Chest
Theophylline in Obstructive Sleep Apnea: A Double-Blind Evaluation
Section snippets
Patient Selection
Twelve male patients with recently diagnosed OSA (>15 apneas or hypopneas per hour of sleep) were enrolled in the study. Patients with a history of cardiac or hepatic disorders were excluded, as were those taking hypnotics or sedatives, or any medication known to interfere with the absorption or metabolism of theophylline. Patients with a substantial alcohol intake (>20 units per week) were also excluded. The study was approved by the Hospital Ethics Committee, and all patients gave informed
RESULTS
Nine patients completed the trial, and the anthropometric and spirometric data for these patients are presented in Table 1. They were all above ideal body weight for height, and two were morbidly obese. They had established OSA of varying severity prior to entry into the study, with an A+H index ranging from 25 to 100. Some of the patients also had mixed and a small number of central apneas, but all had predominantly obstructive disease. All had excessive daytime sleepiness of varying severity.
DISCUSSION
The main finding of this study was that theophylline significantly reduced the number of apneas and hypopneas during sleep with obstructive apneas being preferentially reduced. When these data are corrected for the deterioration in sleep quality while receiving theophylline, the frequency of obstructive apneas and hypopneas remains significantly lower with theophylline than placebo. These findings differ from those of Espinoza and colleagues,1 who in a placebo-controlled trial of a single
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Adjunctive and alternative therapies for obstructive sleep apnea
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2019, Sleep Medicine ReviewsCitation Excerpt :Sample sizes were generally small and although some effect on the AHI was documented [25,41], the nocturnal intravenous infusion of opioid receptor antagonists influenced the overall sleep architecture which made interpretation of the results impossible and the clinical usefulness of these drugs questionable [25,36,41]. Several RCTs used respiratory stimulants as an intervention to take advantage of the central stimulatory effect, mainly on the medullary respiratory center (theophylline [35,46,62], aminophylline [40], doxapram [70], almitrine [57]), via NMDA receptors (sabeluzole [43], AR-R15896AR [73]), or via a metabolic acidosis (acetazolamide [38,75,81]). These interventions were either negative [40,43,70,73] or showed a relatively small effect on the AHI (usually 15–20% reduction [35,38,46,57,62,75], Fig. 2) owing to a massive deterioration in sleep quality (i.e., lower sleep efficiency and massive sleep fragmentation).
Drug Therapy in Obstructive Sleep Apnea
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2017, ChestCitation Excerpt :Both agents have no significant impact on sleep quality. Theophylline also reduces nocturnal hypoxemia and has been shown to benefit OSA by reducing the AHI.32,33 However, the clinical usefulness of theophylline is limited by side effects, particularly cardiovascular and GI effects.
Reprint requests: Dr. McNicholas, St. Vincents Hospital, Dublin 4, Ireland