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Utilization of Wake-Promoting Drugs in Patients on CPAP Therapy

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CPAP Adherence

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Abstract

Excessive daytime sleepiness (EDS) is a complaint affecting half of patients with obstructive sleep apnea (OSA) and can persist in some patients despite normalization of breathing, oxygenation, and sleep quality with primary OSA therapy, such as continuous positive airway pressure (CPAP). EDS is often overlooked and underdiscussed in the primary care setting and in the follow-up of CPAP-treated patients due to difficult assessment of such a multidimensional symptom. This review aims to provide suggestions for procedures that can be implemented into routine clinical practice to identify, evaluate, and manage EDS in patients with OSA, including how to appropriately use various self-report and objective assessments along the clinical pathway. In addition, examples of when it is appropriate for a healthcare provider to refer a patient to a sleep specialist for evaluation are discussed. Despite certain limitations of this method, healthcare professionals (HCPs) should screen all patients diagnosed with OSA for EDS with the Epworth Sleepiness Scale. If a patient is suspected of having EDS, it needs to be confirmed that the underlying airway obstruction is being optimally treated with CPAP or another OSA primary treatment. If the patient continues to experience EDS despite adherence to primary OSA therapy, the treating clinician should review the patient in clinic and, when appropriate, using questionnaires, physical exams, laboratory tests, or objective assessments to rule out other potential causes of EDS. After a differential diagnosis of residual EDS has been established, the clinician may consider pharmacologic treatment which may include a wake-promoting agent.

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References

  1. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328(17):1230–5.

    Article  CAS  PubMed  Google Scholar 

  2. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177(9):1006–14.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Benjafield AV, Ayas NT, Eastwood PR, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019;7(8):687–98.

    Article  PubMed  PubMed Central  Google Scholar 

  4. American Academy of Sleep Medicine. Obstructive sleep apnea, adult. International Classification of Sleep Disorders. 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2014. p. 53–62.

    Google Scholar 

  5. Bailly S, Destors M, Grillet Y, et al. Obstructive sleep apnea: a cluster analysis at time of diagnosis. PLoS One. 2016;11(6):e0157318.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. Koutsourelakis I, Perraki E, Economou NT, et al. Predictors of residual sleepiness in adequately treated obstructive sleep apnoea patients. Eur Respir J. 2009;34(3):687–93.

    Article  CAS  PubMed  Google Scholar 

  7. Kapur VK, Baldwin CM, Resnick HE, Gottlieb DJ, Nieto FJ. Sleepiness in patients with moderate to severe sleep-disordered breathing. Sleep. 2005;28(4):472–7.

    Article  PubMed  Google Scholar 

  8. Macey PM, Woo MA, Kumar R, Cross RL, Harper RM. Relationship between obstructive sleep apnea severity and sleep, depression and anxiety symptoms in newly-diagnosed patients. PLoS One. 2010;5(4):e10211.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  9. Lipford MC, Wahner-Roedler DL, Welsh GA, Mandrekar J, Thapa P, Olson EJ. Correlation of the Epworth sleepiness scale and sleep-disordered breathing in men and women. J Clin Sleep Med. 2019;15(1):33–8.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Gabryelska A, Białasiewicz P. Association between excessive daytime sleepiness, REM phenotype and severity of obstructive sleep apnea. Sci Rep. 2020;10(1):34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Kendzerska TB, Smith PM, Brignardello-Petersen R, Leung RS, Tomlinson GA. Evaluation of the measurement properties of the Epworth Sleepiness Scale: a systematic review. Sleep Med Rev. 2014;18(4):321–31.

    Article  PubMed  Google Scholar 

  12. Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG. Treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of sleep medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2019;15(2):335–43.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Epstein LJ, Kristo D, Strollo PJ Jr, et al. Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med. 2009;5(3):263–76.

    Article  PubMed  Google Scholar 

  14. Gasa M, Tamisier R, Launois SH, et al. Residual sleepiness in sleep apnea patients treated by continuous positive airway pressure. J Sleep Res. 2013;22(4):389–97.

