Terri E. Weaver, PhD, RN, on Solriamfetol as Add-on Therapy to CPAP Improves Outcomes

In this video, Terri E. Weaver, PhD, RN, talks about the key take-home messages about solriamfetol for treating symptoms of obstructive sleep apnea, as well as which patients would benefit most.

Additional Resource:

• Weaver T, Pepin JL, Schwab R, et al. Long-term effects of solriamfetol on excessive daytime sleepiness and functional outcomes in participants with OSA. Paper presented at: CHEST 2020; October 18-21, 2020; Virtual. https://journal.chestnet.org/article/S0012-3692(20)34156-8/fulltext

Terri E. Weaver, PhD, RN, is dean and professor in the Department of Behavioral Nursing Science in the College of Nursing and professor in the Division of Pulmonary, Critical Care, Sleep, and Allergy in the Department of Medicine in the College of Medicine at the University of Illinois at Chicago.

TRANSCRIPT:

My name is Terri Weaver, I am Dean and professor at the University of Illinois Chicago College of Nursing.

The key take-home message is that patients who are on continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea (OSA) and who use their CPAP treatment regularly and throughout their sleep cycle and are still complaining of daytime sleepiness should be evaluated.

If, in fact, there's not another reason why they may be sleepy that they should consider pharmaceutical agents such as solriamfetol to improve their alertness. What we found is that their daily activities are enhanced, but in addition, their work productivity is also enhanced. I think that that's very important.

And of course, their self-reported sleepiness was also reduced. We know that in some work that I'm doing that we saw white matter compromise in the brain in those individuals who are still sleepy but using their CPAP for long periods of time every night.

We’re not sure what the relationship is between the action of this dopamine, norepinephrine reuptake inhibitor is. But obviously, there's something that is physiologically present that is causing this sleepiness, and this pharmaceutical does work to improve that.

It's important that not only did we see that there was, as I said, improvement and some really important outcomes, such as daily functioning and sleepiness, but that when we ask patients about their perception of change in the positive or negative that they did feel that those who were on active treatment compared to placebo during the withdrawal phase did see that it was a positive effect with the agent.

Not only that, the clinicians also saw that over the period of time in which there was withdrawal treatment and randomization to either maintain the intervention or be put on placebo that they also saw statistically significant change, which shows that when individuals are given this medication that when you withdraw it that there is a decline in the benefits of it and that when you reintroduce it then, in fact, it gets back to that improvement.

So, I think it has really shown that this—with not much in the way of side effects—really is another tool that we can use to really treat daytime sleepiness in these patients who are optimally adherent to their treatment for sleep apnea.

Thank you for the opportunity to share our work, greatly appreciate it.