Drug therapy of sleep apnea syndromes: results of short-term treatment with theophylline

Abstract

In the treatment of obstructive sleep apnoea syndrome (OSA) nasal ventilation therapy (nCPAP) and various surgical strategies like uvulopalatopharyn-goplasty proved effective. However, not all patients can be successfully treated with these therapies. In our study we investigated the effects of oral theophylline taken at night in patients with OSA. 50 patients with polysomnographically verified OSA were enrolled in two groups in this study. In the therapy group we administered 300-500 mg of oral theophylline at night for 4-22 weeks. In all patients nCPAP therapy was indicated in the beginning of the trial. We 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 cancelled. In the therapy group the number of apnoea and hypopnoea was reduced by 17.08%. The mean apnoa duration and the time of sleep with an oxygen saturation below 90% was reduced by 8.41% and 19.58%, respectively. In the control group we found an increase in apnoeas and hypopnoeas by 10.48%. Apnoea duration and desaturation time increased by 4.71% and 11.04%, respectively. Comparison of the effects between the two groups using the Wilcoxon 2-sample test proved to be statistically significant. Besides these positive effects we found 27.2% non-responders. Theophylline has a short-term relevant beneficial effect only on patients with mild OSA. Because of the limited beneficial effects, permanent theophylline treatment has to be monitored regularly via control polysomnography. Under certain conditions noctural oral administration of theophylline may supplement conventional therapy strategies.