Beginners Guide to Modafinil for Sleep Disorders in 2024

Sleep disorders are very common. About 67% of adults worldwide indicate that they may be suffering from a form of sleep disorder, according to a Philips Global Sleep Survey conducted in 2019. The good news is that many of them, including obstructive sleep apnea (OSA), shift work sleep disorder (SWSD), and narcolepsy, can be treated with modafinil.

However, before rushing into popping the pill, there are certain things worth knowing. This guide sheds light on some of the common sleep disorders, whether they’re treatable with modafinil and much more.

What Is Modafinil?

Modafinil belongs to a class of drugs called wakefulness-promoting medications. It was developed by Lafon Laboratories and a French neuroscientist Michel Jouvet in the 1970s and prescribed to treat narcolepsy in 1994.

Following its safety, effectiveness, and overall success in France, the US Food and Drug Administration (FDA) approved it for the treatment of narcolepsy in 1998 [1]. The drug worked wonders, and in 2003, it was approved to treat SWSD and narcolepsy as well. Since then, many doctors started considering it the best treatment option for sleep conditions.

Today, modafinil is more common among healthy individuals. They use it off-label to enhance their cognitive function and ultimately gain a competitive edge in their respective places of engagement. Although the FDA discourages the drug’s use for this purpose, many continue to use it, stating that it works wonders for them.

As a cognitive enhancer, modafinil is believed to:

• increase alertness;
• promote focus;
• boost memory;
• enhance short-term memory;
• increase mental processing speed.

It is popularly sold under the brand name Provigil, and it comes in dose strengths of 100 mg and 200 mg. Modafinil is available and more commonly found in generic brands such as Modavinil, Modalert, Modvigil, and Modafil MD, among others.

Modafinil is safe and well-tolerated compared to other drugs in its class, but it is only approved for use in individuals who are 17 years of age and older.

What Are Sleep Disorders?

Sleep disorders are conditions that affect sleep duration, timing, amount, and quality of sleep, and ultimately impair functioning. There are over 80 types of sleep disorders, and they are typically caused by mental illnesses, genetics, certain medications, and conditions such as nerve disorders, heart disease, and lung disease, among others [2][3].

Insomnia is one of the most common types of sleep disorders. It is characterized by difficulty in falling asleep and staying asleep long enough after managing to sleep.

Other types of sleep disorders include:

• obstructive sleep apnea (OSA);
• shift work sleep disorder (SWSD);
• parasomnia;
• hypersomnia;
• restless leg syndrome (RLS);
• circadian rhythm disorders.

People who suffer from sleep disorders often find it difficult to sleep at night for long enough and stay alert during the day.

The symptoms of sleep disorders may vary depending on the exact type of disorder the individual may be experiencing. However, the symptoms that are common among a range of disorders include [3]:

• waking up multiple times at night and finding it hard to fall back asleep;
• arms and legs jerking while you’re asleep;
• making choking sounds, snoring, or experiencing a shortage of breath during sleep;
• often taking more than 30 minutes to fall asleep;
• experiencing excessive daytime sleepiness.

Sleep disorders are very common; about 70 million people suffer from them in the US alone. It is advisable to consult a doctor if you experience one or more of the above symptoms because sleep disorders can disrupt thinking, reduce performance at work or school, and affect your overall quality of life.

Treating Sleep Disorders with Modafinil

There are several treatment options healthcare providers recommend for the treatment of sleep disorders. Some of them include counseling, regular exercise, and making certain lifestyle changes such as minimizing light and noise and maintaining a regular sleep pattern [4].

Many healthcare providers often recommend supplements or medications to treat the condition. And in most cases, they employ modafinil as the first line of treatment. But why modafinil? Does it have any special benefits?

Well, it is because it is super-effective, well tolerated, and poses a relatively low risk of side effects. Modafinil is so safe compared to other drugs that researchers at Oxford and Harvard University deem it the “world’s first safe ‘smart drug.’”

Let us take a look at the major sleep disorders modafinil is used to treat and the basic principles behind its use in treating them.

Narcolepsy

Narcolepsy is a condition that causes persons suffering from it to feel excessively tired and sleepy at times when they do not intend to sleep. The major symptoms associated with it include fatigue, hallucinations, cataplexy, changes in rapid eye movement (REM) sleep, and cataplexy.

Modafinil has proven to be a safe and effective treatment for narcolepsy. It is better tolerated and has a far lower risk of side effects and dependence compared to older options such as Ritalin and Adderall. Although all drugs have side effects, most people who use modafinil have reported those associated with modafinil to be mild and short-lived.

At this point, it is worth noting that drugs do not completely cure narcolepsy. However, they can help to reduce the symptoms and ultimately increase alertness, productivity, and overall quality of life.

To get the best out of modafinil when used to treat narcolepsy, a single dose is to be taken. Doctors typically recommend starting with a small dose of 50 mg or 100 mg and only increasing to 200 mg or 400 mg if the lower doses prove to be ineffective. The drug is typically taken once per day, early in the morning. However, healthcare providers may recommend taking two 50 mg doses – one in the morning and the second in the midafternoon.

Obstructive Sleep Apnea

Obstructive sleep apnea, commonly called OSA for short, is a sleep disorder that is caused by partial blockage of the upper airways by the soft palate and tongue in the throat. It is one of the 3 types of sleep apnea, and unlike the other two types (central sleep apnea and complex sleep apnea), its cause has nothing to do with brain signals.

