In patients with mild to moderate obstructive sleep apnea (OSA), modafinil improves daytime sleepiness. It is an oral drug that can be taken by mouth with or without food, usually once daily in the morning or at noon.
In a 12-week, randomized, double-blind study of nCPAP-adherent patients with OSA and refractory excessive sleepiness (ES), Modalert 200 Australia significantly improved wakefulness, cognition, and daytime sleep latency as objectively assessed by the Maintenance of Wakefulness Test.
Symptoms
Obstructive sleep apnea (OSA) is a disorder that occurs when the throat or airway collapses during sleep. This can cause breathing to stop for a brief time and increase levels of both oxygen and carbon dioxide in the blood.
The most common symptom of mild to moderate OSA is excessive daytime sleepiness, which can lead to problems with concentration and fatigue. It also increases the risk of drowsy driving and car accidents.
If you have mild to moderate OSA, it is important to get treatment. It can improve your symptoms and help you avoid serious health conditions such as stroke, heart disease, diabetes, and high blood pressure that can occur with OSA.
The best way to reduce the symptoms of mild to moderate OSA is by making changes in your lifestyle. These can include getting regular exercise, avoiding alcohol and other stimulants close to bedtime, and reducing body weight if you are overweight or obese.
Diagnosis
Obstructive sleep apnea (OSA) is diagnose based on a combination of symptoms, medical history, and the results of a diagnostic sleep study. The most commonly use test is polysomnography performed in a sleep laboratory.
Often, a positive PSG is enough to diagnose OSA. However, a negative test may still be consider.
The level of oxygen desaturation, a decrease in your blood oxygen levels, is also considered when making the diagnosis. A normal level should be around 96 to 97 percent.
Mild sleep apnea can be treat with CPAP therapy, oral appliances, and surgery. These treatments can reduce breathing disruptions, improve your sleep, and reduce the risk of other health problems. Depending on your symptoms and the severity of your OSA, your doctor may recommend one or more of these options.
Treatment
Modafinil improves daytime sleepiness in patients with mild to moderate OSA, including those who are not willing or able to use nasal continuous positive airway pressure (CPAP) therapy. A randomized, double-blind, placebo-controlled trial evaluated the efficacy and safety of 200 or 400 mg of modafinil once daily for 4 weeks in patients with residual daytime sleepiness despite CPAP.
A post-hoc analysis of subjective ESS scores demonstrated significantly greater improvements in patients treated with modafinil at Week 4 (p 0.001), with a similar effect for multiple sleep latency times (MSLT). This study supports the use of modafinil to improve sleepiness in obstructive sleep apnea syndrome in patients who are not willing or able to tolerate CPAP.
The treatment of OSA should be a multidisciplinary approach that includes patient education and counseling, weight loss when indicated, behavioral measures (eg, avoidance of alcohol and sedatives before bedtime), and continuous positive airway pressure, positional therapy, or oral devices. The patient should be consult for decisions about which strategy is most appropriate.
Monitoring
Obstructive sleep apnea (OSA) is a serious disorder characterize by upper airway collapse while sleeping and is associate with a high risk of metabolic and cardiovascular comorbidities and mortality. Symptoms include excessive daytime sleepiness (EDS), fatigue, and neurocognitive dysfunction.
Patients with REDS due to OSA should be refer for evaluation by a sleep specialist and objective testing, such as polysomnography, is recommend. Multifactorial pathophysiologic mechanisms may be involve, including chronic hypoxia-reoxygenation-induced injury to orexinergic neurons, genetic factors, oxidative stress, dysbiosis, inflammation issues, alter melatonin circadian rhythms, sleep fragmentation, and possible disturbances of the glymphatic system.
In a study of 157 subjects with mild to moderate OSA who were treat with Modafinil, compared with the control group, the average Epworth Sleepiness Scale score decreased from 15 at baseline to 7 after treatment. In addition, a number of functional outcomes, such as physical functioning and the ability to engage in everyday activities, were improve by treatment with Modafinil.