{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T02:31:19Z","timestamp":1786415479303,"version":"build-2736575974"},"reference-count":45,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Sleep Medicine"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.sleep.2026.109116","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T15:33:28Z","timestamp":1783784008000},"page":"109116","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Modafinil for excessive daytime sleepiness: A systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.1016","volume":"147","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6871-9081","authenticated-orcid":false,"given":"Mauricio Silva","family":"de Lima","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando Morgadinho Santos","family":"Coelho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrique Andrea","family":"de Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"de Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Fernandes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Dias","family":"Louren\u00e7o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"do Prado-Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"10357","key":"10.1016\/j.sleep.2026.109116_bib1","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/S0140-6736(22)01018-2","article-title":"Understanding and approaching excessive daytime sleepiness","volume":"400","author":"P\u00e9rez-Carbonell","year":"2022","journal-title":"Lancet"},{"issue":"2","key":"10.1016\/j.sleep.2026.109116_bib2","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1007\/s11325-019-01921-4","article-title":"Excessive daytime sleepiness and fatigue in neurological disorders","volume":"24","author":"Maestri","year":"2020","journal-title":"Sleep Breath"},{"issue":"9918","key":"10.1016\/j.sleep.2026.109116_bib3","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/S0140-6736(13)60734-5","article-title":"Adult obstructive sleep apnoea","volume":"383","author":"Jordan","year":"2014","journal-title":"Lancet"},{"issue":"2","key":"10.1016\/j.sleep.2026.109116_bib4","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1093\/occmed\/kqg046","article-title":"Shift work and disturbed sleep\/wakefulness","volume":"53","author":"Akerstedt","year":"2003","journal-title":"Occup Med (Lond)"},{"issue":"S8","key":"10.1016\/j.sleep.2026.109116_bib5","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.5694\/mja13.10561","article-title":"Sleep loss and circadian disruption in shift work: health burden and management","volume":"199","author":"Rajaratnam","year":"2013","journal-title":"Med J Aust"},{"issue":"4","key":"10.1016\/j.sleep.2026.109116_bib6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0033981","article-title":"Shift work disorder in nurses\u2013assessment, prevalence and related health problems","volume":"7","author":"Flo","year":"2012","journal-title":"PLoS One"},{"issue":"4","key":"10.1016\/j.sleep.2026.109116_bib7","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1111\/jsr.12039","article-title":"Scientific council of the sleep registry of the French Federation of Pneumology-FFP. Residual sleepiness in sleep apnea patients treated by continuous positive airway pressure","volume":"22","author":"Gasa","year":"2013","journal-title":"J Sleep Res"},{"issue":"2","key":"10.1016\/j.sleep.2026.109116_bib8","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1513\/pats.200708-119MG","article-title":"Adherence to continuous positive airway pressure therapy: the challenge to effective treatment","volume":"5","author":"Weaver","year":"2008","journal-title":"Proc Am Thorac Soc"},{"issue":"8","key":"10.1016\/j.sleep.2026.109116_bib9","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1093\/sleep\/27.8.1453","article-title":"Shift work sleep disorder: prevalence and consequences beyond that of symptomatic day workers","volume":"27","author":"Drake","year":"2004","journal-title":"Sleep"},{"issue":"11","key":"10.1016\/j.sleep.2026.109116_bib10","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1093\/sleep\/30.11.1460","article-title":"Zhdanova IV; American academy of sleep medicine. Circadian rhythm sleep disorders: part I, basic principles, shift work and jet lag disorders","volume":"30","author":"Sack","year":"2007","journal-title":"Sleep"},{"issue":"3","key":"10.1016\/j.sleep.2026.109116_bib11","doi-asserted-by":"crossref","first-page":"575","DOI":"10.3109\/07420521003749956","article-title":"Consequences of shiftworking on sleep duration, sleepiness, and sleep attacks","volume":"27","author":"Ohayon","year":"2010","journal-title":"Chronobiol Int"},{"key":"10.1016\/j.sleep.2026.109116_bib12","doi-asserted-by":"crossref","first-page":"i5210","DOI":"10.1136\/bmj.i5210","article-title":"Health consequences of shift work and insufficient sleep","volume":"355","author":"Kecklund","year":"2016","journal-title":"BMJ"},{"issue":"4","key":"10.1016\/j.sleep.2026.109116_bib13","first-page":"306","article-title":"Treatment