Modafinil for excessive daytime sleepiness: A systematic review and meta-analysis of randomized controlled trials.
Mauricio Silva de Lima, Fernando Morgadinho Santos Coelho, Henrique Andrea de Lima et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy and safety of modafinil for excessive daytime sleepiness (EDS) in adults with obstructive sleep apnea (OSA) or shift work sleep disorder (SWSD). Nine randomized controlled trials involving 1265 participants were analyzed. Modafinil significantly improved objective wakefulness, with a mean difference of 2.95 minutes (95% CI 0.66-5.23, p=0.01) in the Maintenance of Wakefulness Test, although continuous Epworth Sleepiness Scale outcomes showed no significant differences.
Key findings
- Modafinil improved objective wakefulness in OSA patients, with a mean difference of 2.95 minutes.
- Clinical response analyses favored modafinil for subjective daytime sleepiness.
- Increased risk of treatment discontinuation due to adverse events was noted, with a relative risk of 2.50.
- Common adverse events included headache, insomnia, and anxiety, occurring significantly more with modafinil.
Why it matters
Understanding the efficacy and safety of modafinil in treating EDS is crucial for clinicians managing patients with OSA and SWSD. The findings highlight potential benefits in wakefulness but also emphasize the need to monitor for adverse effects.