OSA is often caused by two main factors: obesity and medical conditions such as kidney or heart failure, premature birth, endocrine diseases, neuromuscular disorders, etc. Overweight individuals are likely to suffer from it because of the tendency of their soft palate to be fleshier than normal. Consequently, when they sleep, the muscles that support the soft tissues relax, allowing the tongue and soft palate to collapse into the throat. This ultimately results in partial obstruction of the airways – the reason why individuals with OSA soar.

Symptoms of OSA may include snoring, lack of focus during the day, difficulty breathing, insomnia, nightmares, and waking up tired. They’re majorly caused by low oxygen levels due to poor breathing patterns during sleep.

It is worth noting that modafinil is not the first-line treatment for OSA; continuous positive airway pressure (CPAP) is. However, it has proven to be effective in eliminating the associated symptoms which CPAP does not handle; this is why both treatment options are often used together. Amphetamine and other CNS stimulants can also be used to treat the symptoms of OSA; however, modafinil is preferred because it has fewer adverse effects and poses minimal risk of causing dependence.

The recommended dosage of modafinil for OSA treatment is 200 mg. It is to be taken only once per day early in the morning and should be swallowed whole with a substantial amount of water. Under certain situations, doctors may recommend a lower or higher dose of the drug to patients.

Shift Work Sleep Disorder

Shift work sleep disorder (SWSD) is a sleep disorder that affects individuals whose work hours fall outside the traditional work hours (9-5). People who suffer from the condition have their sleep patterns all mixed up. They find themselves struggling to stay awake and alert during work hours but find it extremely difficult to fall or stay asleep when they wish to.

SWSD is characterized by a regular feeling of tiredness, difficulty concentrating, moodiness, and trouble making and sustaining relationships. It is often caused by exposure to light and darkness at the wrong times. On the one hand, light entering the eyes during the day prompt the brain to produce a wakefulness-inducing hormone called cortisol. On the other hand, the absence of light causes the brain to produce a sleep-inducing hormone called melatonin.

People who work odd shifts often get exposed to bright light at times they should be asleep. In the long run, their weird sleep pattern affects the normal release of the sleep and wakefulness hormones and ultimately leaves them with SWSD.

Treatment of SWSD typically involves creating a sleep-enabling environment and minimizing exposure to light. Great ways of creating a sleep-enabling environment involve minimizing noise, turning off gadgets such as mobile phones and screens that may be distracting, and keeping the room dark during the intended bedtime. While these routine changes can help improve the condition, many people adapt better with the help of drugs.

The FDA has two drugs approved for SWSD treatment; they are modafinil and armodafinil. These drugs are to be used exactly as prescribed and under the supervision of a healthcare provider because they are used to treat other conditions, and how they are used matters.

Idiopathic Hypersomnia

Idiopathic hypersomnia is a sleep disorder that causes individuals suffering from it to experience excessive daytime sleepiness and the inability to concentrate even after a good night’s sleep.

The disorder is an uncommon brain abnormality that is commonly associated with low levels of a neurotransmitter or brain chemical called histamine. Like many other sleep disorders, this sleep disorder is uncurable, but its symptoms can be reduced with adequate treatment [5][6].

The exact cause of Idiopathic hypersomnia is unknown, and as a result, most treatments are often aimed at reducing the symptoms. For treatment, many doctors often prescribe modafinil off-label. They also recommend making certain lifestyle changes such as avoiding alcohol use, developing a regular bedtime schedule, and avoiding meds that affect sleep [7].

Idiopathic hypersomnia is a serious condition, and it requires adequate care and supervision by a doctor or healthcare provider.

The Verdict: Modafinil for Sleep Disorders

Modafinil is a mild stimulant. It eases the symptoms of certain sleep disorders by regulating the levels of neurotransmitters such as dopamine and serotonin in the hypothalamus and certain parts of the brain [8][9].

Compared to other CNS stimulants such as Adderall and Ritalin, modafinil for sleep disorders is usually what many sleep doctors recommend. This is due to 3 major reasons: the fact that it is well-tolerated has mild adverse effects and has an incredibly low potential for addiction.

However, it is worth noting that it is a serious medication. Consequently, it is to be used under a doctor’s or healthcare provider’s supervision. The medical professionals may conduct tests to enable them to ascertain the exact sleep disorder a person may be suffering from and recommend the right dose that will be administered.

References

1. Modafinil. Retrieved: July 31, 2022. Wikipedia.org.
2. What are Sleep Disorders? Reviewed by Felix Torres, MD, MBA, DFAPA. Retrieved: July 31, 2022. Psychiatry.org.
3. Sleep Disorders. Retrieved: July 31, 2022. Medlineplus.gov.
4. Common Sleep Disorders: Symptoms, Causes & Treatment. Reviewed by a Cleveland Clinic medical professional. Retrieved: July 31, 2022. My.clevelandclinic.org.
5. Idiopathic hypersomnia – Symptoms and causes. Written By Mayo Clinic Staff. Retrieved: July 31, 2022. Mayoclinic.org.
6. The Mystery Behind Idiopathic Hypersomnia. By Keri Wiginton. Medically Reviewed by Neha Pathak, MD. Retrieved: July 31, 2022. Webmd.com.
7. Idiopathic hypersomnia – Diagnosis and treatment. Written By Mayo Clinic Staff. Retrieved: July 31, 2022. Mayoclinic.org.
8. How Modafinil Promotes Wakefulness. By Naveed Saleh, MD, MS. Medically reviewed by Steven Gans, MD. Retrieved: July 31, 2022. Verywellmind.com.
9. How Does Modafinil Work To Regulate Sleep? Posted by Jennifer Hines. Retrieved: July 31, 2022. Alaskasleep.com.