    Article  PubMed  Google Scholar 

  15. Pepin JL, Viot-Blanc V, Escourrou P, et al. Prevalence of residual excessive sleepiness in CPAP-treated sleep apnoea patients: the French multicentre study. Eur Respir J. 2009;33(5):1062–7.

    Article  PubMed  Google Scholar 

  16. Antic NA, Catcheside P, Buchan C, et al. The effect of CPAP in normalizing daytime sleepiness, quality of life, and neurocognitive function in patients with moderate to severe OSA. Sleep. 2011;34(1):111–9.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Weaver TE, Maislin G, Dinges DF, et al. Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning. Sleep. 2007;30(6):711–9.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Budhiraja R, Kushida CA, Nichols DA, et al. Predictors of sleepiness in obstructive sleep apnoea at baseline and after 6 months of continuous positive airway pressure therapy. Eur Respir J. 2017;50(5):1700348.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Stepnowsky C, Sarmiento KF, Bujanover S, Villa KF, Li VW, Flores NM. Comorbidities, health-related quality of life, and work productivity among people with obstructive sleep apnea with excessive sleepiness: findings from the 2016 US National Health and Wellness Survey. J Clin Sleep Med. 2019;15(2):235–43.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Lal C, Strange C, Bachman D. Neurocognitive impairment in obstructive sleep apnea. Chest. 2012;141(6):1601–10.

    Article  PubMed  Google Scholar 

  21. Werli KS, Otuyama LJ, Bertolucci PH, et al. Neurocognitive function in patients with residual excessive sleepiness from obstructive sleep apnea: a prospective, controlled study. Sleep Med. 2016;26:6–11.

    Article  PubMed  Google Scholar 

  22. Mulgrew AT, Ryan CF, Fleetham JA, et al. The impact of obstructive sleep apnea and daytime sleepiness on work limitation. Sleep Med. 2007;9(1):42–53.

    CAS  PubMed  Google Scholar 

  23. Tregear S, Reston J, Schoelles K, Phillips B. Obstructive sleep apnea and risk of motor vehicle crash: systematic review and meta-analysis. J Clin Sleep Med. 2009;5(6):573–81.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Garbarino S, Guglielmi O, Sanna A, Mancardi GL, Magnavita N. Risk of occupational accidents in workers with obstructive sleep apnea: systematic review and meta-analysis. Sleep. 2016;39(6):1211–8.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Gottlieb DJ, Ellenbogen JM, Bianchi MT, Czeisler CA. Sleep deficiency and motor vehicle crash risk in the general population: a prospective cohort study. BMC Med. 2018;16(1):44.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  26. Won CH, Bogan RK, Doghramji K, et al. Assessing communication between physicians and patients with excessive daytime sleepiness associated with treated obstructive sleep apnea: insights from an ethnographic study of in-office visits [abstract]. Am J Respir Crit Care Med. 2019;199:A1390.

    Google Scholar 

  27. Pépin JL, Tamisier R, Hwang D, Mereddy S, Parthasarathy S. Does remote monitoring change OSA management and CPAP adherence? Respirology. 2017;22(8):1508–17.

    Article  PubMed  Google Scholar 

  28. He K, Kapur VK. Sleep-disordered breathing and excessive daytime sleepiness. Sleep Med Clin. 2017;12(3):369–82.

    Article  PubMed  Google Scholar 

  29. Javaheri S, Javaheri S. Update on persistent excessive daytime sleepiness in obstructive sleep apnea. Chest. 2020;158:776–86.

    Article  CAS  PubMed  Google Scholar 

  30. Chervin RD. Sleepiness, fatigue, tiredness, and lack of energy in obstructive sleep apnea. Chest. 2000;118(2):372–9.

    Article  CAS  PubMed  Google Scholar 

  31. Vernet C, Redolfi S, Attali V, et al. Residual sleepiness in obstructive sleep apnoea: phenotype and related symptoms. Eur Respir J. 2011;38(1):98–105.

