Impact of solriamfetol treatment on sleep quality in Chinese patients with OSA-EDS: results of a randomized controlled trial

Introduction Wake-promoting agents (WPAs), such as solriamfetol, have emerged as effective treatment options for treating excessive daytime sleepiness (EDS) in patients with obstructive sleep apnea (OSA). However, the impact of solriamfetol on nocturnal sleep quality remains underexplored. This exploratory analysis of a 12-week, randomized, double-blind, placebo-controlled, multicenter, parallel-arm, phase 3 trial involving Chinese patients with OSA-EDS evaluated the effect of solriamfetol on nocturnal sleep quality. Methods Participants were randomized (1:1) to receive solriamfetol (150 mg) or placebo once daily. The coprimary efficacy endpoints were the changes from baseline to week 12 in mean sleep latency during the Maintenance Wakefulness Test and in Epworth Sleepiness Scale scores. The exploratory endpoints included changes in participants’ polysomnography (PSG) parameters from baseline at Weeks 2, 5, and 12. These parameters were unadjusted and hypothesis-generating. The sleep quality parameters included total sleep time (TST) and wakefulness after sleep onset (WASO). Respiratory parameters included mean oxygen saturation (SaO 2 ), minimum SaO 2 , apnea index, and apnea-hypopnea index (AHI). Results Of the 357 participants screened, 201 were included in the full analysis set (FAS) (solriamfetol, n = 101; placebo, n = 100). At all-time points (Weeks 2, 5, and 12), no significant changes in TST, WASO, stage N2 sleep, and AHI were observed between the solriamfetol and placebo groups ( P > 0.05). No significant changes were observed in N1 and N3, although significant changes were observed in N1 at Week 2 ( P = 0.0022) and N3 at Week 5 ( P = 0.0212). Conclusion No clinically significant or consistent changes in PSG parameters were observed compared with placebo, indicating that solriamfetol morning administration has no significant effect on nocturnal sleep parameters.