Modafinil is a wakefulness-promoting agent that is used to treat narcolepsy and shift work sleep disorder (problems falling asleep during scheduled working hours in people who have nighttime jobs). It can also be taken along with CPAP or other treatments for obstructive sleep apnea/hypopnea syndrome.

At the placebo-baseline, the MWT and MSLT measures were severely impaired in the entire study population. The 200-mg once-daily and 400-mg once-daily modafinil groups all showed improved alertness, but the 600-mg split-dose group did better in this measure of sleepiness.

Effects of Modafinil on Sleep

Modafinil Australia exerts some acute and long-lasting beneficial effects on sleep and wakefulness in humans. In four randomized studies of sleepy patients with OSA or SWD, as well as one open-label extension study, improvements in subjectively determined sleepiness and functional performance were maintained for 12 weeks when modafinil was added to ongoing CPAP therapy (Pack et al 2001). 

In the qEEG, 9 weeks of modafinil treatment reduced power in the delta, theta, low and high gamma, and alpha frequency bands in NREMS, while in the passive phase, it suppressed the amount and mean duration of REMS episodes (Fig S2a). After 2 weeks of washout, these changes returned to baseline levels.

This medication may make you dizzy or drowsy. Do not drive or use machinery until you know how this drug affects you. Avoid alcoholic beverages or marijuana (cannabis) while taking modafinil. Your doctor will prescribe a dose based on your age, weight, and other medical conditions.

Effects of Modafinil on Alertness

Modafinil is a wakefulness-promoting agent that works by blocking the reuptake of dopamine, an excitatory neurotransmitter. It is also known to enhance activity in the prefrontal cortex and cerebellum. This makes you feel more awake and increases your ability to react quickly. You should avoid alcohol or marijuana (cannabis) while taking this medication.

In placebo-controlled trials utilizing an extended daytime version of the MWT, Modalert Tablets improved objectively determined wakefulness and reduced patient-reported sleepiness in a dose-dependent manner. The 200-mg once-daily and 400-mg split-dose regimens resulted in a greater improvement in wakefulness than did the 600-mg once-daily dose at both the morning and midday MWT sessions.

The 200-mg once-daily modafinil dose also improved patient-reported vigilance and activity on the FOSQ. However, there was no significant difference in scores for general productivity or intimacy. These differences may reflect methodological variations in assessing vigilance and activity.

Nonetheless, the improvements in these trials suggest that once-daily modafinil is an effective treatment for excessive sleepiness related to narcolepsy and shift work disorder.

Effects of Modafinil on Performance

Modafinil increases performance on a variety of tasks, including decision-making, planning, and problem-solving. In addition, it improves the ability to cope with circadian rhythm disruptions and the natural trough in wakefulness during sleep loss.

These effects are thought to be due to the drug’s ability to bind weakly and selectively to the dopamine transporter, increasing extracellular levels of monoamines (particularly dopamine) in brain regions involved in regulating sleep and wakefulness.

Several studies of older adults have reported that modafinil significantly improves subjectively determined sleepiness on the MWT and FOSQ. It also improves functional outcomes on the SF-12 and health-related quality of life on the EORQ.

Although these benefits are promising, further studies are needed to determine if the drug can be used as an effective treatment in people with OSA and SWD who also have excessive sleepiness.

Moreover, modafinil can interact with many medications, so doctors should consider the interactions when prescribing this drug. Nonetheless, it is an appealing option for treating excessive sleepiness in people with these disorders.

Effects of Modafinil on Core Body Temperature

Modafinil significantly improved objectively measured sleep latency (MSLT and MWT) and subjectively assessed sleepiness levels (ESS) compared with placebo in clinical studies. It also improved health-related quality of life (SF-36) compared with placebo with increased vitality, less limitation on daily activities due to physical or emotional problems, and fewer restrictions in social interactions because of fatigue or sleepiness.

However, modafinil did not affect the number of narcolepsy episodes and did not completely normalize sleep latency in patients with narcolepsy in comparison with placebo. It did, however, halve inadvertent sleep onsets during scheduled wakefulness periods.

Modafinil (2-[(phenylmethyl)sulfinyl] acetamide) is available as a prescription medicine for the treatment of sleep disorders such as narcolepsy and shift work disorder. It can also be used to improve alertness in patients with mild to moderate obstructive sleep apnea, as an adjunct to continuous positive airway pressure (CPAP) therapy.

It should be taken as directed. Be sure to read the Medication Guide and other patient information, and ask your doctor or pharmacist any questions you have.