Your healthcare provider may recommend PROVIGIL (modafinil) for you to treat excessive sleepiness if you have obstructive sleep apnea. It is important to follow your healthcare provider’s instructions for using this medicine.
Modafinil was administered at 200 mg/d once daily for 4 weeks in 114 Japanese OSAS patients with residual excessive sleepiness despite optimal nap therapy (ESS > 11). Efficacy assessments included the ESS and the SL-MWT.
Effects of Modafinil on Sleepiness
The medication modafinil australia online has been found to increase alertness and performance in humans in many different situations. It has been shown to improve both subjective and objective measures of sleepiness, such as the YMRS score, Epworth Sleepiness Scale, and Fatigue Severity Scale.
It is a wake-promoting drug that affects the dopamine and norepinephrine systems in the brain in ways similar to classical psychostimulants. It has been found that modafinil is also able to affect the histaminergic system, though in a less direct way than the dopaminergic and norepinephrinergic systems.
Studies have shown that adjunctive modafinil treatment can reduce residual sleepiness in patients with narcolepsy and shift work sleep disorder, as well as OSAHS patients who are receiving effective therapy.
However, it is important to note that the improvement in sleepiness induced by modafinil is separate from the improvement in the symptoms of obstructive sleep apnea. Therefore, patients should continue to treat their obstructive sleep apnea with the use of a mouth device or continuous positive airway pressure (CPAP) machine.
Effects of Modafinil on Apnea
Modafinil can be used to reduce excessive daytime sleepiness in narcolepsy, shift work sleep disorder (sleepiness during scheduled working hours in those who work at night or on rotating shifts), and obstructive sleep apnea/hypopnea syndrome (OSAHS; a condition that causes repeated episodes of choking and/or gasping for breath in people with chronic obstructive airway disease). It is also effective as an adjunctive treatment in patients who are receiving nasal continuous positive airway pressure therapy for OSAHS.
In a recent double-blind, placebo-controlled study, modafinil was found to be an effective and well-tolerated medication for reducing residual EDS in people with OSA who were compliant with CPAP therapy.
However, it should not be abused for this purpose in cases where EDS appears to be caused by clinically significant OSA, since a polysomnogram is the most accurate diagnostic method and should be performed before any medication is prescribed.
Moreover, the authors note that modafinil can suppress REM sleep, and this should be taken into consideration when prescribing it for people who are suspected of having OSA.
Effects of Modafinil on Daytime Performance
Modafinil is a wake-promoting agent that improves daytime performance in patients with excessive sleepiness associated with shift work sleep disorder, obstructive sleep apnea, and narcolepsy. Six randomized, double-blind, placebo-controlled studies were combined to assess the safety and tolerability of modafinil in these patient populations.
The studies included data from a total of 1,259 patients who received either 200, 300, or 400 mg modafinil per day or placebo. Patients were titrated to the target dose over 9 weeks.
Clinical laboratory tests and polysomnography were recorded for all subjects. Clinically significant abnormalities in mean laboratory tests were rare. There was no difference in mean nocturnal polysomnography or Multiple Sleep Latency Test (MLST) parameters between the Modalert 200 Australia and placebo groups.
Seventy percent of patients receiving modafinil were rated as “much improved” or “very much improved” on the Clinical Global Impression of Change scale at the final visit, compared to 36 percent of patients receiving a placebo. Modafinil also significantly reduced the symptoms of pathological somnolence in narcolepsy and increased sleep latency on the MSLT in shift work sleep disorder.
Effects of Modafinil on Fatigue
Modafinil is a wake-promoting agent that has been shown to ameliorate excessive daytime sleepiness (EDS) associated with narcolepsy, shift work disorder, and obstructive sleep apnea. It is also known to increase cognitive function in patients with narcolepsy.
114 patients were randomly assigned to either receive modafinil or placebo in a double-blind, randomized, placebo-controlled trial. The primary efficacy endpoint was the change in ESS total score from baseline to Week 4. The ESS score decreased from > 11 to 11 in 67% of modafinil-treated patients and in 30% of placebo-treated patients, a difference that was statistically significant by ANCOVA (controlling for the effects of changes in nocturnal polysomnography, apnea-hypopnea index, and PSQI) (Figure 2).
A secondary endpoint was the change in fatigue using a visual analog scale at the final evaluation visit in both groups. The mean change in the VAS-F score was 5.4 at the end of the modafinil treatment phase compared to 4.5 at the placebo run-in phase.
