1. Introduction
Sleep quality is very important for health and daily life performance [
1]. Improving sleep quality involves not only developing good sleep habits but also creating a suitable sleeping environment. Indoor environmental quality is composed of a thermal and humid environment, indoor air quality, an acoustic environment, and a light environment. Influential thermal environment factors in the bedroom include temperature, relative humidity, airflow velocity, radiation temperature, etc. CO
2 concentration is also an important index to judge indoor air quality [
2]. Existing data show that if people are indoors with CO
2 concentrations greater than 1000 ppm for a long time, the functions of the respiratory system, circulatory system, and brain organs are affected, and symptoms such as deepened breathing, accelerated circulation, or slow brain response will appear, resulting in discomfort [
3]. CO
2 is an exhaust gas from the human respiratory system, and indoor breathing has become the main source of indoor CO
2 in most civil buildings, while indoor CO
2 concentration has a strong impact on human health [
4]. When the content of CO
2 in the air is normal, it is harmless to the human body, but after exceeding a certain degree, it starts to affect people’s respiratory system, causing an increase in the concentration of carbonic acid in the blood, an increase in acidity, acidosis to occur, and can cause people’s physiological reactions as well as various discomforts [
5]. Some guidelines and standards list the maximum CO
2 concentration acceptable indoors, usually at around 800 ppm or 1000 ppm [
6,
7]. However, due to a decrease in ventilation during sleep, CO
2 discharged by human breathing accumulates indoors, and its concentration gradually increases until it far exceeds national standards [
8].
A high concentration of bedroom CO
2 also has a negative impact on sleep quality. Low CO
2 concentration can provide a healthy and comfortable sleeping environment and is conducive to improving sleep quality, which has a far-reaching impact on human physical and mental health. Zhang et al. [
9] recruited 104 subjects for a home sleep test during spring and autumn in Beijing, China, and divided them into a high CO
2 concentration group and a low CO
2 concentration group with 1000 ppm as the line. The average CO
2 levels of the two groups were 2012 ppm and 672 ppm. Subjective assessment results showed that the high CO
2 concentration group had poor sleep satisfaction and strong smell intensity, while the objective results showed that the awake stage was longer and sleep efficiency was significantly poorer. Strøm-Tejsen et al. [
10] conducted an experiment on the relationship between CO
2 concentration and sleep quality in Danish dormitories. In the study, two different CO
2 conditions were created using ultra-low noise fans controlled by sensors, and researchers found that sleep quality and performance significantly improved under low CO
2 conditions the next day. Fan et al. [
11] studied the per capita production of CO
2 in a naturally ventilated room and monitored the concentration using a CO
2 concentration sensor. The per capita CO
2 production rate was calculated based on the measured data. Kapalo et al. [
12] divided the per capita CO
2 production of different activity intensities into two types and conducted a test with the mass conservation equation. The test activities included students’ sit-in painting and talking, standing and talking, walking around the classroom, mild activity, and moderate activity. For both test methods, the classroom doors and windows were subject to the permeability test in an unmanned state. However, it is easy to have inaccurate test results due to many factors of interference in the field test. Qi et al. [
13] studied the per capita CO
2 production under two activity levels, including sitting and standing, and asked the subjects to move in a well-sealed experimental cabin for about half an hour. The per capita CO
2 production of the two activity levels was indirectly calculated by comparing and calculating the changes in CO
2 concentration in the closed experimental cabin before and after the activity. This method is simple and is characterized by the ease of obtaining the instrument, but it has high requirements for laboratory airtightness. However, this experiment does not consider that the CO
2 produced by the subjects during their activities in the experimental cabin leads to an increase in CO
2 concentration in the experimental cabin. This further affects the CO
2 production of the human body, resulting in the experimental results being not completely equal to the CO
2 production of the human body in a normal environment.
