Nav: Home

Drug used to treat daytime sleepiness does not appear to improve driving in those with sleep apnea

May 18, 2018

In "Does Armodafinil Improve Driving Task Performance and Weight Loss in Sleep Apnea? A Randomized Trial," Nathaniel Marshall, PhD, and his colleagues at the Woolcock Institute for Medical Research, University of Sydney, report on their study of armodafinil, which has been approved by the U.S. Food and Drug Administration to treat excessive daytime sleepiness due to OSA, narcolepsy and other conditions.

The researchers found that armodafinil did not improve the driving performance of those with OSA after six months of use, the study's primary outcome. Nor did those taking the drug report less daytime sleepiness than those receiving a placebo, as measured by the Epworth Sleepiness Scale and the Functional Outcomes of Sleep Questionnaire.

In the study, 113 participants (ages 18 to 70) were randomly assigned to either receive 150 mg of armodafinil daily or a placebo. Participants had moderate to severe OSA, were moderately obese and did not use continuous positive airway pressure (CPAP) or an oral appliance that advances their lower jaw. Both therapies treat OSA by preventing the pauses in breathing that occur in OSA when the back of the throat collapses.

All participants were also randomly assigned to one of two popular diets in Australia: the Australian Guide to Healthy Eating diet, which is similar to the American Dietary Guidelines "Choose My Plate," or a low-glycemic index, high-protein diet. Driving ability was assessed during a simulated 90-minute drive.

According to Dr. Marshall, a clinical trials epidemiologist, about half of patients seen in sleep clinics fall into the category of having sleep apnea and abdominal obesity but being unable to tolerate CPAP or an oral appliance. "My clinical colleagues and I call these patients the 'forgotten patients,'" he said. "We felt we needed to help our patients lose weight to address their metabolic risks over the longer term whilst addressing their sleepiness and neurocognitive dysfunction immediately with armodafinil."

He added that sporadic reports indicate that patients using armodafinil and its cousin modafinil to improve wakefulness experienced weight loss, so he and his coauthors wanted to test whether the drugs might increase the success of a deliberate weight loss program.

In the current study, armodafinil did, in fact, have a positive effect on body mass. Participants on the drug lost more body fat on either of the diets, which appeared to reduce weight equally well, than those who received the placebo. At six months, those in the armodafinil arm of the study lost an average of 6.4 pounds more body fat than those receiving the placebo. The researchers said that some of this additional weight loss may be due to the increased activity levels of those receiving the drug, as measured by an activity tracker. Importantly, the authors noted that armodafinil did not appear to increase blood pressure.

Armodafinil also appeared to improve driving ability after three months. The researchers speculate that those taking armodafinil learned their simulated driving tasks faster than those receiving the placebo because by six months there was no difference between the two groups. Even with the improvements that came with practice, the authors noted that, on average, driving ability among these participants with untreated OSA was two standard deviations worse than healthy people without OSA.
-end-
About the American Journal of Respiratory and Critical Care Medicine (AJRCCM):

The AJRCCM is a peer-reviewed journal published by the American Thoracic Society. The Journal takes pride in publishing the most innovative science and the highest quality reviews, practice guidelines and statements in pulmonary, critical care and sleep medicine. With an impact factor of 12.996, it is the highest ranked journal in pulmonology. Editor: Jadwiga Wedzicha, MD, professor of respiratory medicine at the National Heart and Lung Institute (Royal Brompton Campus), Imperial College London, UK.

About the American Thoracic Society:

Founded in 1905, the American Thoracic Society is the world's leading medical association dedicated to advancing pulmonary, critical care and sleep medicine. The Society's 15,000 members prevent and fight respiratory disease around the globe through research, education, patient care and advocacy. The ATS publishes three journals, the American Journal of Respiratory and Critical Care Medicine, the American Journal of Respiratory Cell and Molecular Biology and the Annals of the American Thoracic Society

The ATS will hold its 2018 International Conference, May 18-23, in San Diego, California, where world-renowned experts will share the latest scientific research and clinical advances in pulmonary, critical care and sleep medicine.

