Canadian university researchers find 'most effective' treatment for excessive daytime sleepiness

Two researchers from McMaster University have found what they call the ‘most effective’ treatment for excessive daytime sleepiness, which is commonly caused by obstructive sleep apnea.(Photo: pexels)

Researchers from McMaster University have found what they call the “most effective” treatment for people with obstructive sleep apnea (OSA) who suffer from excessive daytime sleepiness (EDS).

Dena Zeraatkar and Tyler Pitre published their results in the peer-reviewed publication Annals of Internal Medicine, claiming the drug solriamfetol is “likely the best medication” for EDS.

Their findings are based on a systematic review of 14 clinical trials of anti-fatigue medications involving 3,085 people, as well as analysing data from MEDLINE, CENTRAL, EMBASE and ClinicalTrials.gov in a specific network meta-analysis.

Their research was conducted from October 2022 to January 2023.

EDS is when someone falls asleep or has a desire for sleep while expected to be awake, and it is often a symptom of sleep-related disorders.

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.

Tyler Pitre, study author and resident physician in internal medicine at McMaster University and incoming respirology fellow at the University of Toronto, suggests people with OSA should use their PAP machine first to treat EDS, and if they are still sleepy they can turn to medication for treatment.

“Fifteen to 30 per cent 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,” added Pitre. “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.”

According to Pitre, OSA affects nearly one billion people in the world and puts many of them at risk of EDS.

While the study determined solriamfetol is “likely the best” anti-fatigue drug for EDS, senior study author and an assistant professor of the Department of Anesthesia Zeraatkar says the drugs armodafinil–modafinil and pitolisant are also effective in combating fatigue.

Zeraatkar also says solriamfetol can raise blood pressure and it may be 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,” added Zeraatkar.

 

Reporting for this story was paid for through The Afghan Journalists in Residence Project funded by Meta.