1215 Adjunctive Use of Solriamfetol in Pediatric Excessive Daytime Sleepiness: A Single Center Experience

Abstract Introduction Solriamfetol (Sunosi) has been FDA-approved for adults aged 18 years or older particularly for excessive daytime sleepiness (EDS) associated with obstructive sleep apnea or narcolepsy. It works as a selective norepinephrine and dopamine reuptake inhibitor to promote wakefulness in this particular population. The benefit of this medication, compared to other medications to promote wakefulness, is that it is a non-stimulant medication. It has also been noted to have significant long-term efficacy rates for adults with EDS. Given the success of solriamfetol in the adult population, it has been trialed on EDS patients within the pediatric population. The purpose of this study is to better summarize the safety, efficacy, dosing, and side effect profile of pediatric patients using solriamfetol. Report of case(s) We performed a retrospective analysis of 11 pediatric patients who have been placed on solriamfetol and studied the improvement of daytime sleepiness with this intervention. Typical up-titration of the medication and monitoring for failure of improvement of sleepiness required a follow up period of at least 3 months. We collected the following data points: gender, weight, age, diagnosis (OSA or narcolepsy), medications, sleep study findings, and subjective endorsement of improvement based on Likert scale with increments of 0-25%, 26-50%, 51-75%, and 76-100% improvement. Our results demonstrated >50% responsiveness in 18% (2/11) of the patients in our cohort with 27% (3/11) of patients having some improvement of their excessive daytime sleepiness by 26-50%. Only 18% (2/11) patients reported adverse effects of headaches or increased anxiety with none of the patients reporting SJS-like rashes or insomnia. All patients tolerated the 150 mg daily dosing. No interactions were noted with patients taking OCPs. Conclusion Solriamfetol demonstrates similar tolerability, safety and side effect profile within the pediatric population when compared to the adult population and may provide additional benefit in refractory cases of EDS at maximal doses. More studies are needed to validate these observations. Support (if any)