Editing Microsleep (section)

==Disorders, clinical studies, and pharmacology==
Microsleeps are often tied to disorders. [[Sleep apnea]] is by far the most significant disease tied to microsleeps in terms of prevalence, affecting roughly 10–15 million people.<ref>Kanagala, R., Murali, N. S., Friedman, P. A., Ammash, N. M., Gersh, B. J., Ballman, K. V., ... & Somers, V. K. (2003). Obstructive sleep apnea and the recurrence of atrial fibrillation. ''Circulation'', 107(20), 2589-2594.</ref> Other disorders that may be tied to microsleeps include [[narcolepsy]], [[hypersomnia]], [[schizophrenia]], and other causes of [[excessive daytime sleepiness]]. Microsleep episodes are often neglected and are not used as a diagnostic indicator for these disorders. Instead, clinicians use instrumentation like PSG to do a sleep study on patients to assess overall sleep quality in a laboratory setting.<ref>Tufik, S., Santos-Silva, R., Taddei, J. A., & Bittencourt, L. R. A. (2010). Obstructive sleep apnea syndrome in the Sao Paulo epidemiologic sleep study. Sleep Medicine Reviews, 11(5), 441-446.</ref>

Microsleeps that recur and negatively influence day-to-day living often are clustered into the category of excessive daytime sleepiness. Thus, most clinical studies related to microsleeps are in the context of reducing microsleeps in excessive daytime sleepiness through the use of pharmacological interventions. Particularly, [[modafinil]] has become a popular drug to reduce microsleeps due to its [[eugeroic]] effect with comparatively mild side effects relative to classical psychostimulants. New drugs are often compared to the results of modafinil and [[placebo]] to assess efficacy (e.g. methylphenidate in Parkinson's Disease). Modafinil is also being tested across a range of disorders such as schizophrenia, narcolepsy, cataplexy, and sleep apnea. Overall, the trajectory of clinical studies relating to negative symptom microsleeps seems to more thoroughly test modafinil across more disorders and compare new drugs to the efficacy of modafinil to reduce the negative effects of microsleeps on people across a spectrum of disorders.

