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The therapeutic effect of theophylline on sustained attention in patients with obstructive sleep apnea

Die Wirkung von Theophyllin auf die Daueraufmerksamkeit von Patienten mit OSAS

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Summary

Question of the Study

Patients with obstructive sleep apnea syndrome (OSAS) often suffer from daytime sleepiness and reduced alertness which frequently cannot be normalized despite of nCPAP therapy. Therefore additional treatment options for residual deficits is urgently needed. The objective of this study was to prove the efficacy of Theophylline on a component of attention (tracking) in patient with untreated obstructive sleep apnea syndrome (OSAS).

Patients and Methods

Theophylline or placebo was given two times in the morning (8∶00 and 12∶00 a.m.) in randomized order on two consecutive days. During the afternoon, 39 OSAS patients performed a randomised cross-over driving simulation test with the aid of “Carsim”, a newly developed driving simulator, prior to undergoing CPAP-therapy. The program “Carsim” simulates a road with curves on a screen, the simulated vehicle should be kept on the right lane by moving the steering wheel

Results

Under the effect of Theophylline (the serum level under placebo at the beginning of the measurement was 2.1 μg/ml±1.6 μg/ml and under Theopylline 11.2 μg/ml±2.8 μg/ml), the duration of track deviations measured by the driving simulator improved significantly from 49.3±99.5 s to 13.6±18.0 s.

Conclusions

Theophylline may improve alertness in patients with sleep fragmentation and reduced sustained attention.

Zusammenfassung

Fragestellung

Patienten mit obstruktivem Schlafapnoe-Syndrom (OSAS) leiden häufig u. a. an Tagesschäfrigkeit und reduzierter Wachheit, die häufig trotz nCPAP-Therapie nicht normalisiert werden kann. Daher werden verschiedene Behandlungsoptionen benötigt, um die residualen Schläfrigkeits-Probleme zu behandeln. Ziel dieser Modell-Studie war es, mittels eines neu entwicklten Fahrisimulators “Carsim” die Wirkung von Theophyllin auf die Daueraufmerksmakeit bei Patienten mit obstruktivem Schlafampoesyndrom (OSAS) vor CPAP-Therapie zu untersuchen.

Patienten und Methodik

Eine Placebo-kontrollierte Stichprobe von OSAS-Patienten (n=39) führte nach zweimeliager morgendlicher Gabe von Theophyllin (8∶00 und 12∶00 Uhr), vor Therapieeinleitung einen Fahrsimulator-Test randomisierts cross-over durch. Mit dem Programm “Carsim” wirdk mittles Bildschirm eine Straße mit Kurven simultiert, wobei das Fahrzeug durch Lenkradbewegungen auf der rechten Spur gehalten werden muß.

Ergebnisse

Wir konnten zeigen, dass sich die mittels Fahrsimulator gemessene Zeitdauer der Spurabweichungen unter Theophyllin (der Serumspiegel unter Placebo zu Beginn der Messung betrug 2,1 μg/ml±1,6 μg/ml und unter Theopylline 11,2 μg/ml± 2.8 μg/ml) von 49.3±99.5 s auf 13.6±18.0 s verbesserte.

Schlussfolgerungen

Theophyllin ist in der Lage, bei OSAS-Patienten mit gestörtem Schlaf und reduzierter Daueraufmerksamkeit die Leistungsfähigkeit am Tage zu verbessern.

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  1. Klinik Ambrock, Klinik für Pneumologie, Allergologie und Schlafmesizin, Universität Witen-Herdecke, Ambrocker Weg 60, 58 091, Hagen, Germany

    Antje Büttner &  Karl-Heinz Rühle

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  1. Antje Büttner
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  2. Karl-Heinz Rühle
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Correspondence to Karl-Heinz Rühle.

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Büttner, A., Rühle, KH. The therapeutic effect of theophylline on sustained attention in patients with obstructive sleep apnea. Somnologie 7, 23–27 (2003). https://doi.org/10.1046/j.1439-054X.2003.02190.x

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