UK - There is little evidence to justify some newly approved uses for modafinil, a treatment for excessive daytime sleepiness, according to Consumers' Association's Drug and Therapeutics Bulletin DTB.

The widening of the drug's potential use could also mean that the underlying cause of sleepiness is increasingly overlooked or not addressed.

Up to one in eight adults has severe, potentially dangerous, sleepiness during the daytime. Many of these have an underlying medical reason, such as pain at night or use of drugs that cause excessive daytime sleepiness, such as sedating antihistamines, or that interfere with sleep at night, for example caffeine. Another important cause is obstructive sleep apnoea, a condition in which the upper airway repeatedly collapses and becomes obstructed during sleep.

Modafinil, a stimulant drug, was originally licensed for, and can benefit, patients with narcolepsy, a rare neurological disease that leads to bouts of irresistible daytime sleepiness. However, modafinil has not been tested directly against dexamfetamine, the established stimulant drug for narcolepsy.

Recently, the licence for modafinil has been extended to include patients with excessive daytime sleepiness due to any long-term disease, including obstructive sleep apnoea and so-called "shift work sleep disorder". CONTINUES............which

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