Xu et al. [
14] investigated the sleep quality of 12 subjects (6 males and 6 females) at three CO
2 concentrations; they observed a linear positive correlation between sleep onset latency (SOL) and CO
2 concentration and a linear negative correlation between SWS and CO
2 concentration. Sekhar et al. [
15] observed that when compared to air-conditioned bedrooms, the average CO
2 concentration in natural ventilation bedrooms decreased by 310 ppm, and the average sleep duration increased by 0.4 h.
Based on 41 people [
16], it found that the lower the CO
2 concentration and noise level, the more comfortable the participants felt. This information can be helpful in guiding the control of bedroom environments. SWS was negatively correlated with air temperature and CO
2 concentration. Compared to males, air temperature and CO
2 concentration had a greater impact on the sleep quality of females. Zhang et al. [
17] observed that heart rate decreased less when CO
2 was 3000 ppm compared with the reference condition of 500 ppm. They also recruited twenty-four subjects to sleep two nights for different CO
2 conditions: 780 and 2027 ppm. The results showed that people subjectively perceived a decrease in their sleep quality when exposed to high indoor CO
2, and subjects had shorter durations of deep sleep and total sleep at high CO
2 exposure levels than those at low CO
2 exposure levels [
18]. Sekhar et al. [
19] summarized 46 studies concerned with bedroom (or whole house) ventilation tests; they proposed that CO
2 concentration above 2600 ppm would disrupt sleep duration and negatively affect next-day cognitive performance.
The above results show that moderate ventilation can improve subjective sleep quality. However, The aim of the appeal study was mainly to focus on the effect of different concentrations of CO2 on sleep quality, and the concentrations tested varied widely, so the results showed that CO2 concentrations had a significant effect on sleep. However, in reality, there is an upper limit on the concentration of CO2 in the room. In order to study the changes in human sleep quality with carbon dioxide concentration within the range of carbon dioxide concentration in a typical home environment, this paper determines the concentration of CO2 according to the three cases of living in a bedroom: one person, two people, and three people. First, we wanted to determine if changes in carbon dioxide levels in the bedroom had any effect on sleep quality. The analysis of variance is used to test whether there are significant differences in the proportion of the N3 period under different CO2 conditions. The importance of whether a room has a fresh air system to improve sleep quality is verified, and the quantitative relationship between indoor CO2 concentration and sleep quality is established through sleep experiments on subjects, through multiple dimensions such as subjective feeling, time awake, and deep sleep ratio.
2. Methods
In order to study the effect of different carbon dioxide concentrations on human sleep quality, a total of 30 subjective tests were carried out with 10 subjects. The experimental study was conducted in a temperature-controlled sleep laboratory. The laboratory’s air conditioning system was used to control the ambient temperature and humidity. Environmental parameters control: each test environment temperature was 26 ± 0.5 °C, relative humidity was 40 ± 5%, there was no obvious heat source in the room, and the radiation temperature and air temperature difference was less than 1 °C. The experimental test was carried out in Beijing, China, from January to February 2022, which belongs to the winter heating season.
Subject selection: in order to ensure that the experimental results were scientific and effective, subjects were strictly selected according to the general requirements of sleep testing, and a professional subjective sleep quality questionnaire was designed. Finally, the experimental testing process was strictly followed.
2.1. Environment for Testing
The test was carried out in a laboratory to simulate an ordinary bedroom sleeping environment. Covering an area of about 12 m
2, this laboratory had temperature and humidity adjustment functions, could accurately control the indoor temperature and humidity, and could ensure the consistency and reproducibility of test conditions. The layout of the experimental site is shown in
Figure 1. According to GB/T18204.1-2013 [
20], the laboratory air leakage coefficient was calibrated, and it was 0.484.
The subjective assessment and objective data were used to test the changes in sleep quality under the conditions of three different CO2 concentrations, and the influence relationship between CO2 concentration changes and sleep quality was obtained using statistical analysis. The sleep quality was tested with different CO2 concentrations, according to the sleep conditions of 1, 2, and 3 persons indoors. The subjects were tested with the prescribed dress conditions (uniform summer cotton shorts with short sleeves, the thermal resistance of clothing: 1.97 clo).
