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According to the American College of Cardiology, there is no causal relationship between Vyvanse and heart complications or sudden death with first-line stimulants approved by FDA

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Elevated TMAO levels have been linked to a number of diseases, including cardiovascular and neurological disorders, renal disease, metabolic syndrome, obesity, type 2 diabetes (T2D), non-alcoholic fatty liver disease (NAFLD), cancer, and severe COVID-19

The actual impact on the OSA market by the wonder drugs is yet to be determined

Off-label prescribing is legal, common, and ethically sound when supported by clinical evidence and prescribed by licensed providers