McMaster University researchers Dena Zeraatkar and Tyler Pitre found that the drug solriamfetol is the most effective treatment for excessive daytime sleepiness (EDS) in people with obstructive sleep apnea (OSA).
The standard treatment for OSA is a positive airway pressure (PAP) mask that uses compressed air to support the airways of the lungs 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 for people with OSA to do is use their PAP machine, but if they’re still sleepy, there are options in the form of medications that can reduce their tiredness,” said first author Tyler Pitre, an internal medicine resident. at McMaster University and an incoming respirology fellow at the University of Toronto.
“Between 15 and 30 percent of people in North America have a diagnosis of OSA and the prevalence could be much higher since many others go undiagnosed. Many people have symptoms as the condition is highly associated with obesity , which affects large and growing numbers 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, makes them less productive, and also puts them at risk for other psychological problems. Improving this situation is of paramount importance to clinicians.”
Pitre said that OSA affects nearly a billion people around the world, leaving many at risk of EDS.
Zeraatkar and Pitre made their findings by conducting a systematic review of 14 anti-fatigue drug clinical trials involving 3,085 people, as well as by analyzing data from MEDLINE, CENTRAL, EMBASE, and ClinicalTrials.gov in a dedicated network meta-analysis. They conducted their research from October 2022 to January 2023.
Lead author Zeraatkar said that while solriamfetol is probably the best drug for EDS, the drugs armodafinil-modafinil and pitolisant are also effective in combating fatigue.
Solriamfetol can also increase blood pressure, which is especially risky for people with OSA, since many of them also have cardiovascular problems.
“It would be interesting to see how effective these anti-fatigue drugs will be in treating related illnesses, such as chronic fatigue syndrome and long-term COVID, now that we know they work for a similar condition,” said Zeraatkar, an assistant professor in the Department. of Anesthesia.
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