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J Appl Physiol 87: 897-901, 1999;
8750-7587/99 $5.00
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Vol. 87, Issue 3, 897-901, September 1999

Drug-induced arterial pressure elevation is associated with arousal from NREM sleep in normal volunteers

Branko Kesler1,3, Amit Anand1,3,4, Sandrine H. Launois1,3,4, and J. Woodrow Weiss1,2,3,4

1 Charles A. Dana Institute and Harvard-Thorndike Laboratory of Beth Israel Deaconess Medical Center, 2 Beth Israel Deaconess Sleep Disorders Center, and Departments of Medicine, 3 Beth Israel Deaconess Medical Center and 4 Harvard Medical School, Boston, Massachusetts 02115

Abrupt changes in arterial pressure produce arousal in sleeping animals. To determine whether arterial pressure elevations can cause arousal from sleep in humans, we studied five healthy individuals without sleep complaints or cardiac abnormalities. Monitoring included electroencephalogram, electrooculogram, and electromyogram to determine stage sleep; finger cuff to measure arterial pressure; and electrocardiogram to measure heart rate. We administered intravenous bolus doses of either phenylephrine or saline after performing a dose-response curve to establish the amount of phenylephrine that produced a 20-mmHg increase in mean arterial pressure. Ten boluses of phenylephrine and ten boluses of saline were then administered in random order during stable non-rapid-eye-movement sleep. An observer blinded to the order of drug administration identified arousals using a standard definition. Arousals were five times more likely to occur after phenylephrine than after saline (58 vs. 12%; P = 0.0071). Phenylephrine administration produced heart rate slowing, indicative of baroreflex stimulation. We conclude that pharmacologically induced arterial pressure elevation is associated with arousal from sleep in normal volunteers.

hypertension; phenylephrine; non-rapid-eye-movement sleep


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