Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder, and excessive daytime sleepiness (EDS) is one of its hallmark clinical manifestations, impairing quality of life and increasing public-safety risks such as road traffic accidents. A considerable proportion of patients continue to experience residual EDS despite adequate treatment with continuous positive airway pressure (CPAP). This review summarizes research over the past decade on wake-promoting agents for OSA-related EDS, synthesizing clinical evidence for modafinil, armodafinil, solriamfetol, and pitolisant. Across randomized controlled trials and observational studies, wake-promoting agents improve subjective sleepiness (Epworth Sleepiness Scale, ESS) and objective wakefulness (Maintenance of Wakefulness Test, MWT); recently approved agents agents such as solriamfetol and pitolisant demonstrate overall favorable efficacy and safety profiles compared with traditional options. Subgroup analyses indicate that benefits can be observed irrespective of adherence to primary OSA therapy. Importantly, wake-promoting agents are adjunctive, symptomatic treatments for EDS and do not replace CPAP or other etiologic therapies; evaluation should exclude alternative causes of sleepiness prior to initiation, and patients should continue standard OSA management throughout treatment.