Modafinil As a Prolonged Remedies for Sleep Issues

Modafinil Australia is the benzyhydrylsulfinylacetamide derivative developed to treat narcolepsy and shift work sleep disorder (SWSD). It has also been used off-label as a'smart drug' for cognitive enhancement where alertness and concentration are desired.

The primary pharmacological activity of modafinil is to promote wakefulness and it has been demonstrated to be effective in narcolepsy and sleep-disordered breathing studies (Shelton et al 1995; Panckeri et al 1996; Lagarde et al 2000). It is chemically unrelated to and pharmacologically distinguishable from CNS stimulants such as dextroamphetamine and methylphenidate.

The authors of this study randomly assigned 157 patients with chronic SWSD to receive modafinil 200 mg, modafinil 300 mg, or placebo taken 30 to 60 minutes before regularly scheduled night shifts for 12 weeks. Modafinil significantly improved overall clinical condition for sleepiness, with 71% of patients receiving modafinil rated by the investigator as 'improved' compared to 35% of patients receiving placebo.

This improvement was largely due to the reduction in the level of sleepiness on the commute home from the workplace, as measured by mean change in the Mini Mental State Examination-Sleepiness scale (MSME-S; mean difference 0.6).

A reduced level of sleepiness on the commute home was associated with an improved quality of life as measured by SF-36 domain scores for vitality and general health, but not vigilance or fatigue. The authors also found that the use of modafinil significantly decreased mistakes, accidents, and near-accidents on the night shift (mean change 1.9 vs 2.0).

These findings suggest that the use of a wakefulness-promoting agent can be beneficial in improving the quality of life for individuals who are sleepy as a result of chronic SWSD. However, it is important to remember that modafinil does not cure narcolepsy or sleep apnea/hypopnea syndrome; rather, it acts as a temporary remedy.

Therefore, the first thing that should be done when a patient complains of excessive daytime sleepiness is to ensure that a diagnostic polysomnogram is obtained and that the patient is treated with CPAP for a sufficient period of time to demonstrate whether or not his/her symptoms are responsive to treatment.

The symptom of EDS is the earliest clinical symptom of OSA, and suppressing it with medication will likely obscure this diagnosis. This may ultimately cause more harm than good. If, however, the results of the polysomnogram demonstrate that OSA is the underlying cause of EDS, it would be appropriate to prescribe modafinil to alleviate this particular symptom while the patient undergoes CPAP therapy. This is the best way to reduce the risk of serious complications such as cardiovascular disorders.