Wakefulness-promoting medicines for sleep apnea

Modafinil or armodafinil is taken as a pill once a day to decrease sleepiness during the day.

Modafinil and armodafinil work by affecting chemicals in the brain. The effects improve alertness and memory.

Modafinil and armodafinil are used to relieve extreme sleepiness in people who are using continuous positive airway pressure (CPAP) therapy to treat sleep apnea but are still sleepy during the day.

In people with sleep apnea who used CPAP, treatment with modafinil or armodafinil improved alertness, reduced tiredness, and improved memory.^{1, 2}

The most common side effects of modafinil and armodafinil are:

• Headache.
• Nausea.
• Back pain.
• Nervousness and anxiety.
• Upset stomach and diarrhea.
• Inflammation of the tissues in the nose (rhinitis).
• Problems sleeping (insomnia).
• Dizziness.

When side effects occur, they are usually mild to moderate.

Rarely, modafinil and armodafinil can cause:

• A dangerous skin rash that needs immediate medical treatment.
• A severe allergic reaction, such as swelling of the face, tongue, or throat.
• Mental health problems, such as hallucinations, mania, or thoughts of suicide.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

Wakefulness-promoting medicines are recommended only after continuous positive airway pressure (CPAP) therapy alone does not get rid of daytime sleepiness in a person with sleep apnea. The CPAP therapy should continue during modafinil or armodafinil treatment.

Wakefulness-promoting medicines may interfere with birth control methods that use a form of estrogen (ethinyl estradiol), such as birth control pills, the birth control patch, and the vaginal ring. You may need to use another form of birth control while you are taking modafinil or armodafinil.

Some other medicines may be affected by modafinil and armodafinil, including warfarin, cyclosporin, and tricyclic antidepressants (such as clomipramine and desipramine). Before you start using modafinil or armodafinil, tell your doctor about all of the other medicines you are taking.

People with severe liver disease may need a lower dose of modafinil or armodafinil.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Citations

1. Hirshkowitz M, et al. (2007). Adjunct armodafinil improves wakefulness and memory in obstructive sleep apnea/hypopnea syndrome. Respiratory Medicine, 101(3): 616–627.

2. Black JE, Hirshkowitz M (2005). Modafinil for treatment of residual excessive sleepiness in nasal continuous positive airway pressure-treated obstructive sleep apnea/hypopnea syndrome. Sleep, 28(4): 464–471.