18-4 Beneficial effects of artificial carbon-dioxide water bathing on the quality of sleep in healthy volunteers: A pilot study / 日本温泉気候物理医学会雑誌

Objectives: To preliminarily assess the effects of a single warm-water bath (WWB) on the quality of sleep, we measured sleep pattern after WWB in healthy volunteers. The primary objective of the present before-after study was to evaluate whether a single 10-minute WWB at 41°C could modulate sleep pattern in a single group of healthy subjects. In this pilot study, we also assessed the difference in general fatigue and subjects’ satisfaction responses to WWB under two conditions: WWB using tap water (WWB with tap water) and WWB using a bath additive that included inorganic salts and artificial carbon-dioxide (CO2) (WWB with ISCO2). Methods: Eleven healthy volunteers aged 20 to 48 years (29.8±8.9 years, mean ± SD) participated in this study. Inclusion criteria were as follows: age 20-50 years; free of cardiovascular disease; not taking medications or supplements. In this within-subject, two-way crossover study, all subjects underwent WWB with tap water or WWB with ISCO2 in random order for two consecutive nights. Objective sleep measures from sleep sensor mat (sleep-scan) and subjective subjects’ reports were collected. This study was approved by the Ethics Committee of Kagoshima University Hospital and written informed consent was obtained from all of the subjects. Results: None of the subjects experienced discomfort before, during or after the study period. The objective sleep measures and subjects’ reports were completed safely in all subjects. WWB with ISCO2 bathing produced significant improvement in objective and subjective sleep latency compared with WWB with tap water bathing (P<0.05). Sleep-scan-determined wake time after sleep onset (WASO), sleep efficiency, and number of awakenings (NA), and patient-reported measures of WASO, NA, sleep quality, sleep depth, and daytime functioning significantly improved following WWB with ISCO2 bathing versus WWB with tap water bathing (P<0.05). WWB with ISCO2 bathing also increased deep sleep time and sleep score (P<0.01 for both comparisons), but did not alter REM or slow-wave sleep. Conclusion: In conclusion, in our group of healthy volunteers, a single warm-water bath was shown to have the potential to modulate the quality of sleep. These findings demonstrate that WWB with ISCO2 bathing might be effective in improving some domains of sleep quality of healthy volunteers, and the subjects showed acceptance towards the intervention. Strengths and limitations of the present study as well as suggestions for further studies were considered. Further evaluations with larger and longer-term randomized double-blind placebo-controlled trials based on the present study are needed.

A Case of Carbon Dioxide Poisoning from Dry Ice Inhalation

Carbon dioxide (CO2) poisoning is rare, but its clinical features of acute exposure include cardiovascular, respiratory, neurologic and metabolic aspects. CO2 can also have a direct toxicological effect. At very high concentrations (>9%), CO2 induces respiratory depression and narcotic-like effects on the central nervous system. Especially, acute poisoning from dry ice is caused by CO2 gas inhalation and asphyxiation, and may impose excess load on the myocardium. This case was an acute CO2 poisoning from dry ice gas inhalation. In spite of an initial severe status, the male patient rapidly improved with no complications following the application of highly concentrated oxygen and fluid therapy.

Treatment of Nasal Telangiectasis with Carbon Dioxide(CO2) Laser

Telangiectasis is defined as permanent visible dilatation of the cutaneous blood vessels. Clinically, its diameter ranges from 0.1 to 1.0 mm which represents either an expanded venule, an capillary, or sometimes an arteriole on the face. Until now, many treatment methods have been reported such as various laser therapy, sclerotherapy, electrodessication and so on. We used superpulse CO2 laser to remove nasal telangiectasis in 8 patients between May 2004 and July 2007. Laser therapy was done in continual 5 sessions with intervals of 3 - 5 weeks. In each session, laser beam was shot to the point of the bifurcation, trifurcation of telangiectatic vessels or to the points of the widest diameter. In each point, shots of the laser beam were repeated 5 times to reach deep dermis. The laser setting was 7 W with 0.5 mm diameter in superpulse mode. Photographs were taken before and after procedures to ascertain the changes of nasal telangiectasis. Our results showed that the main lesions were cleared effectively. We think that irradiation of CO2 laser onto the bifurcating points can be a valuable tool to treat nasal telangiectasis.