Actually, because we access the aircraft via a virtual cockpit it would be far easier in MSFS than a full scale simulator.
I would design it so that you would have an inbuilt ‘error’ probability of increasing severity - so that when you click a switch or tune a dial, it either doesn’t fire the event, fires something else or uses the wrong value.
Hypoxia is insidious - the initial effects are hard to spot and the victim is often unaware even as it gets worse. Only at the final stages should you then get camera effects like fade and blackout.