Sunosi (solriamfetol) is a type of medicine called a dopamine- and norepinephrine reuptake inhibitor (DNRI). It was approved by the FDA in 2019 to treat daytime sleepiness caused by narcolepsy (a disorder that causes you to fall asleep at unexpected times) or obstructive sleep apnea (a condition that affects your breathing at night). It is available as a tablet that you can take by mouth.
How Does Sunosi Treat Sleepiness?
People with obstructive sleep apnea (OSA) or narcolepsy can feel very sleepy during the daytime. This medicine helps you feel more awake. It increases the levels of two substances in the brain called norepinephrine and dopamine, but the exact way it works is not known.
This medicine does not treat nighttime breathing problems caused by OSA; it just helps make you feel more awake during the day. If you have OSA, you will need to continue your treatments for nighttime breathing such as continuous positive airway pressure (CPAP).
How Was This Medicine Studied, and What Benefits Were Seen?
Sleepiness caused by narcolepsy
Sunosi was studied in a trial that included more than 200 adults with narcolepsy. They were told to take Sunosi or placebo pills (containing no medicine) once daily for 12 weeks. The dose used in the trial was either 75 milligrams, 150 milligrams, or 300 milligrams. Since the 300-milligram dose is higher than the maximum recommended dose, this article will not focus on those results. The average age of people in the trial was about 36, more than half were females (59.3%), and about 80% were White. After taking the medicine for 12 weeks, people took surveys (called the Epworth Sleepiness Scale). It asked them eight questions to find out how sleepy they felt and assigned a score based on their response. The highest score was 24, which meant they felt very sleepy. They also did a sleep study (called a Maintenance of Wakefulness Test or MWT test) that measured how long they could stay awake during the day in a dark and quiet room. After 12 weeks of treatment, the study reported the following results:
- People who took Sunosi felt less sleepy. They had lower scores on their surveys compared to those who took placebo pills.
- For those who took Sunosi 75 milligrams, their scores were about 2 points lower (out of 24 total points)
- For those who took Sunosi 150 milligrams, their scores were about 4 points lower (out of 24 total points)
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People who took Sunosi were able to stay awake longer during their sleep study than those who took placebo pills.
- Those who took Sunosi 75 milligrams stayed awake about 3 minutes longer (this small difference may have been due to chance rather than the medicine)
- Those who took the 150 milligrams of Sunosi daily stayed awake for about 8 minutes longer
Sleepiness caused by obstructive sleep apnea
Sunosi was studied in a trial that included more than 400 people diagnosed with obstructive sleep apnea. They were told to take Sunosi or placebo pills (containing no medicine) once daily for 12 weeks. The dose of Sunosi used in this trial was either 37.5 milligrams, 75 milligrams, 150 milligrams, or 300 milligrams. Since the 300-milligram dose is higher than the maximum recommended dose, this article will not focus on those results. The average age of people in the trial was 55, 37% were female, and the majority (76%) were White. After taking Sunosi for 12 weeks, people took surveys about how sleepy they felt (called the Epworth Sleepiness Scale, described above) and did a sleep study that measured how long they could stay awake during the day in a dark and quiet room (called a Maintenance of Wakefulness test or MWT test). After 12 weeks of treatment, the study reported the following results:
- Those who took Sunosi (regardless of the dose) reported feeling less sleepy compared to those who took placebo pills. Their survey scores were about 2-4 points lower than those who took the placebo, meaning they were less sleepy.
- Those who took Sunosi (regardless of the dose) stayed awake 5-11 minutes longer during their sleep study compared to those who took placebo pills. People who took the higher doses stayed awake longer than those who took lower doses.
Another longer trial was done afterwards that included people who had narcolepsy and obstructive sleep apnea. People took Sunosi for up to 52 weeks in this trial, and Sunosi continued to work in these patients for the duration of the trial.
- Related:Do These 14 Things to Get the Best Sleep Ever
What Are the Side Effects, and How Can I Prevent or Manage Them?
Increased blood pressure and heart rate
Sunosi can cause your blood pressure and heart rate to increase. This can increase your risk for other serious health issues including stroke, heart attack, or death. Your health care provider will check your blood pressure and heart rate before you start taking this medicine and during treatment. If you have high blood pressure, continue to take your blood pressure medicine unless otherwise directed by your health care provider.
Here are some things you can do to help maintain a healthy blood pressure.
- Eat a healthy diet and limit salt.
- Exercise regularly as directed by your health care provider.
- Maintain a healthy weight.
- Quit smoking.
- Avoid drinking a lot of alcohol.