Introduction: Obstructive sleep apnea (OSA) is highly prevalent and constitutes 
a major health hazard. Current pharmacotherapy is ineffective in correcting 
sleep-disordered breathing and is used adjunctively to address residual 
sleepiness. A new drug, solriamfetol, a selective norepinephrine-dopamine 
reuptake inhibitor, is the first drug of its class that is being considered by 
the US Food and Drug Administration (FDA) to treat excessive sleepiness in OSA 
and narcolepsy patients. Areas covered: This review covers drug chemistry, 
pharmacodynamics, pharmacokinetics, and metabolism of solriamfetol. Results of 
three Phase 3 trials, Treatment of OSA and Narcolepsy Excessive Sleepiness 
(TONES 3, 4, 5), relevant to OSA patients are summarized. Published 
abstracts/articles and a 2017 Jazz Investor Presentation provided data. 
Databases searched included PubMed, Google Scholar, Lexi-Comp, Scopus, Science, 
and Ovid. Expert commentary: Solriamfetol shows promise as adjunctive therapy in 
OSA. It is well tolerated and effective in reducing sleepiness and is an 
alternative to modafinil or armodafinil. Unlike stimulants like methylphenidate 
or dextroamphetamine, it does not have cardiac effects, rebound hypersomnia, or 
withdrawal effects.