2.2. Indoor CO2 Concentration during Sleep Tests
According to the Bulletin of the Seventh National Census issued by the National Bureau of Statistics of China in 2021, the average population of each household in China is 2.62 persons. In China, more than 80% of children under the age of 6 share a room with their parents. Therefore, three kinds of bedroom CO2 concentrations were selected, that is, simulated sleep scenarios with one person, two persons, and three persons in a room.
In order to ensure the reproducibility of the sleep process and to reduce as much interference as possible, only one subject was in the house during the sleep test. Therefore, it was necessary to introduce CO
2 into the room to simulate human CO
2 emissions and create indoor CO
2 concentration conditions for two and three persons. According to ISO 8996 [
21], the average metabolic rate during sleep is 40 W/m
2, and the CO
2 production rate is about 0.239 L/min, calculated according to the human body size of 50th percentile adults.
The indoor carbon dioxide concentration relies on the carbon dioxide emission device to simulate the situation of many people. The device is shown in
Figure 2. According to the above calculation method, the carbon dioxide cylinder is connected through the emission simulation device to control the emissions. There is a carbon dioxide concentration monitoring alarm device to ensure the safety of the experiment.
In order to ensure the accuracy of physical parameters in the experimental bedroom, the physical parameters (air temperature Ta, relative humidity RH, air flow rate va, black-bulb temperature tg, and indoor CO
2 concentration) were measured using the instruments shown in
Table 1 for the duration of the experiment.
The results of the test showed that indoor CO2 concentration was 787 ppm for one person, for two persons, it was 1298 ppm, and for three persons, it was 2271 ppm. Based on the subjective assessment of air quality given by the subjects during the test, combined with relevant indoor air quality standards, and considering the health and ethics of the subjects, it can be seen that the CO2 concentration values of the three simulated conditions finally determined in this sleep experiment were harmless to humans.
2.3. Selection of Subjects
According to statistics principles, the larger the sample size is, the better it can reflect the overall situation of the investigated object. However, due to various reasons, there is a very limited sample size that can be selected in actual conditions. It is necessary to minimize errors caused by individual differences and to seek the relationship between variables on the premise of ensuring a sufficient sample size. On the basis of ensuring that the sample size can meet the reliability and statistical test, as few possible samples should be selected. In order to balance the age, intelligence, sensitivity, and male–female ratio of the subjects, and to ensure high feedback quality, 10 young subjects, including 5 males and 5 females, were selected from more than 30 subjects who had previously participated in research experiments on sensation and sleep quality in different thermal environments. The subjects were selected to participate in the formal experiment and had all been screened using the Pittsburgh Sleep Questionnaire and confirmed to meet all the test requirements. The subjects were aged 29 ± 4.59, weighed 65.6 ± 11 kg, and were 166.2 ± 6.94 cm tall. They were required to work and rest normally, keep a good diet, maintain a stable mood, avoid catching a cold in the near future, have no strenuous exercise to stabilize blood sugar, and avoid excessive nerve excitement over the whole course of the experiment. After each subject signed the informed consent form, all experimental working conditions were completed for three consecutive days according to regulations. The Latin square experimental design method was adopted to balance the influence of the experimental sequence.
2.4. Design of the Subjective Questionnaire
The subjective questionnaire survey mainly evaluates the sleep quality perception of target users under the three concentrations of CO2. The subjective test mainly includes three parts: basic personal information, sleep quality assessment, and health and comfort assessment.
For basic personal information, subjects’ demographic information and thermal sensations are recorded, including gender, age, height, weight, hot and cold preferences, and clothing situation. For the sleep quality part, a modification was made based on the Pittsburgh Sleep Quality Questionnaire [
22] to change the original sleep quality in the past month to an assessment of the sleep quality of the previous night. After the early pre-experiment, it was found that the 4-level scale did not distinguish the subjective feelings of the subjects well, so the original 4-level score was changed to a 5-level score, ranging from “very good → better → average → worse → no rest at all” (the score is 0 → 4, the higher the value is, the more serious the symptoms are). The assessment of health and comfort comes in part from previous research results on CO
2 concentration. The contents of the survey mainly include headache, dry mouth and throat, dyspnea, dry and itchy skin, difficulty falling asleep/waking up, listlessness, runny nose, congested nose, and bad air smell. The higher the score is, the worse the subjective experience is, that is, “no obvious feeling → very serious” (0 → 4) [
23].
