Solriamfetol improves objective wakefulness and reduces subjective sleepiness in Chinese OSA patients with EDS across all disease severity levels.
In a post hoc analysis of a 12-week RCT, solriamfetol (up to 150 mg/day) significantly prolonged MWT sleep latency vs placebo in all AHI subgroups: AHI<5 (LS mean difference 12.13 min, p<0.0001), 5≤AHI<30 (12.68 min, p<0.0001), and AHI≥30 (10.94 min, p=0.0001). ESS scores significantly improved in the two milder subgroups but not in the severe OSA subgroup (p=0.2497).
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Solriamfetol improves objective wakefulness and reduces subjective sleepiness in Chinese OSA patients with EDS across all disease severity levels. The current body of evidence comprises 1 study, including 1 randomized controlled trial. EvidenceHub rates the overall confidence at 48/100 (low).
The Claim
Solriamfetol improves objective wakefulness and reduces subjective sleepiness in Chinese OSA patients with EDS across all disease severity levels.
This conclusion is most relevant to: Chinese OSA patients with excessive daytime sleepiness, stratified by baseline AHI (<5, 5 to <30, ≥30).
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Post Hoc Analysis of Solriamfetol Efficacy in Obstructive Sleep Apnea Patients with Excessive Daytime Sleepiness Stratified by Disease Severity. (Advances in therapy, 2026) —
How It Works
The proposed biological pathway:
- ▸Solriamfetol inhibits dopamine and norepinephrine reuptake
- ▸Increased synaptic dopamine and norepinephrine levels
- ▸Enhanced arousal and wake-promoting signaling in the brain
- ▸Result: Improved objective wakefulness and reduced subjective sleepiness
Who Might Benefit
Evidence fit by population:
- ▸Chinese OSA patients with excessive daytime sleepiness, stratified by baseline AHI (<5, 5 to <30, ≥30)
Recommended Dose
Up to 150 mg/day (titrated)
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Post hoc subgroup analysis, not pre-specified as primary endpoint
- ▸ESS improvement not statistically significant in the severe OSA (AHI≥30) subgroup
- ▸Single Chinese population limits generalizability to other ethnic groups
Frequently Asked Questions
What is solriamfetol?▼
Solriamfetol is a dopamine and norepinephrine reuptake inhibitor approved for excessive daytime sleepiness associated with obstructive sleep apnea.
Did solriamfetol work equally well in all OSA severity groups?▼
Objective wakefulness (MWT) improved significantly in all AHI subgroups, but subjective sleepiness (ESS) only improved significantly in milder OSA (AHI<30) and not in severe OSA (AHI≥30).
What were the common side effects?▼
The most common adverse events (>10% incidence) included upper respiratory tract infection, hyperuricemia, dizziness, and hypertension.
How long was the treatment period?▼
The study lasted 12 weeks with dose titration up to 150 mg/day.
References
- 1.Su C, Shen J, Guo K, Wang J, Wang Z, Gao S, Wang Q, Han F, Zhang W, Ye H, Li X, Zhang R, Chen R. “Post Hoc Analysis of Solriamfetol Efficacy in Obstructive Sleep Apnea Patients with Excessive Daytime Sleepiness Stratified by Disease Severity..” Advances in therapy, 2026. PMID: 42423948 DOI: 10.1007/s12325-026-03690-5