    Article  CAS  PubMed  Google Scholar 

  32. Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep. 1991;14(6):540–5.

    Article  CAS  PubMed  Google Scholar 

  33. Johns M, Hocking B. Daytime sleepiness and sleep habits of Australian workers. Sleep. 1997;20(10):844–9.

    Article  CAS  PubMed  Google Scholar 

  34. About the Epworth Sleepiness Scale. 2020. Available at: https://epworthsleepinessscale.com/about-the-ess/. Accessed 16 Oct 2020.

  35. Lapin BR, Bena JF, Walia HK, Moul DE. The Epworth Sleepiness Scale: validation of one-dimensional factor structure in a large clinical sample. J Clin Sleep Med. 2018;14(8):1293–301.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Rosenberg R, Babson K, Menno D, et al. Epworth Sleepiness Scale Test-Retest reliability analysis in solriamfetol studies [abstract]. Sleep. 2020;43(Suppl 1):A285–6.

    Article  Google Scholar 

  37. Taylor E, Zeng I, O’Dochartaigh C. The reliability of the Epworth Sleepiness Score in a sleep clinic population. J Sleep Res. 2019;28(2):e12687.

    Article  PubMed  Google Scholar 

  38. Campbell AJ, Neill AM, Scott DAR. Clinical reproducibility of the Epworth Sleepiness Scale for patients with suspected sleep apnea. J Clin Sleep Med. 2018;14(5):791–5.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Nguyen AT, Baltzan MA, Small D, Wolkove N, Guillon S, Palayew M. Clinical reproducibility of the Epworth Sleepiness Scale. J Clin Sleep Med. 2006;2(2):170–4.

    Article  PubMed  Google Scholar 

  40. Hoddes E, Dement W, Zarcone V. The development and use of the Stanford sleepiness scale (SSS) [abstract]. Psychophysiology. 1972;9:150.

    Google Scholar 

  41. Hoddes E, Zarcone V, Smythe H, Phillips R, Dement WC. Quantification of sleepiness: a new approach. Psychophysiology. 1973;10(4):431–6.

    Article  CAS  PubMed  Google Scholar 

  42. Carskadon MA, Dement WC. Cumulative effects of sleep restriction on daytime sleepiness. Psychophysiology. 1981;18(2):107–13.

    Article  CAS  PubMed  Google Scholar 

  43. Herscovitch J, Broughton R. Sensitivity of the Stanford sleepiness scale to the effects of cumulative partial sleep deprivation and recovery oversleeping. Sleep. 1981;4(1):83–91.

    Article  CAS  PubMed  Google Scholar 

  44. Akerstedt T, Gillberg M. Subjective and objective sleepiness in the active individual. Int J Neurosci. 1990;52(1–2):29–37.

    Article  CAS  PubMed  Google Scholar 

  45. Shahid A, Wilkinson K, Marcu S, Shapiro CM, Karolinska Sleepiness Scale (KSS). STOP, THAT and one hundred other sleep scales. New York: Springer; 2012. p. 209–10.

    Book  Google Scholar 

  46. Rotenberg BW, Murariu D, Pang KP. Trends in CPAP adherence over twenty years of data collection: a flattened curve. J Otolaryngol Head Neck Surg. 2016;45(1):43.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Weaver TE, Sawyer AM. Adherence to continuous positive airway pressure treatment for obstructive sleep apnoea: implications for future interventions. Indian J Med Res. 2010;131:245–58.

