Drug could inhibit OSA detection

July 12, 2004 NEW YORK — A growing number of people are using Provigil, a drug that boosts the central nervous system and lets them stay awake for hours or even days without the addiction and euphoria of amphetamines, the New York Times reported June 29. Health experts said people taking Provigil might go undiagnosed for underlying diseases, such as diabetes or sleep apnea, that cause fatigue. Doctors warn that reducing sleep by even one hour a night could cause long-term neurological and cardiovascular effects. The drug, which has been around since 1998, has become attractive to millions of people because there are very few side effects, the worst being a mild headache or slight nausea. But experts are concerned that Provigil is becoming a pick-me-up for college students, long-haul truckers, computer programmers, and others who need to push their bodies to stay awake in a culture of 24-hour stores and graveyard shifts. In 1998, Provigil was first marketed in the United States as a treatment for narcolepsy, a severe sleep disorder. Earlier this year, the Food and Drug Administration expanded its uses to include obstructive sleep apnea and sleeping problems caused by shift work. However, data from the drug's manufacturer, Cephalon, shows that 90% of all prescriptions for Provigil are "off-label" uses, including fatigue, depression, attention deficit hyperactivity disorder, and sleepiness caused by other prescription medications. Worldwide sales of Provigil continue to grow. In 2003, sales totaled $290 million, up from $207 million in 2002. This year, worldwide sales are expected to reach $409 million.