Meds reduce apnea crashes

15 April, 2010

People with severe sleep apnea have excessive daytime sleepiness and triple the risk of car crashes.

A study released this week by The Woolcock Institute of Medical Research at the University of Sydney and published in the prestigious American Journal of Respiratory and Critical Care Medicine found for the first time that the wakefulness promoter, modafinil, improves driving and alertness in people with untreated sleep apnea.

Sleep apnea patients who were using continuous positive airway pressure (CPAP) were withdrawn from therapy for 2 nights and given either modafinil or a placebo. Compared with placebo, modafinil treatment resulted in markedly better performance both on a driving simulator and a special task measuring lapses in attention.

"Continuous positive airway pressure (CPAP) is the most common treatment for sleep apnea but many people stop using it, for brief periods due to travel or colds," said Dr Shaun Williams, lead author of the study. "Given the concern regarding road crashes particularly around holiday weekends we can't simply leave people with sleep apnea untreated. Modafinil offers a practical solution to an important problem."

CPAP consists of a nose or face mask attached by plastic tubing to a bedside device that helps sleep apnea patients breathe normally during sleep. Modafinil is currently registered in the USA, Australia and elsewhere to improve alertness in patients with sleep disorders who have significant daytime sleepiness.

Professor Ron Grunstein, senior author of the study said the findings were important as untreated sleep apnea is costly to society and methods to manage daytime sleepiness are needed especially for patients who cannot use CPAP machines.

Future research from the Woolcock Institute will focus on investigating the effect of longer trials of modafinil in patients who cannot tolerate CPAP treatment for sleep apnea.

Source: Woolcock Institute of Medical Research