    PubMed  Google Scholar 

  48. Weaver TE. Novel aspects of CPAP treatment and interventions to improve CPAP adherence. J Clin Med. 2019;8(12):2220.

    Article  PubMed Central  Google Scholar 

  49. Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc. 2008;5(2):173–8.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Sawyer AM, Gooneratne NS, Marcus CL, Ofer D, Richards KC, Weaver TE. A systematic review of CPAP adherence across age groups: clinical and empiric insights for developing CPAP adherence interventions. Sleep Med Rev. 2011;15(6):343–56.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Pengo MF, Czaban M, Berry MP, et al. The effect of positive and negative message framing on short term continuous positive airway pressure compliance in patients with obstructive sleep apnea. J Thorac Dis. 2018;10(Suppl 1):S160–s169.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Parthasarathy S, Haynes PL, Budhiraja R, Habib MP, Quan SF. A national survey of the effect of sleep medicine specialists and American Academy of Sleep Medicine Accreditation on management of obstructive sleep apnea. J Clin Sleep Med. 2006;2(2):133–42.

    Article  PubMed  Google Scholar 

  53. Parthasarathy S, Subramanian S, Quan SF. A multicenter prospective comparative effectiveness study of the effect of physician certification and center accreditation on patient-centered outcomes in obstructive sleep apnea. J Clin Sleep Med. 2014;10(3):243–9.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Sleep and sleep disorders data and statistics. 2017. Available at: https://www.cdc.gov/sleep/data_statistics.html. Accessed 16 Oct 2020.

  55. Watson NF, Badr MS, Belenky G, et al. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. 2015;38(6):843–4.

    PubMed  PubMed Central  Google Scholar 

  56. Ejaz SM, Khawaja IS, Bhatia S, Hurwitz TD. Obstructive sleep apnea and depression: a review. Innov Clin Neurosci. 2011;8(8):17–25.

    PubMed  PubMed Central  Google Scholar 

  57. American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2014.

    Google Scholar 

  58. Littner MR, Kushida C, Wise M, et al. Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep. 2005;28(1):113–21.

    Article  PubMed  Google Scholar 

  59. Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest. 2014;146(5):1387–94.

    Article  PubMed  Google Scholar 

  60. Doghramji K, Mitler MM, Sangal RB, et al. A normative study of the maintenance of wakefulness test (MWT). Electroencephalogr Clin Neurophysiol. 1997;103(5):554–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Bennett LS, Stradling JR, Davies RJ. A behavioural test to assess daytime sleepiness in obstructive sleep apnoea. J Sleep Res. 1997;6(2):142–5.

    Article  CAS  PubMed  Google Scholar 

  62. Priest B, Brichard C, Aubert G, Liistro G, Rodenstein DO. Microsleep during a simplified maintenance of wakefulness test. A validation study of the OSLER test. Am J Respir Crit Care Med. 2001;163(7):1619–25.

    Article  CAS  PubMed  Google Scholar 

  63. Dinges DF, Powell JW. Microcomputer analyses of performance on a portable, simple visual RT task during sustained operations. Behav Res Methods Instrum Comput. 1985;17(6):652–5.

    Article  Google Scholar 

  64. Naito E, Kinomura S, Geyer S, Kawashima R, Roland PE, Zilles K. Fast reaction to different sensory modalities activates common fields in the motor areas, but the anterior cingulate cortex is involved in the speed of reaction. J Neurophysiol. 2000;83(3):1701–9.

    Article  CAS  PubMed  Google Scholar 

  65. Jung CM, Ronda JM, Czeisler CA, Wright KP Jr. Comparison of sustained attention assessed by auditory and visual psychomotor vigilance tasks prior to and during sleep deprivation. J Sleep Res. 2011;20(2):348–55.

    Article  PubMed  Google Scholar 

  66. D'Rozario AL, Field CJ, Hoyos CM, et al. Impaired neurobehavioural performance in untreated obstructive sleep apnea patients using a novel standardised test battery. Front Surg. 2018;5:35.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Batool-Anwar S, Kales SN, Patel SR, Varvarigou V, DeYoung PN, Malhotra A. Obstructive sleep apnea and psychomotor vigilance task performance. Nat Sci Sleep. 2014;6:65–71.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Thomann J, Baumann CR, Landolt HP, Werth E. Psychomotor vigilance task demonstrates impaired vigilance in disorders with excessive daytime sleepiness. J Clin Sleep Med. 2014;10(9):1019–24.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Deering S, Amdur A, Borelli J, Headapohl W, Stepnowsky CJ. A three-minute mobile version of the psychomotor vigilance task [abstract 1053]. Sleep. 2018;41(Suppl 1):A391–2.

