Sleep

Obstructive sleep apnea (OSA) and other sleep disturbances are common in people with Prader-Willi syndrome. Many studies in the medical literature suggest that the oxygen deprivation and fragmented sleep associated with OSA are associated with deficits in learning. A new study looks at just how damaging untreated OSA can be in children.

Modafinil (Provigil) has been suggested as a potential wake-promoting drug that might be helpful in PWS. Interestingly, this article (although a very small study) showed that individuals taking modafinil consumed less food. Compared to amphetamine, which also increases wakefulness and decreases appetite, modafinil did not cause increased heart rate at high doses.

Here is a new study is just out in the journal “Pediatrics” using the new formulation of modafinil for ADHD in children (age 6-17)

You may remember that orexin is a small protein (peptide) released in the brain, which was originally identified because it stimulates feeding. In addition to a role in feeding/energy regulation, it is also critical in wakefulness. People with narcolepsy have very low (to undetectable) levels of orexin in their cerebral-spinal fluid (CSF). Notably, the only other disorder that has been associated with low orexin in the CSF to date (and it has only been tested in a couple of individuals) is PWS.

Here is a recent study (link to abstract below) looking at the use of modafinil, a wake-promoting drug, in children with excessive daytime sleepiness (in this study, primarily narcolepsy).