Solriamfetol promising for safer driving in people with OSA-related excessive daytime sleepiness

In patients with excessive daytime sleepiness (EDS) associated with obstructive sleep apnoea (OSA), treatment with solriamfetol produces significant improvements in on-the-road driving performance, as shown in a study.

The study enrolled adult patients (aged 21–75 years) with OSA and EDS (Maintenance of Wakefulness Test mean sleep latency <30 minutes and Epworth Sleepiness Scale score ≥10). They were randomized to receive solriamfetol (150 mg/day initially for 3 days, then 300 mg/day for the next 4 days) or placebo for 7 days, before crossing over to the other treatment regimen.

Efficacy was assessed using standardized on-road driving tests at 2 and 6 hours postdose at day 7 of each treatment period. The primary endpoint was standard deviation of lateral position (SDLP).

Solriamfetol was associated with significant reductions in SDLP both at 2 hours (n=34; least squares mean difference, –1.1 cm, 95 percent confidence interval [CI], –1.85 to –0.32; p=0.006) and 6 hours postdose (n=32; least squares mean difference, –0.8 cm, 95 percent CI, –1.58 to –0.03; p=0.043).

Of note, incomplete driving tests occurred less frequently with solriamfetol than with placebo (2 hours postdose: 1 vs 4 patients; 6 hours postdose; 3 vs 7 patients).

Commonly reported treatment-emergent adverse events were included headache, nausea, and insomnia.

The findings highlight the potential of solriamfetol for making driving safer for patients suffering from EDS.