    Article  Google Scholar 

  70. Smith MT, McCrae CS, Cheung J, et al. Use of actigraphy for the evaluation of sleep disorders and circadian rhythm sleep-wake disorders: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2018;14(7):1209–30.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Martin JL, Hakim AD. Wrist actigraphy. Chest. 2011;139(6):1514–27.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Li Y, Zhang J, Lei F, Liu H, Li Z, Tang X. Self-evaluated and close relative- evaluated Epworth Sleepiness Scale vs. multiple sleep latency test in patients with obstructive sleep apnea. J Clin Sleep Med. 2014;10(2):171–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Li Y, Vgontzas A, Kritikou I, et al. Psychomotor vigilance test and its association with daytime sleepiness and inflammation in sleep apnea: clinical implications. J Clin Sleep Med. 2017;13(9):1049–56.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Provigil [package insert]. North Wales, PA: Teva Pharmaceuticals; 2018.

    Google Scholar 

  75. Nuvigil [package insert]. North Wales, PA: Teva Pharmaceuticals; 2018.

    Google Scholar 

  76. Pack AI, Black JE, Schwartz JR, Matheson JK. Modafinil as adjunct therapy for daytime sleepiness in obstructive sleep apnea. Am J Respir Crit Care Med. 2001;164(9):1675–81.

    Article  CAS  PubMed  Google Scholar 

  77. Black JE, Hirshkowitz M. Modafinil for treatment of residual excessive sleepiness in nasal continuous positive airway pressure-treated obstructive sleep apnea/hypopnea syndrome. Sleep. 2005;28(4):464–71.

    Article  PubMed  Google Scholar 

  78. Hirshkowitz M, Black JE, Wesnes K, Niebler G, Arora S, Roth T. Adjunct armodafinil improves wakefulness and memory in obstructive sleep apnea/hypopnea syndrome. Respir Med. 2007;101(3):616–27.

    Article  CAS  PubMed  Google Scholar 

  79. Roth T, White D, Schmidt-Nowara W, et al. Effects of armodafinil in the treatment of residual excessive sleepiness associated with obstructive sleep apnea/hypopnea syndrome: a 12-week, multicenter, double-blind, randomized, placebo-controlled study in nCPAP-adherent adults. Clin Ther. 2006;28(5):689–706.

    Article  CAS  PubMed  Google Scholar 

  80. Hirshkowitz M, Black J. Effect of adjunctive modafinil on wakefulness and quality of life in patients with excessive sleepiness-associated obstructive sleep apnoea/hypopnoea syndrome: a 12-month, open-label extension study. CNS Drugs. 2007;21(5):407–16.

    Article  CAS  PubMed  Google Scholar 

  81. Black JE, Hull SG, Tiller J, Yang R, Harsh JR. The long-term tolerability and efficacy of armodafinil in patients with excessive sleepiness associated with treated obstructive sleep apnea, shift work disorder, or narcolepsy: an open-label extension study. J Clin Sleep Med. 2010;6(5):458–66.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Chapman JL, Vakulin A, Hedner J, Yee BJ, Marshall NS. Modafinil/armodafinil in obstructive sleep apnoea: a systematic review and meta-analysis. Eur Respir J. 2016;47(5):1420–8.

    Article  PubMed  Google Scholar 

  83. European Medicines Agency. Modafinil - Article 31 referral - Annex I, II, III, IV. 2011. Available at: https://www.ema.europa.eu/documents/referral/modafinil-article-31-referral-annex-i-ii-iii-iv_en.pdf. Accessed 24 Jan 2019.

  84. Sukhal S, Khalid M, Tulaimat A. Effect of wakefulness-promoting agents on sleepiness in patients with sleep apnea treated with CPAP: a meta-analysis. J Clin Sleep Med. 2015;11(10):1179–86.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Sunosi® (solriamfetol) tablets Prescribing Information. Palo Alto, CA: Jazz Pharmaceuticals, Inc; 2019.

