Drug therapy of obstructive sleep apnoea syndrome: results of a short-term treatment with theophylline

Abstract

In the treatment of obstructive sleep apnoea syndrome (OSA), nasal ventilation therapy (nCPAP) and various surgical strategies such as uvulopalatopharyngoplasty have proved effective. However, not all patients can be successfully treated with these therapies. The present study investigated the effects of oral theophylline taken at night in patients with OSA. Fifty patients with polysomnographically verified OSA were enrolled in this study and divided into two equal groups. In the therapy group, 300–500 mg of oral theophylline were administered at night for 4–22 weeks. The non-therapy group served as a control for comparison. In all patients, nCPAP therapy was indicated at the beginning of the trial. The authors found a positive effect of theophylline treatment in patients with a comparatively low apnoea-hypopnoea index, low overweight and inconspicuous status of the upper airways. In 5 cases, the initially indicated nCPAP treatment could be stopped. In the therapy group, the number of apnoea and hypopnoea episodes was reduced by 17.08%. The mean apnoea duration and the time of sleep with an oxygen saturation below 90% were reduced by 8.41% and 19.58%, respectively. In the control group, an increase of 10.48% was found in the number of apnoeas and hypopnoeas. Apnoea duration and desaturation time were increased by 4.71% and 11.04%, respectively. Comparison of the effects in the two groups using the Wilcoxon 2-sample test showed the differences to be statistically significant. Besides these positive effects, 27.2% of the therapy group did not respond to treatment. The authors concluded that theophylline has a short-term effect on patients with mild OSA. Because of the limited beneficial effects, permanent theophylline treatment has to be monitored regularly by polysomnography. Under certain conditions, nocturnal oral administration of theophylline may supplement conventional therapy strategies. Henning Schliephake