J Sleep Med.  2022 Aug;19(2):75-82. 10.13078/jsm.220015.

Effects of Low-Concentration Carbon Dioxide Exposure at Bedtime on Sleep in Adults With Insomnia Symptoms

• Choi SJ
• Joo EY

• KMID: 2533047
• DOI: http://doi.org/10.13078/jsm.220015

Abstract

Objectives
Carbon dioxide (CO₂) accumulation in an enclosed space might cause drowsiness. This study aimed to assess the effect of bedtime exposure to low concentrations of CO₂ gas on the sleep quality of adults with insomnia.
Methods
In this double-blind, randomized, sham-controlled cross-over study, we consecutively recruited 24 adults (9 men; age, 55.4±6.3 y) complaining of sleep disturbances (Pittsburgh Sleep Quality Index ≥5). The following two interventions were used in the study: exposure to 2% low-concentration edible CO₂ gas (experimental intervention) and exposure to room air (sham-controlled intervention). A sleep air device (Gosleep^®, NYX), which atomizes CO₂ gas, was used in both experimental and sham-controlled interventions. For the sham session, room air was generated for 18 min, and then, gradually reduced by degrees in the next 5 min with the device finally being turned off.
Results
The group exposed to CO₂ gas had longer time in bed (361.3±55.2 min vs. 347.2±35.7 min, p=0.034) and total sleep time (311.0±74.3 min vs. 287.2±69.4 min, p=0.010) than the group exposed to room air. Meanwhile, the total arousal (19.7±9.5/h vs. 24.0±13.7/h, p=0.011) and non-REM arousal (20.9±11.3/h vs. 25.1±14.9/h, p=0.008) indices were lower in the group exposed to CO₂ gas than in the group exposed to room air. However, perceived total sleep time or sleep latency and Karolinska Sleepiness Scale scores were not significantly different between the two groups.
Conclusion
Exposure to low concentrations of CO₂ improved the total sleep time and arousal index in adults with insomnia. Unexpectedly, CO₂ administration was found to be effective for sleep maintenance.