Poster
116
(#116) Effects of Solriamfetol on Neuropsychological Outcomes in Patients with Obstructive Sleep Apnea in the Real-World SURWEY Study
Psych Congress 2025
Abstract: Introduction:
Patients with excessive daytime sleepiness (EDS) associated with obstructive sleep apnea (OSA) often exhibit cognitive deficits. Solriamfetol (Sunosi®) is a dopamine-norepinephrine reuptake inhibitor and TAAR1/5HT1A agonist approved to treat EDS associated with narcolepsy or OSA. Here, we report a post-hoc analysis of neuropsychological outcomes in patients with EDS in OSA treated with solriamfetol in a real-world setting.
Methods:
SURWEY was a retrospective, observational study using data from physicians prescribing solriamfetol. Neuropsychological assessments were performed in a subgroup of patients prior to and 3 months after solriamfetol initiation. Tests included: Test of Attentional Performance (TAP) subtest alertness, the Regensburger Word Fluency Test, the Wechsler Memory Scale subtest visual reproduction, Wechsler Adult Intelligence Scale (WAIS-IV) subtest coding and British Columbia Cognitive Complaints Inventory (BC-CCI).
Results:
Before solriamfetol initiation, participants (N=46) showed impaired alertness on the TAP (mean±SD 268.2±21.8 ms with warning signal, 270.2±21.9 ms without), impaired cognitive function on the BC-CCI (8.6±2.2), and reduced psychomotor and visual processing speed on the WAIS-IV coding subtest (7.1±1.5); no impairments in word fluency or memory were observed. Following solriamfetol treatment, TAP scores improved by a mean of 11.4% (237.7±21.4 ms with warning; 239.5±21.3 ms without, p 0.01 for both). BC-CCI scores improved by a mean of 40.8% (5.1±3.1, p 0.01). WAIS-IV coding scores improved by 30.6% (9.3±1.8, p 0.01). Epworth Sleepiness Scale scores improved by 4.7±2.7 (p 0.01); change in EDS was not associated with cognitive improvement (|r|=0.16, p=0.3).
Conclusion:
In this observational study, solriamfetol reduced OSA-associated cognitive impairment, independently of improvements in EDS.
Short Description: This real-world study assessed neuropsychological outcomes in patients treated with solriamfetol for excessive daytime sleepiness (EDS) associated with obstructive sleep apnea. Before treatment, patients showed subjective cognitive complaints, and deficits in objectively assessed alertness, and psychomotor and visual processing speed; after solriamfetol treatment, significant improvements were observed in these domains. Patient-reported EDS also improved but was not associated with cognitive improvement. Solriamfetol may reduce cognitive impairment independently of its effect on EDS in this population.
Name of Sponsoring Organization(s): Axsome Therapeutics, Inc., and Pharmanovia
Patients with excessive daytime sleepiness (EDS) associated with obstructive sleep apnea (OSA) often exhibit cognitive deficits. Solriamfetol (Sunosi®) is a dopamine-norepinephrine reuptake inhibitor and TAAR1/5HT1A agonist approved to treat EDS associated with narcolepsy or OSA. Here, we report a post-hoc analysis of neuropsychological outcomes in patients with EDS in OSA treated with solriamfetol in a real-world setting.
Methods:
SURWEY was a retrospective, observational study using data from physicians prescribing solriamfetol. Neuropsychological assessments were performed in a subgroup of patients prior to and 3 months after solriamfetol initiation. Tests included: Test of Attentional Performance (TAP) subtest alertness, the Regensburger Word Fluency Test, the Wechsler Memory Scale subtest visual reproduction, Wechsler Adult Intelligence Scale (WAIS-IV) subtest coding and British Columbia Cognitive Complaints Inventory (BC-CCI).
Results:
Before solriamfetol initiation, participants (N=46) showed impaired alertness on the TAP (mean±SD 268.2±21.8 ms with warning signal, 270.2±21.9 ms without), impaired cognitive function on the BC-CCI (8.6±2.2), and reduced psychomotor and visual processing speed on the WAIS-IV coding subtest (7.1±1.5); no impairments in word fluency or memory were observed. Following solriamfetol treatment, TAP scores improved by a mean of 11.4% (237.7±21.4 ms with warning; 239.5±21.3 ms without, p 0.01 for both). BC-CCI scores improved by a mean of 40.8% (5.1±3.1, p 0.01). WAIS-IV coding scores improved by 30.6% (9.3±1.8, p 0.01). Epworth Sleepiness Scale scores improved by 4.7±2.7 (p 0.01); change in EDS was not associated with cognitive improvement (|r|=0.16, p=0.3).
Conclusion:
In this observational study, solriamfetol reduced OSA-associated cognitive impairment, independently of improvements in EDS.
Short Description: This real-world study assessed neuropsychological outcomes in patients treated with solriamfetol for excessive daytime sleepiness (EDS) associated with obstructive sleep apnea. Before treatment, patients showed subjective cognitive complaints, and deficits in objectively assessed alertness, and psychomotor and visual processing speed; after solriamfetol treatment, significant improvements were observed in these domains. Patient-reported EDS also improved but was not associated with cognitive improvement. Solriamfetol may reduce cognitive impairment independently of its effect on EDS in this population.
Name of Sponsoring Organization(s): Axsome Therapeutics, Inc., and Pharmanovia
