Modafinil Improves Functional Outcomes in Patients with Residual Excessive Sleepiness Associated with CPAP Treatment

摘要: Obstructive sleep apnea-hypopnea syndrome (OSA) has been shown to be associated with substantial morbidity and increased mortality.1–8 A condition as common diabetes, OSA is estimated occur in 2% 4% of middle-aged adults.9 Excessive sleepiness a often debilitating symptom which disturbed or fragmented by repeated arousals caused partial complete airway obstruction.3 This hypersomnolence can result profound impairment daytime functioning, psychosocial dysfunction, cognitive impairment, decreased vigilance, diminished quality life.3, 10–14 Moreover, patients are at risk for having work-related automobile accidents.3, 15–19 The first-line treatment nasal continuous pressure (CPAP),20 effective alleviating the underlying obstruction well reducing patients' excessive improving their functioning health-related life.13, 21–26 However, even among those who use CPAP recommended through night, some experience residual sleepiness.14, 27, 28 Indeed, recent study, 22% used 6 more hours per night reported sleepiness, 52% had objective evidence physiologic measured Multiple Sleep Latency Test.14 Modafinil, wakefulness-promoting agent, improve wakefulness remain excessively sleepy despite use. In this population, multiple double-blind, placebo-controlled studies have that modafinil consistently improves on measures overall clinical condition, ability sustain attention, enhances life.29–31 Chemically pharmacologically distinct from central nervous system stimulants,32, 33 lower abuse potential causing adverse cardiovascular events.34 The purpose current study was examine further effect daily component life, experiencing using data 2 previously conducted studies. Specifically, we examined changes baseline Functional Outcomes Questionnaire (FOSQ), measure Total score individual domain scores identify FOSQ responders entire population. We also explored association between improvement functional status subjective level baseline.