If Kelli White has narcolepsy, it is unlikely that she could compete in sports without treatment, particularly at a world-class level ["Double Gold Medalist Tests Positive," Sports, Aug. 31]. Untreated, narcolepsy is an incapacitating disability whose effects have been found to be as severe as multiple sclerosis on quality-of-life assessment scales.

Does treatment with modafinil provide a competitive edge?

Based on the evidence, probably not more than someone else drinking several cups of coffee. Just as people become tolerant of coffee, a person with narcolepsy would have to consume ever greater amounts of modafinil to get any boosting effect.

Modafinil is not an amphetamine and is not classified as one by the Drug Enforcement Administration or the Food and Drug Administration. It has not been shown to improve strength, speed or other athletic characteristics -- just to keep people awake and alert enough to function.

Rather than condemn Ms. White, we should applaud her motivation for overcoming symptoms that make training difficult. She is competing overseas against the world's best -- and she is winning -- not because she is taking a medication that helps her stay awake but because she is a great athlete.


Executive Director

National Sleep Foundation