{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T22:02:36Z","timestamp":1789596156082,"version":"build-2803163510"},"reference-count":25,"publisher":"European Respiratory Society (ERS)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2008,1,22]]},"published-print":{"date-parts":[[2008,6]]},"abstract":"<jats:p>A low arousal threshold is believed to predispose to breathing instability during sleep. The present authors hypothesised that trazodone, a nonmyorelaxant sleep-promoting agent, would increase the effort-related arousal threshold in obstructive sleep apnoea (OSA) patients.<\/jats:p><jats:p>In total, nine OSA patients, mean\u00b1<jats:sc>sd<\/jats:sc>age 49\u00b19\u2005yrs, apnoea\/hypopnoea index 52\u00b132\u2005events\u00b7h<jats:sup>\u22121<\/jats:sup>, were studied on 2\u2005nights, one with trazodone at 100\u2005mg and one with a placebo, in a double blind randomised fashion. While receiving continuous positive airway pressure (CPAP), repeated arousals were induced: 1) by increasing inspired CO<jats:sub>2<\/jats:sub>and 2) by stepwise decreases in CPAP level. Respiratory effort was measured with an oesophageal balloon. End-tidal CO<jats:sub>2<\/jats:sub>tension (<jats:italic>P<\/jats:italic><jats:sub>ET,CO<jats:sub>2<\/jats:sub><\/jats:sub>) was monitored with a nasal catheter.<\/jats:p><jats:p>During trazodone nights, compared with placebo nights, the arousals occurred at a higher<jats:italic>P<\/jats:italic><jats:sub>ET,CO<jats:sub>2<\/jats:sub><\/jats:sub>level (mean\u00b1<jats:sc>sd<\/jats:sc>7.30\u00b10.57<jats:italic><jats:italic>versus<\/jats:italic>6.62\u00b10.64\u2005kPa (54.9\u00b14.3<jats:italic>versus<\/jats:italic>49.8\u00b14.8\u2005mmHg), respectively). When arousals were triggered by increasing inspired CO<jats:sub>2<\/jats:sub>level, the maximal oesophageal pressure swing was greater (19.4\u00b14.0<jats:italic>versus<\/jats:italic>13.1\u00b14.9\u2005cmH<jats:sub>2<\/jats:sub>O) and the oesophageal pressure nadir before the arousals was lower (-5.1\u00b14.7<jats:italic>versus<\/jats:italic>-0.38\u00b14.2\u2005cmH<jats:sub>2<\/jats:sub>O) with trazodone. When arousals were induced by stepwise CPAP drops, the maximal oesophageal pressure swings before the arousals did not differ.<\/jats:italic><\/jats:p><jats:p>Trazodone at 100\u2005mg increased the effort-related arousal threshold in response to hypercapnia in obstructive sleep apnoea patients and allowed them to tolerate higher CO<jats:sub>2<\/jats:sub>levels.<\/jats:p>","DOI":"10.1183\/09031936.00067607","type":"journal-article","created":{"date-parts":[[2008,2,7]],"date-time":"2008-02-07T01:34:28Z","timestamp":1202348068000},"page":"1308-1312","source":"Crossref","is-referenced-by-count":94,"title":["Trazodone increases arousal threshold in obstructive sleep apnoea"],"prefix":"10.1183","volume":"31","author":[{"given":"R. C.","family":"Heinzer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. P.","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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