of narcolepsy with methamphetamine","volume":"16","author":"Mitler","year":"1993","journal-title":"Sleep"},{"issue":"7","key":"10.1016\/j.sleep.2026.109116_bib14","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1038\/sj.npp.1301534","article-title":"Modafinil: a review of neurochemical actions and effects on cognition","volume":"33","author":"Minzenberg","year":"2008","journal-title":"Neuropsychopharmacology"},{"issue":"11","key":"10.1016\/j.sleep.2026.109116_bib15","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1001\/jama.2009.351","article-title":"Effects of modafinil on dopamine and dopamine transporters in the male human brain: clinical implications","volume":"301","author":"Volkow","year":"2009","journal-title":"JAMA"},{"issue":"1","key":"10.1016\/j.sleep.2026.109116_bib16","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1002\/ana.410430115","article-title":"Randomized trial of modafinil for the treatment of pathological somnolence in narcolepsy","volume":"43","year":"1998","journal-title":"Ann Neurol"},{"issue":"2","key":"10.1016\/j.sleep.2026.109116_bib17","doi-asserted-by":"crossref","first-page":"123","DOI":"10.2165\/00003088-200342020-00002","article-title":"Clinical pharmacokinetic profile of modafinil","volume":"42","author":"Robertson","year":"2003","journal-title":"Clin Pharmacokinet"},{"issue":"6","key":"10.1016\/j.sleep.2026.109116_bib18","doi-asserted-by":"crossref","first-page":"595","DOI":"10.5664\/jcsm.26970","article-title":"Evaluation of the safety of modafinil for treatment of excessive sleepiness","volume":"3","author":"Roth","year":"2007","journal-title":"J Clin Sleep Med"},{"key":"10.1016\/j.sleep.2026.109116_bib19","series-title":"Modafinil \u2013 referral","year":"2010"},{"issue":"4","key":"10.1016\/j.sleep.2026.109116_bib20","doi-asserted-by":"crossref","first-page":"554","DOI":"10.4088\/JCP.v67n0406","article-title":"A systematic review of modafinil: potential clinical uses and mechanisms of action","volume":"67","author":"Ballon","year":"2006","journal-title":"J Clin Psychiatr"},{"issue":"n71","key":"10.1016\/j.sleep.2026.109116_bib21","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"10.1016\/j.sleep.2026.109116_bib22","series-title":"Cochrane handbook for systematic reviews of interventions","year":"2019"},{"key":"10.1016\/j.sleep.2026.109116_bib23","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"10.1016\/j.sleep.2026.109116_bib24","unstructured":"Review Manager (RevMan). Version (version number). The Cochrane Collaboration, (version date). Available at: revman.cochrane.org."},{"issue":"7414","key":"10.1016\/j.sleep.2026.109116_bib25","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"issue":"7109","key":"10.1016\/j.sleep.2026.109116_bib26","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"issue":"4","key":"10.1016\/j.sleep.2026.109116_bib27","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","article-title":"GRADE guidelines: 1. Introduction\u2014GRADE evidence profiles and summary of findings tables","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"issue":"10","key":"10.1016\/j.sleep.2026.109116_bib28","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1016\/j.sleep.2013.04.010","article-title":"Alertness and psychomotor performance effects of the histamine-3 inverse agonist MK-0249 in obstructive sleep apnea patients on continuous positive airway pressure therapy with excessive daytime sleepiness: a randomized adaptive crossover study","volume":"14","author":"Herring","year":"2013","journal-title":"Sleep Med"},{"key":"10.1016\/j.sleep.2026.109116_bib29","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1056\/NEJMoa041292","article-title":"Modafinil for excessive sleepiness associated with shift-work sleep disorder","volume":"353","author":"Czeisler","year":"2005","journal-title":"N Engl J Med"},{"key":"10.1016\/j.sleep.2026.109116_bib30","doi-asserted-by":"crossref","first-page":"751","DOI":"10.5664\/jcsm.2912","article-title":"Efficacy and safety of adjunctive modafinil treatment on residual excessive daytime sleepiness among nasal continuous positive airway pressure-treated Japanese patients with obstructive sleep apnea syndrome: a double-blind placebo-controlled study","volume":"9","author":"Inoue","year":"2013","journal-title":"J Clin Sleep Med"},{"key":"10.1016\/j.sleep.2026.109116_bib31","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1164\/rccm.200908-1307OC","article-title":"Modafinil effects during acute continuous positive airway pressure withdrawal","volume":"181","author":"Williams","year":"2010","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.sleep.2026.109116_bib32","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/j.pnpbp.2007.10.016","article-title":"Placebo and modafinil effect on sleepiness in obstructive sleep