Treatment of Excessive Daytime Sleepiness

Introduction to Solriamfetol

The American Academy of Sleep Medicine strongly recommends Solriamfetol as a first-line treatment for adults with excessive daytime sleepiness due to narcolepsy and can be effectively used for obstructive sleep apnea (OSA) with appropriate dosing protocols 1

The recommended starting dose of Solriamfetol is 75 mg once daily upon awakening, which may be increased to 150 mg once daily after at least 3 days if needed, with a maximum dose of 150 mg once daily 1

Solriamfetol has a manageable safety profile, with common adverse events including headache, decreased appetite, insomnia, anxiety, and nausea, which are typically mild to moderate in severity and occur within 2 weeks of treatment initiation 1
The American Academy of Sleep Medicine notes that Solriamfetol is contraindicated with concurrent MAOI use or within 14 days of MAOI use, and should be used with caution in patients with unstable cardiovascular disease, serious heart arrhythmias, or history of psychosis or bipolar disorders 1

The American Academy of Sleep Medicine recommends measuring baseline blood pressure and heart rate, screening for history of psychosis or bipolar disorders, and ensuring adequate treatment of underlying OSA for at least one month before initiating Solriamfetol therapy 1