2.5. Sleep Quality Testing with PSG
The objective test result is used to interpret the sleep data of the subjects in stages, generate a PSG sleep report, and record the total experiment time, total sleep time, awake time after falling asleep, sleep efficiency, sleep incubation period, REM incubation period, awakening index, the number of changes in body position and movement, and the duration and proportion of each stage (N1, N2, N3, and REM period).
Test data were extracted from the duration and proportion of each stage (N1, N2, N3, and REM) under different working conditions from the PSG sleep report. Because the subjects sleep and wake up naturally, the total recording time of each test person is inconsistent, and the reference value of duration data is not ideal, so the proportion of each sleep stage is selected.
2.6. Experimental Flow
A pre-experiment was conducted to guide the subjects through the experimental process, fill out subjective questionnaires, and familiarize themselves with the feeling of sleeping with PSG. The working conditions (CO2 concentration, temperature, and humidity) were set before the formal experiment began, and the investigator helped the subjects wear relevant equipment and record current environmental measurements. In order to avoid disturbing the sleep of the subjects as much as possible, the subjects completed the indoor thermal environment and environmental quality assessment questionnaire after waking up naturally the next day.
In the last two days of testing, only the CO
2 concentration in the environment was changed. It is worth noting that, due to “gender differences in body temperature”, men and women had inconsistent thermal feelings. Considering the subjective experience of the subjects, the comfortable sleeping temperature under current clothing conditions was determined: the temperature of male subjects during sleep was controlled at 26 ± 0.5 °C, while that of female subjects during sleep was controlled at 27 ± 0.5 °C. The polysomnography (PSG) was also used to measure the sleep quality of the subjects. PSG can measure signals, including brain waves, eye movement, muscle bioelectricity (EOG, ECG), leg movement, body movement, and blood oxygen saturation. It is primarily used in sleep and dream research and is internationally recognized as a “gold standard” for sleep quality assessment [
24,
25]. The sleep data of the subjects during the previous night were interpreted in stages to form PSG sleep reports, of which the indexes are recorded, including total recording time, total sleep time, time awake after falling asleep, sleep efficiency, sleep incubation period, REM incubation period, awakening index, number of changes in body position and movement, and duration and proportion of each stage (N1, N2, N3, and REM period).
5. Conclusions
In order to investigate whether higher carbon dioxide levels at night, due to a lack of indoor ventilation, have an impact on sleep quality, the study of human sleep quality under three different carbon dioxide concentrations was conducted; the following conclusions were obtained using a questionnaire and a PSG objective test:
(1) According to the research and test results, when 1, 2, and 3 people sleep in a room with an air leakage coefficient of 0.484, the average carbon dioxide concentration is about 800, 1300, and 2200 ppm;
(2) Subjects’ sleep quietness, satisfaction, and duration gradually decreased as the CO2 concentration increased. The strongest subjective discomfort includes mouth and throat difficulty, dyspnea, dry and itchy skin, difficulty falling asleep, difficulty waking up, congested nose, and unpleasant air smell;
(3) According to the group of CO2 concentration conditions, the mean of the N3 period proportion under the conditions of one person, two persons, and three persons is 20.4%, 17.3%, and 14.4%, respectively. There is a statistically significant difference in the proportion of the N3 period with a one-person condition and a three-person condition;
(4) The subjects both turn over and wake up more throughout the night in high CO2 conditions. Under the three carbon dioxide concentrations, the number of body movements increased by about 50%, and the awakening time increased by about 3 min. Thus, it can be seen that sleep quality is worse under conditions with a high CO2 concentration.