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Management options for excessive daytime sleepiness in patients with obstructive sleep apnea

Title: Management options for excessive daytime sleepiness in patients with obstructive sleep apnea
Authors: Bonsignore M. R.; Fanfulla F.; Ingrao P.; Lombardo S.; Tondo P.; Lo Nano V.; Lombardi C.
Contributors: Bonsignore, M; Fanfulla, F; Ingrao, P; Lombardo, S; Tondo, P; Lo Nano, V; Lombardi, C
Publisher Information: Taylor and Francis Ltd.; GB
Publication Year: 2025
Collection: Università degli Studi di Milano-Bicocca: BOA (Bicocca Open Archive)
Subject Terms: Cardiovascular risk; compliance to treatment; continuous positive airway pressure (CPAP); modafinil/armodafinil; pitolisant; residual sleepine; sleepiness at the wheel; solriamfetol
Description: Introduction: Excessive daytime sleepiness (EDS) is a symptom of obstructive sleep apnea (OSA) associated with the risk of accidents at work or while driving. OSA treatment decreases EDS, but some patients remain sleepy despite optimal control of OSA. Patients who do not tolerate or refuse OSA treatment may be symptomatically treated for EDS. Solriamfetol and pitolisant are wake-promoting agents (WPA) recently approved for use in sleepy OSA patients accepting or refusing OSA treatment. Areas covered: This narrative review provides updated information on: how to assess EDS in OSA patients, epidemiology, and management of residual EDS in treated OSA patients and the results of recent studies using new WPAs in patients accepting or refusing CPAP treatment. Literature was accessed from PubMed between 1 December 2024 and 6 January 2025. Expert opinion: The new WPAs are useful drugs with a favorable safety profile to be included as a possible therapeutic option for sleepy OSA patients. However, it is still uncertain which subgroups of patients should be treated for the symptom of EDS while maintaining a low-risk profile in terms of the consequences of OSA on health. Until such data is available, use of WPA in OSA patients should be managed by Sleep Specialists.
Document Type: article in journal/newspaper
File Description: STAMPA
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/40105060; info:eu-repo/semantics/altIdentifier/wos/WOS:001449042900001; volume:19; issue:4; firstpage:325; lastpage:345; numberofpages:21; journal:EXPERT REVIEW OF RESPIRATORY MEDICINE; https://hdl.handle.net/10281/553507
DOI: 10.1080/17476348.2025.2479614
Availability: https://hdl.handle.net/10281/553507; https://doi.org/10.1080/17476348.2025.2479614
Accession Number: edsbas.5AED749A
Database: BASE