We compared the effects of a placebo with 0.125 and 0.25 mg of
triazolam (
Halcion) on sleep quality, oximetry, and respiratory events during sleep in ten stable outpatients with
chronic obstructive pulmonary disease. The subjects had a forced expiratory volume in 1 s ranging from 17% to 76% of the predicted value (mean +/- SD, 38.1% +/- 19%) and a waking arterial
oxygen pressure from 46 to 84 mm Hg (mean +/- SD, 67 +/- 12 mm Hg). Polysomnography was done on three nights within a two-week period after the patients received on a "blinded" basis either placebo or 0.125 or 0.25 mg of
triazolam.
Triazolam produced improvements in total sleep duration, time spent in stage 2 nonrapid eye movement (NREM) sleep, and subjective of sleep quality. For most patients, there was a nighttime drop in arterial
oxygen percentage of saturation (SaO2) in the placebo condition, but
triazolam did not cause a significant worsening, of the mean SaO2, minimum SaO2, or the number of apneic and hypopneic events. Across all experimental conditions, we documented little desaturation during wakefulness (mean low, 87.2% +/- 10.2%), more during NREM sleep (mean low, 83.2% +/- 12.6%), and most desaturation in REM sleep (mean low, 80.1% +/- 15.7%). We conclude that single-night use of
triazolam improved the quality and duration of sleep in patients with
chronic obstructive pulmonary disease. In patients without severe waking
hypoxemia and without
carbon dioxide retention,
triazolam did not increase either nocturnal
hypoxemia or respiratory events during sleep.