Excessive daytime sleepiness (EDS) is characterized by failure to maintain wakefulness and alertness, with a compelling need to sleep and may even fall asleep involuntarily. It is often accompanied by deficits in attention and memory, impairs daily functioning, and poses safety risks. Dysregulation of monoaminergic arousal pathways-particularly noradrenergic and dopaminergic systems—is closely implicated. Although several commonly used agents act via monoamine reuptake inhibition, only solriamfetol, a selective dopamine-norepinephrine reuptake inhibitor (DNRI), currently has clear evidence supporting efficacy for EDS associated with narcolepsy and obstructive sleep apnea (OSA). As a selective dopamine and norepinephrine reuptake inhibitor (DNRI), solriamfetol exerts its wake-promoting effects by blocking the corresponding transporters, thereby increasing monoamine levels in the synaptic cleft. Results from multiple clinical trials indicate that solriamfetol significantly improves patients' subjective sleepiness scores and objective ability to maintain wakefulness, with an overall favorable safety profile and no observed rebound sleepiness or withdrawal reactions. Real-world studies further confirm the feasibility of its long-term use. Against the backdrop of the mechanism of action and clinical application of monoamine reuptake inhibitors, this article focuses on reviewing the pharmacological characteristics of solriamfetol and its clinical research progress in both approved and investigational indications, aiming to provide evidence-based references for personalized wake-promoting treatment strategies in patients with EDS as a core phenotype.