The effects of doxofylline versus theophylline on sleep architecture in COPD patients

C. Sacco, A. Braghiroli, E. Grossi, C. F. Donner

Research output: Contribution to journalArticlepeer-review


Theophylline is known to alter sleep architecture because of its affinity to adenosine receptors. One of the consequences of disrupted sleep is impaired cognitive performance. A single-blind, randomized cross-over study of eight male chronic obstructive pulmonary disease (COPD) patients was undertaken to evaluate the effects of theophylline versus doxofylline on sleep architecture. The patients, who were all ex-smokers, had been treated with theophylline. Mean age was 53±12 yrs, forced expiratary volume in one second (FEV1) 50±22% predicted and forced vital capacity (FVC) 70±18% predicted. Following a wash-out period, four patients were given oral slow-release throphylline (T) (300 mg b.i.d.) for one week, followed by a cross-over to doxofylline (D) (400 mg t.i.d.) for a second week. The other four patients were given the drugs in the reverse order. All patients underwent polysomnography at baseline and at the end of each week of treatment. The number of arousals per hour was 5.5±2.9 at baseline, 9.4±5.2 during T treatment and 5.4±1.4 during D treatment. During T treatment, sleep efficiency was 60±19% vs 75±13% recorded at baseline trial and 68±25 recorded during D treatment. Sleep quality, during T treatment, was poorer than at baseline, with a greater increase in the percentage of wakefulness and more stage 2 sleep than at baseline. Slow wave sleep was reduced with bath treatments, particularly D. Neither drug affected the arterial oxygen saturation (SaO2) or respiratory rate during sleep. In conclusion, doxofylline appears to disrupt sleep less than theophylline, and could be of benefit to COPD patients complaining of sleep disturbances.

Original languageEnglish
Pages (from-to)98-103
Number of pages6
JournalMonaldi Archives for Chest Disease - Cardiac Series
Issue number2
Publication statusPublished - 1995


  • Chronic obstructive pulmonary disease
  • Doxofylline
  • Sleep architecture
  • Theophylline

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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