I Used to Think I Slept Well. Then I Tried This.
A new class of sleep drugs targets your wakefulness system directly. Here’s what that does to your recovery, your cognition, and your mornings.
About fourteen years ago, I put modafinil on the map. ABC Nightline came to my house and filmed for two days because I was the only executive in Silicon Valley willing to talk about using a cognitive enhancer without a bag over my head. Watch it here. The drug was called Provigil. It had been FDA-approved for narcolepsy since 1998, but nobody outside of a small circle was talking about using it as a performance tool. They had to invent a brand new category of medication to describe what it does, a “wakefulness-promoting agent,” because it wasn’t a stimulant. It doesn’t raise your heart rate. It doesn’t make you jittery. The lights simply turn on.
Modafinil increases orexin signaling in your hypothalamus, one reason it produces clean wakefulness without the jittery profile of traditional stimulants. Orexin is a neuropeptide, a signaling molecule your brain produces to regulate alertness and the sleep-wake cycle.
I wrote about the full science of modafinil, how to dose it, and how I stack it at daveasprey.com/modafinil-benefits.
The same orexin system that modafinil ramps up to keep you awake is the system that, when it fires too hot at night, costs you sleep quality. There is now a class of drugs that works on the exact opposite end of that same system. Instead of increasing orexin signaling to promote wakefulness, they block orexin receptors to let sleep happen.
They’re called DORA drugs. Dual orexin receptor antagonists. A new drug category. Most primary care doctors have never prescribed one.
In the full version you’ll get:
Why the orexin system is the missing variable in most people’s sleep, even people who think they sleep fine
A breakdown of all three FDA-approved DORA drugs, how they differ, and which one the evidence currently favors
How to have a productive conversation with your doctor about getting access
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