    Google Scholar 

  86. Sunosi® (solriamfetol) tablets summary of product characteristics. Dublin, Ireland: Jazz Pharmaceuticals Ireland Ltd; 2020.

    Google Scholar 

  87. Schweitzer PK, Rosenberg R, Zammit GK, et al. Solriamfetol for excessive sleepiness in obstructive sleep apnea (TONES 3): a randomized controlled trial. Am J Respir Crit Care Med. 2019;199(11):1421–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  88. Strollo PJ Jr, Hedner J, Collop N, et al. Solriamfetol for the treatment of excessive sleepiness in OSA: a placebo-controlled randomized withdrawal study. Chest. 2019;155(2):364–74.

    Article  PubMed  Google Scholar 

  89. Malhotra A, Shapiro C, Pepin JL, et al. Long-term study of the safety and maintenance of efficacy of solriamfetol (JZP-110) in the treatment of excessive sleepiness in participants with narcolepsy or obstructive sleep apnea. Sleep. 2020;43(2):zsz220.

    Article  PubMed  Google Scholar 

  90. Wakix [package insert]. Plymouth Meeting, PA: Harmony Biosciences; 2019.

    Google Scholar 

  91. Dauvilliers Y, Verbraecken J, Partinen M, et al. Pitolisant for daytime sleepiness in obstructive sleep apnea patients refusing CPAP: a randomized trial. Am J Respir Crit Care Med. 2020;201(9):1135–45.

    Article  PubMed  PubMed Central  Google Scholar 

  92. Rosenberg R, Baladi M, Menno D, Bron M. Clinically relevant effects of solriamfetol on excessive daytime sleepiness: a post-hoc analysis of the magnitude of change in clinical trials in adults with narcolepsy or obstructive sleep apnoea [abstract]. Sleep Med. 2019;64(suppl):S325.

    Article  Google Scholar 

  93. Scrima L, Emsellem HA, Becker PM, et al. Identifying clinically important difference on the Epworth Sleepiness Scale: results from a narcolepsy clinical trial of JZP-110. Sleep Med. 2017;38:108–12.

    Article  PubMed  Google Scholar 

  94. Lammers GJ, Bogan R, Schweitzer PK, et al. Thresholds for clinically meaningful changes on the Epworth sleepiness scale and maintenance of wakefulness test sleep latency [abstract]. Presented at: Biennial World Sleep Congress; September 20–25, 2019; Vancouver, BC, Canada.

    Google Scholar 

  95. Rosenberg R, Schweitzer PK, Malhotra A, et al. Incidence and duration of common adverse events in a solriamfetol (JZP-110) phase 3 study for treatment of excessive daytime sleepiness in obstructive sleep apnea [abstract 0569]. Sleep. 2019;42(suppl 1):A226–7.

    Article  Google Scholar 

  96. Ritalin [package insert]. East Hanover, NJ: Novartis Pharmaceuticals Corporation; 2019.

    Google Scholar 

  97. Adderall [package insert]. Horsham, PA: Teva Pharmaceuticals; 2017.

    Google Scholar 

  98. Dextroamphetamine sulfate [package insert]. North Wales, PA: Teva Pharmaceuticals; 2016.

    Google Scholar 

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  1. Neurotrials Research, Atlanta, GA, USA

    Russell Rosenberg

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    Colin M. Shapiro

  2. Maple Leaf Medical Clinic, Toronto, ON, Canada

    Meenakshi Gupta

  3. Sleep on the Bay, Toronto, ON, Canada

    Dora Zalai

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Rosenberg, R. (2022). Utilization of Wake-Promoting Drugs in Patients on CPAP Therapy. In: Shapiro, C.M., Gupta, M., Zalai, D. (eds) CPAP Adherence. Springer, Cham. https://doi.org/10.1007/978-3-030-93146-9_30

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