{|class="wikitable"
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! Title!! Interventions !! Conditions
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| Effects of BF2.649 in the Treatment of Excessive Daytime Sleepiness in Narcolepsy.<ref>Effects of BF2.649 in the Treatment of Excessive Daytime Sleepiness in Narcolepsy. http://clinicaltrials.gov/ct2/show/record/NCT01638403</ref> || Drug: BF2.649, Drug: [[Modafinil]], Drug: Placebo || Treatment of Excessive Daytime Sleepiness in Narcolepsy. 
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| Efficacy and Safety Study of BF2.649 in the Treatment of Excessive Daytime Sleepiness in Narcolepsy<ref>Efficacy and Safety Study of BF2.649 in the Treatment of Excessive Daytime Sleepiness in Narcolepsy. http://ClinicalTrials.gov/show/NCT01067222</ref>||Drug: BF2.649, Modafinil, [[Placebo]] ||Narcolepsy, Excessive Daytime Sleepiness, [[Cataplexy]], Sleep Disorders
|-
| Dose Range Finding Study of BF2.649 Versus Placebo to Treat Excessive Daytime Sleepiness in Parkinson's Disease Patients<ref>Dose Range Finding Study of BF2.649 Versus Placebo to Treat Excessive Daytime Sleepiness in Parkinson's Disease Patients . http://ClinicalTrials.gov/show/NCT00642928</ref> ||Drug: Placebo, Drug: BF 2.649 5&nbsp;mg, Drug: BF 2.649 10&nbsp;mg, Drug: BF 2.649 20&nbsp;mg, Drug: BF 2.649 40&nbsp;mg || Excessive Daytime Sleepiness, [[Parkinson's disease]]
|-
|  A Study Of A Novel Compound For Excessive Daytime Sleepiness Associated With Narcolepsy<ref>A Study Of A Novel Compound For Excessive Daytime Sleepiness Associated With Narcolepsy. http://ClinicalTrials.gov/show/NCT01006122</ref> || Drug: Placebo, Drug: PF-03654746 || Excessive Daytime Sleepiness, Narcolepsy
|-
| Treatment of Refractory Excessive Daytime Sleepiness in Patients With Obstructive Sleep Apnea/Hypopnea Syndrome (OSA/HS) Using Nasal Continuous Positive Airway Pressure (nCPAP) Therapy (0249-015)<ref>Treatment of Refractory Excessive Daytime Sleepiness in Patients With Obstructive Sleep Apnea/Hypopnea Syndrome (OSA/HS) Using Nasal Continuous Positive Airway Pressure (nCPAP) Therapy (0249-015). http://ClinicalTrials.gov/show/NCT00620659
</ref>||  Comparator: MK0249, Drug: Comparator: placebo, Drug: Comparator: modafinil||Sleep Apnea (Obstructive), Hypopnea Syndrome, Excessive Daytime Sleepiness
|-
| Pitolisant to Assess Weekly Frequency of Cataplexy Attacks and EDS in Narcoleptic Patients (HARMONY CTP)<ref>Pitolisant to Assess Weekly Frequency of Cataplexy Attacks and EDS in Narcoleptic Patients (HARMONY CTP). http://ClinicalTrials.gov/show/NCT01800045</ref>|| Drug: [[Pitolisant]], Drug: Placebo|| Narcolepsy with Cataplexy, Excessive Daytime Sleepiness
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| Comparison of Modafinil and Methylphenidate in Treatment of Excessive Daytime Sleepiness in Patients With Parkinson's Disease<ref>Comparison of Modafinil and Methylphenidate in Treatment of Excessive Daytime Sleepiness in Patients With Parkinson's Disease. http://ClinicalTrials.gov/show/NCT00393562</ref> ||  Drug: modafinil, Drug: [[methylphenidate]] || Parkinson's Disease
|-
| Modafinil Augmentation Therapy for Excessive Daytime Sleepiness and Negative Symptoms in Patients With Schizophrenia<ref>Modafinil Augmentation Therapy for Excessive Daytime Sleepiness and Negative Symptoms in Patients With Schizophrenia . http://ClinicalTrials.gov/show/NCT00546403</ref> || Drug: Modafinil, Drug: Placebo || Schizophrenia
|-
| Efficacy and Safety of BF2.649 in Excessive Daytime Sleepiness (EDS) in Parkinson's Disease<ref>Efficacy and Safety of BF2.649 in Excessive Daytime Sleepiness (EDS) in Parkinson's Disease. http://ClinicalTrials.gov/show/NCT01066442</ref> || Drug: BF2.649 (Pitolisant) || Parkinson's Disease
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| Trial of Xyrem for Excessive Daytime Sleepiness and Sleep Disturbance in Parkinson's Disease (PD)<ref>Trial of Xyrem for Excessive Daytime Sleepiness and Sleep Disturbance in Parkinson's Disease (PD). http://ClinicalTrials.gov/show/NCT00641186</ref>|| Drug: [[sodium oxybate]] ||  Parkinson's Disease
|}

Microsleeps sometimes are a side effect of various drugs, particularly in reference to dopamine-stimulating drugs in Parkinson's Disease. Particularly, [[somnolence]] is a recognized adverse effect of [[dopamine agonists]], [[pramipexole]] and [[ropinirole]]. These drugs are known to cause sudden-onset sleep spells in roughly 50% of patients with Parkinson's disease (PD) while they were driving.<ref>Hobson, D. E., Lang, A. E., Martin, W. W., Razmy, A., Rivest, J., & Fleming, J. (2002). "Excessive daytime sleepiness and sudden-onset sleep in Parkinson disease. "''JAMA: The Journal of the American Medical Association'', 287(4), 455–463. Chicago</ref> Therefore, clinical interventions pertaining to microsleeps may also encompass reducing excessive sleepiness as a side effect of drug administration. Orexin antagonists such as daridorexant and suvorexant may cause hypersomnolence and microsleeps.

Most microsleeps are not clinically significant, however. Individuals who feel sleepy and wish to maintain alertness often consume over-the-counter stimulants such as [[caffeine]] in [[coffee]]. More specifically, it has been shown that high-frequency low-dose caffeine intake is effective at countering poor work performance effects due to extended wakefulness, confirming the hypothesis that adenosine is a mediator of performance decrements associated with extended wakefulness.<ref>Wyatt, J. K., Cajochen, C., Cecco, A. R. D., Czeisler, C. A., & Dijk, D. J. (2004). "Low-dose repeated caffeine administration for circadian-phase-dependent performance degradation during extended wakefulness." ''SLEEP-NEW YORK THEN WESTCHESTER-'', 27(3), 374–382.</ref> Other stimulants that could decrease microsleep frequency include [[Adderall]], [[amphetamine]], [[cocaine]], and [[tobacco]].<ref>Jacobs, A. (2005). "The Adderall advantage." ''New York Times'', 31.</ref><ref>Gawin, F. H., & Ellinwood, E. H. (1988). "Cocaine and other stimulants: actions, abuse, and treatment." ''The New England Journal of Medicine''.</ref>