Patients with obstructive sleep apnoea (OSA) often have residual sleepiness despite optimal treatment with continuous positive airway pressure (CPAP). Modafinil, a wakefulness-promoting agent, is effective in improving sleepiness.
In a placebo-controlled trial, modafinil improved objective measures of wakefulness (Multiple Sleep Latency Test and Maintenance of Wakefulness Test) and subjective sleepiness measures (Epworth Sleepiness Scale). Moreover, improvements in wakefulness with modafinil were maintained through 136 weeks of open-label therapy.
What is modafinil?
Modafinil Online Australia is a wakefulness-promoting drug that is effective in treating sleep apnea. It can significantly reduce excessive daytime sleepiness in apnea patients, who are not getting the best results from CPAP therapy. Modafinil can be prescribed at a dosage of 200 to 400 mg per day, taken in the morning. The dosage will be determined by a healthcare professional and should be adjusted as needed based on the patient’s response and tolerance.
In a series of large-scale, double-blind, placebo-controlled clinical trials in obstructive sleep apnea (OSA) patients, who had residual EDS despite optimal use of CPAP, once-daily doses of 200-400 mg of modafinil led to a significant reduction in EDS compared to placebo. In the same trials, patients taking modafinil also reported an increase in their overall activity, alertness, and performance. These improvements were maintained through 12 weeks of open-label treatment with modafinil. In addition, modafinil is well-tolerated by apnea patients and has demonstrated a low rate of adverse side effects.
In addition to its effectiveness in treating EDS, modafinil has been used since 1988 in Europe to treat narcolepsy and idiopathic hypersomnolence. It is also approved in the USA and Canada for the treatment of narcolepsy, shift work sleep disorder, and res-OSA. The R-isomer of modafinil, armodafinil, is currently being studied for its efficacy in treating narcolepsy and EDS.
How should I take modafinil?
The medication comes in tablets to be taken by mouth and is usually taken once daily in the morning. The exact dosage will vary depending on your individual needs and can be customized by your doctor. The medicine is typically well tolerated and a few side effects may occur, including nausea, anxiety, nervousness, diarrhea, dry mouth, and infection. Modafinil can interact with several medications, so be sure to tell your doctor about any other drugs you are taking (including over-the-counter and herbal remedies).
Two placebo-controlled studies have demonstrated that 400 mg of Modalert 200 Tablet daily improves wakefulness in people with narcolepsy and obstructive sleep apnea who are treated with CPAP. These improvements are attributed to the drug’s ability to increase catecholamine levels and indirectly increase cerebral serotonin, orexin, and glutamate while decreasing cerebral gamma-aminobutyric acid (GABA) activity.
A recent review of research on cognitive enhancement with modafinil by Dr Ruairidh Battleday and Dr. Anna-Katharine Brem found that the drug can boost performance in tasks that require planning, flexibility, memory, and learning. However, it has less consistent cognitive-enhancing effects in tests measuring speed of processing and accuracy.
Serious side effects of the medication can include depression, anxiety, hallucinations, and aggression. If the side effects become severe, contact emergency services (call 911 or your local emergency number) or text TALK to 741741 for help from a crisis counselor.
Modafinil side effects
Modafinil is in a class of medications known as wakefulness-promoting agents and has a proven record of safety. It is not a stimulant and does not affect the central nervous system (CNS) like dextroamphetamine or methylphenidate, which have the potential to cause serious side effects.
Modafinil has been shown to effectively promote wakefulness in a variety of laboratory and clinical studies. It has been demonstrated to increase wakefulness in animal models of narcolepsy and sleep disorders, as well as in healthy sleep-deprived volunteers. It has also been shown to improve performance on recognized tests of daytime sleepiness, such as the ESS (a self-report scale that assesses eight common situations where a person is likely to fall asleep or doze) and the Multiple Sleep Latency Test. It has also been shown to improve symptoms of fatigue in patients with narcolepsy.
Several large randomized clinical trials have shown that modafinil is effective and safe in the treatment of excessive daytime sleepiness in narcolepsy, shift work disorder, or obstructive sleep apnea/hypopnea syndrome (OSAHS). Modafinil has been shown to reduce the number of episodes of sleepiness during a scheduled waking period and to improve mood and overall wellbeing. It has also been shown to decrease commuting accidents and injuries and improve patient quality of life in patients with OSAHS who are taking other treatments for their condition, such as continuous positive airway pressure therapy.
Modafinil for sleep apnoea
In patients with obstructive sleep apnea who have residual daytime sleepiness, modafinil (and its R-enantiomer, armodafinil) is an effective wakefulness-promoting agent. It has been shown to improve both subjective and objective measures of EDS in adults with OSA, shift work disorder, or narcolepsy (PROVIGIL 2007).
In double-blind placebo-controlled studies, patients with narcolepsy, obstructive sleep apnea/hypopnea syndrome who were regular users of nasal continuous positive airway pressure therapy (CPAP), or narcolepsy treated with CPAP had significantly improved nocturnal awakenings, sleepiness during the day, and cognitive function after treatment with modafinil for up to 12 weeks. These improvements were maintained during 136 weeks of open-label modafinil treatment.
However, in one study of 44 CPAP-treated patients with narcolepsy, modafinil did not result in a significant increase in nocturnal REM/sleep cycles, despite improvements in subjective and objective EDS measured by the MSLT and MWT, or on a self-rating scale, the Epworth Sleepiness Scale (ESS). This was probably due to the small sample size, the relatively poor ability of the MWT and ESS to measure wakefulness or methodological differences.
In a recently published randomized, double-blind, placebo-controlled trial, Kingshott et al11 found that 400 mg of modafinil administered orally once daily resulted in improved objective and subjective EDS measures and a reduced frequency of narcolepsy symptoms. In addition, the patients receiving modafinil had an increased mean duration of nCPAP use compared to placebo.