Let's Check Out the Best Treatment for Excessive Daytime Sleepiness

Drug solriamfetol is the best treatment for excessive daytime sleepiness (EDS), especially for people with obstructive sleep apnea (OSA), suggests a new study led by McMaster University researchers Dena Zeraatkar and Tyler Pitre.

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‘Beyond positive airway pressure (PAP) mask: Drugs such as solriamfetol, armodafinil–modafinil and pitolisant can treat excessive daytime sleepiness (EDS) in people with obstructive sleep apnea (OSA).’
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Sleep Apnea Treatment Options

The standard treatment for OSA is a positive airway pressure (PAP) mask that uses compressed air to support lung airways during sleep. However, some people with OSA still experience EDS and may benefit from anti-fatigue medication.

Zeraatkar and Pitre published their results in the Annals of Internal Medicine ().

“The most important thing that people with OSA should do is use their PAP machine, but if they are still sleepy there are options in the form of medications that can reduce their tiredness,” said first author Tyler Pitre, a resident physician in internal medicine at McMaster University and incoming respirology fellow at the University of Toronto.

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Prevalence of Obstructive Sleep Apnea (OSA)

“Fifteen to 30 percent of people in North America have a diagnosis of OSA and the prevalence could be much higher as many others are undiagnosed. Many people have symptoms as the condition is highly associated with obesity, which affects a large and increasing number of people in Canada, the United States and other high-income countries,” he said.

“Among those patients, many will have EDS, which affects their quality of life, making them less productive and also puts them at risk of other psychological issues. Improving this situation is of paramount importance to physicians.”

Pitre said that OSA affects nearly one billion people globally, leaving many of them at risk of EDS.

Zeraatkar and Pitre made their findings by conducting a systematic review of 14 clinical trials of anti-fatigue medications involving 3,085 people, as well as analyzing data from MEDLINE, CENTRAL, EMBASE and ClinicalTrials.gov in a specific network meta-analysis. They conducted their research from October 2022 to January 2023.

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How to Treat Excessive Daytime Sleepiness with Medications?

Senior author Zeraatkar said that while solriamfetol is likely the best medication for EDS, the drugs armodafinil–modafinil and pitolisant are also effective in combating fatigue.

Solriamfetol can also raise blood pressure, especially risky for people with OSA, as many of them also have cardiovascular issues.

“It would be interesting to see how effective these anti-fatigue medications will be for treating related illnesses such as chronic fatigue syndrome and long COVID, now that we know they work for a similar condition,” said Zeraatkar, an assistant professor of the Department of Anesthesia.

Reference:

Comparative Efficacy and Safety of Wakefulness-Promoting Agents for Excessive Daytime Sleepiness in Patients With Obstructive Sleep Apnea - (https://www.acpjournals.org/doi/10.7326/M22-3473)

Source-Eurekalert

Quiz on Obstructive Sleep Apnea
Do you feel sleepy all day despite sleeping normal hours? One of the possible reasons for this sleepiness could be obstructive sleep apnea. Test your knowledge on obstructive sleep apnea by taking this quiz.