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Sustained release choline theophyllinate in nocturnal asthma
British Medical Journal (Clinical Research Ed.)
|December 7, 1985
Summary
Sustained release choline theophyllinate improved asthma symptoms and prevented overnight bronchoconstriction. However, this asthma medication negatively impacted sleep quality, as measured by electroencephalography, increasing wakefulness and reducing deep sleep stages.
Area of Science:
- Pulmonary Medicine
- Sleep Medicine
- Pharmacology
Background:
- Nocturnal wheezing is a frequent asthma symptom.
- Slow-release theophyllines are potential treatments for nocturnal asthma symptoms.
Purpose of the Study:
- To evaluate the efficacy of sustained-release choline theophyllinate in patients with nocturnal asthma.
- To assess its effects on overnight bronchoconstriction, nocturnal oxygen saturation, and sleep quality.
Main Methods:
- A double-blind, placebo-controlled crossover study was conducted.
- Nine stable patients with nocturnal asthma received either sustained-release choline theophyllinate or placebo twice daily for 10 days.
- Measurements included spirometry, symptom diaries, polysomnography, and plasma theophylline levels.
Main Results:
- Sustained-release choline theophyllinate significantly improved morning forced expiratory volume in one second (FEV1) compared to placebo.
- Both daytime and nocturnal asthma symptoms were reduced, and subjective sleep quality improved.
- Objective sleep quality, assessed by electroencephalography, deteriorated, with increased wakefulness and reduced non-rapid eye movement sleep.
- No significant effect was observed on nocturnal hypoxemia or sleep-disordered breathing.
Conclusions:
- Sustained-release choline theophyllinate effectively prevents overnight bronchoconstriction and alleviates asthma symptoms.
- Despite subjective improvements, objective sleep quality is impaired by this medication.
- Theophylline's central nervous system stimulant properties may contribute to sleep disturbances in asthma patients.
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