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Efficiency of continuous positive airway pressure versus theophylline therapy in sleep apnea: comparative sleep laboratory studies on objective and subjective sleep and awakening quality.

Abstract
Sleep apnea is the most common sleep-related breathing disorder characterized by repetitive episodes of hypoxemia. Therapies include behavioral, surgical, orthodontic, pneumological, and pharmacological interventions. The aim of the present study was to compare the efficiency of pneumological therapy by nasal continuous positive airway pressure (CPAP) versus a pharmacological approach with theophylline (Respicur retard(R) 400 mg) on respiratory variables as well as objective and subjective sleep and awakening quality in patients with moderate sleep apnea measured by polysomnography and psychometry. Under CPAP therapy all respiratory variables improved and normalized, while under theophylline only the apnea-hypopnea index and the desaturation index improved but still did not return to normal values. Regarding sleep initiation and maintenance, CPAP therapy prolonged sleep latency and reduced movement time, while patients treated with theophylline showed reduced total sleep period, total sleep time and sleep efficiency. Sleep architecture demonstrated an increase in deep sleep and REM stages under CPAP therapy, and remained unchanged under theophylline. Concerning subjective sleep and awakening quality, both treatments improved well-being in the morning. Regarding objective awakening quality, reaction time performance was improved in both groups. In conclusion, CPAP treatment is more effective than theophylline regarding respiratory variables as well as the normalization of sleep maintenance and sleep architecture in sleep apnea patients.
AuthorsB Saletu, S Oberndorfer, P Anderer, G Gruber, H Divos, A Lachner, M Mandl, S Parapatics, W Popp, M Saletu, G Saletu-Zyhlarz, K Sertl, R Strobl, U Tschida, A Winkler
JournalNeuropsychobiology (Neuropsychobiology) Vol. 39 Issue 3 Pg. 151-9 ( 1999) ISSN: 0302-282X [Print] Switzerland
PMID10087460 (Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article)
Chemical References
  • Bronchodilator Agents
  • Theophylline
Topics
  • Bronchodilator Agents (therapeutic use)
  • Cross-Over Studies
  • Humans
  • Male
  • Middle Aged
  • Polysomnography
  • Positive-Pressure Respiration
  • Respiratory Mechanics (drug effects, physiology)
  • Sleep (drug effects, physiology)
  • Sleep Apnea Syndromes (drug therapy, psychology, therapy)
  • Theophylline (therapeutic use)
  • Wakefulness (drug effects, physiology)

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