION IN NORMAL MEN

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Abstract
Anecdotal observations suggest that poor quality of sleep is a frequent complaint during upper respiratory infections (URI). Nasal obstruction occurs frequently during URI and causes sleep apnea in some infants. Sleep apnea disrupts normal sleep and could explain the complaints of poor sleep quality during URI in adults. Ten normal men had full night recordings of sleep stages and breathing rhythm before and during nasal obstruction. The order of obstructed and nonobstructed nights was randomized after a standard acclimatization night. During nasal obstruction time spent in the deep sleep stages decreased from 90 .+-. 11.2 (SEM [standard error of the mean]) to 71 .+-. 12.9 min (P < 0.05); significantly more time was spent in stage 1 sleep (P < 0.03). This loss of deep sleep during obstruction was associated with a 2-fold increase in sleep arousals and awakenings (P < 0.01) resulting from an increased (P < 0.02) number of apneas (34 .+-. 19 during control sleep vs. 86 .+-. 34 during obstructed sleep). Apneas of 20-39 s in duration became 2.5 times more frequent (P < 0.05) during obstruction. O2 saturation [SaO2] was studied in the last 4 subjects using an ear oximeter. Desaturation (SaO2 < 90%) occurred 27 times during control sleep compared with 255 times during obstructed sleep. These desaturation episodes occurred only during apneas. All men complained of poor sleep quality during nasal obstruction. Apneas, sleep arousals and awakenings, and loss of deep sleep occur during nasal obstruction and may explain complaints of poor sleep quality during URI.

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