apnea","volume":"32","author":"Bittencourt","year":"2008","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"key":"10.1016\/j.sleep.2026.109116_bib33","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1164\/ajrccm.163.4.2005036","article-title":"Randomized, double-blind, placebo-controlled crossover trial of modafinil in the treatment of residual excessive daytime sleepiness in the sleep Apnea\/Hypopnea syndrome","volume":"163","author":"Kingshott","year":"2001","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.sleep.2026.109116_bib34","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1164\/ajrccm.164.9.2103032","article-title":"Modafinil as adjunct therapy for sleepiness in obstructive sleep apnea","volume":"164","author":"Pack","year":"2001","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.sleep.2026.109116_bib35","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1093\/sleep\/28.4.464","article-title":"Modafinil for treatment of residual excessive sleepiness in nasal continuous positive airway pressure-treated obstructive sleep Apnea\/Hypopnea syndrome","volume":"28","author":"Black","year":"2005","journal-title":"Sleep"},{"issue":"3","key":"10.1016\/j.sleep.2026.109116_bib36","first-page":"188","article-title":"Modafinil for excessive sleepiness associated with chronic shift work sleep disorder: effects on patient functioning and health-related quality of life","volume":"9","author":"Erman","year":"2007","journal-title":"Prim Care Companion J Clin Psychiatry"},{"issue":"8","key":"10.1016\/j.sleep.2026.109116_bib37","article-title":"Pharmacological interventions for sleepiness and sleep disturbances caused by shift work","author":"Liira","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"issue":"5","key":"10.1016\/j.sleep.2026.109116_bib38","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1183\/13993003.01509-2015","article-title":"Modafinil\/armodafinil in obstructive sleep apnoea: a systematic review and meta-analysis","volume":"47","author":"Chapman","year":"2016","journal-title":"Eur Respir J"},{"issue":"6","key":"10.1016\/j.sleep.2026.109116_bib39","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1007\/s40263-025-01175-7","article-title":"Comparative efficacy and safety of multiple wake-promoting agents for the treatment of residual sleepiness in obstructive sleep apnea despite continuous positive airway pressure: a systematic review and network meta-analysis of randomized controlled trials","volume":"39","author":"Tanayapong","year":"2025","journal-title":"CNS Drugs"},{"issue":"5","key":"10.1016\/j.sleep.2026.109116_bib40","article-title":"Medications for daytime sleepiness in individuals with idiopathic hypersomnia","author":"Trotti","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"issue":"8","key":"10.1016\/j.sleep.2026.109116_bib41","first-page":"RA177","article-title":"Modafinil for narcolepsy: systematic review and meta-analysis","volume":"16","author":"Golicki","year":"2010","journal-title":"Med Sci Monit"},{"issue":"2","key":"10.1016\/j.sleep.2026.109116_bib42","first-page":"MR000033","article-title":"Industry sponsorship and research outcome","author":"Lundh","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"10.1016\/j.sleep.2026.109116_bib43","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1093\/ije\/31.1.140","article-title":"Meta-analyses involving cross-over trials: methodological issues","volume":"31","author":"Elbourne","year":"2002","journal-title":"Int J Epidemiol"},{"issue":"11","key":"10.1016\/j.sleep.2026.109116_bib44","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1164\/rccm.201806-1100OC","article-title":"Solriamfetol for excessive sleepiness in obstructive sleep apnea (TONES 3): a randomized controlled trial","volume":"199","author":"Schweitzer","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"issue":"11","key":"10.1016\/j.sleep.2026.109116_bib45","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1016\/S1474-4422(13)70225-4","article-title":"Pitolisant versus placebo or modafinil in patients with narcolepsy: a double-blind randomized trial","volume":"12","author":"Dauvilliers","year":"2013","journal-title":"Lancet Neurol"}],"container-title":["Sleep Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1389945726003552?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1389945726003552?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T02:11:16Z","timestamp":1786414276000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1389945726003552"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":45,"alternative-id":["S1389945726003552"],"URL":"https:\/\/doi.org\/10.1016\/j.sleep.2026.109116","relation":{},"ISSN":["1389-9457"],"issn-type":[{"value":"1389-9457","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Modafinil for excessive daytime sleepiness: A systematic review and meta-analysis of randomized controlled trials","name":"articletitle","label":"Article Title"},{"value":"Sleep Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.sleep.2026.109116","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"109116"}}