American Thoracic Society

Related Weight Loss Articles:

Cash for weight loss
A new study, published in the journal Social Science and Medicine, has shown that selling rewards programmes to participants entering a weight loss programme is a low cost strategy to increase both the magnitude and duration of weight loss.
Is alternate-day fasting more effective for weight loss?
Alternate day fasting regimens have increased in popularity because some patients find it difficult to adhere to a conventional weight-loss diet.
Bullies and their victims obsessed with weight-loss
School bullies and their victims are more obsessed with weight-loss than anyone else, according to new research by the University of Warwick.
Weight loss actually possible after menopause
Talk to a woman in menopause and you're likely to hear complaints about hot flashes and an inability to lose weight, especially belly fat.
Weight loss reduces psoriasis symptoms
Weight loss has a significant and prolonged positive impact on psoriasis symptoms and quality of life.
Weight loss may help prevent multiple myeloma
Carrying extra weight increases a person's risk that a benign blood disorder will develop into multiple myeloma, a blood cancer.
Gastric bypass is better than other procedures for sustainable weight loss
Gastric bypass surgery is more effective for weight loss and long-term weight maintenance than are other surgical procedures and non-surgical treatment, according to a study led by researchers at Duke Health and the Durham VA Medical Center.
Weight loss surgery associated with increased fracture risk
Severely obese patients undergoing weight loss surgery are more likely to have increased fracture risks both before and after the surgical procedure compared to obese and non-obese people people who don't need surgery, finds a large study published by The BMJ this week.
Online intervention helps sustain weight loss
New research, led by the University of Southampton, has found that an online behavioural counselling tool is effective at helping people lose weight.
Study compares effectiveness of weight-loss drugs
In an analysis that included nearly 30,000 overweight or obese adults, compared with placebo, orlistat, lorcaserin, naltrexone-bupropion, phentermine-topiramate, and liraglutide were each associated with achieving at least 5 percent weight loss at 52 weeks, and phentermine-topiramate and liraglutide were associated with the highest odds of achieving at least 5 percent weight loss, according to a study appearing in the June 14 issue of JAMA.

Related Weight Loss Reading:

21-Day Ketogenic Diet Weight Loss Challenge: Recipes and Workouts for a Slimmer, Healthier You
by Rachel Gregory MS CNS ATC CSCS (Author), Amanda C. Hughes (Author)

Lean Yoga: Shed The Excess Weight From Your Body And Mind (Yoga for Weight Loss, Stress, Anxiety Relief, Mindfulness and Inner Peace, Includes Color Photos of all Asanas)

Instant Loss Cookbook: Cook Your Way to a Healthy Weight with 125 Recipes for Your Instant Pot®, Pressure Cooker, and More
by Brittany Williams (Author)

Lose Weight with Your Instant Pot: 60 Easy One-Pot Recipes for Fast Weight Loss
by Audrey Johns (Author)

The Obesity Code: Unlocking the Secrets of Weight Loss
by Dr. Jason Fung (Author), Timothy Noakes (Foreword)

The Secrets to Ultimate Weight Loss: A revolutionary approach to conquer cravings, overcome food addiction, and lose weight without going hungry
by Chef AJ (Author), Glen Merzer (Author)

The Dash Diet Weight Loss Solution: 2 Weeks to Drop Pounds, Boost Metabolism, and Get Healthy
by Marla Heller (Author)

Simply Keto: A Practical Approach to Health & Weight Loss, with 100+ Easy Low-Carb Recipes
by Suzanne Ryan (Author)

Mini Habits for Weight Loss: Stop Dieting. Form New Habits. Change Your Lifestyle Without Suffering. (Volume 2)
by Stephen Guise (Author)

A Course in Weight Loss: 21 Spiritual Lessons for Surrendering Your Weight Forever
by Marianne Williamson (Author)

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Approaching With Kindness
We often forget to say the words "thank you." But can those two words change how you — and those around you — look at the world? This hour, TED speakers on the power of gratitude and appreciation. Guests include author AJ Jacobs, author and former baseball player Mike Robbins, Dr. Laura Trice, Professor of Management Christine Porath, and former Danish politician Özlem Cekic.
Now Playing: Science for the People

#509 Anisogamy: The Beginning of Male and Female
This week we discuss how the sperm and egg came to be, and how a difference of reproductive interest has led to sexual conflict in bed bugs. We'll be speaking with Dr. Geoff Parker, an evolutionary biologist credited with developing a theory to explain the evolution of two sexes, about anisogamy, sexual reproduction through the fusion of two different gametes: the egg and the sperm. Then we'll speak with Dr. Roberto Pereira, research scientist in urban entomology at the University of Florida, about traumatic insemination in bed bugs.