'Wake-Up Pills' Try to Replace Sleep
The Buzz on Modafinil
Available only by prescription, modafinil is only approved to treat narcolepsy, a disorder in which sleepiness is uncontrollable even during daytime.
"It's a good wake promoter," Walsleben tells WebMD. "It takes two hours to get going but has a half-life of 10 hours, so it works all day long. By evening, there are no after-effects that affect overnight sleep. It allows the sleep rhythm to be normal."
Extensive studies have shown that modafinil is not addictive because it works on different receptor systems than do amphetamines, she says. "There are very few side effects, if any, and there's little concern about abuse. People don't develop a tolerance to it. It's a really neat drug."
Military fighter pilots can stay alert for several days at a time on modafinil -- and perform mental tasks with "near normalcy," she says. The drug may also help people with depression and related psychiatric disorders, "people who get the doldrums and just can't get going."
Night-shift workers also might benefit from modafinil. At the University of Pennsylvania, a study involving 16 participants tested the theory. The group first had to stay awake for 28 hours. Then they began a four-day period of sleeping from 11 a.m. to 7 p.m. and being awake at night. Half were randomly given modafinil during their awake hours, half got a placebo.
Those taking the drug were able to stay alert and performed well on tests, while the placebo group had a significantly higher error rate, she reports.
Modafinil is also being tested as a complementary treatment for sleep apnea (a breathing disorder that causes chronically interrupted sleep) and as an option to treat syndromes like multiple sclerosis, where fatigue is a big problem, Walsleben tells WebMD.
The only caution: modafinil does seem to have problems interacting with other drugs such as anti-seizure and heart medications. "It also lessens the effectiveness of birth control pills," she says. "People need to discuss this with their doctors."
Words of Caution
"It's clear [modafinil] can make people more alert," says Thomas Scammel, MD, a sleep disorder specialist and assistant professor of neurology at Beth Israel Deaconess Hospital in Boston.
"The danger," Scammel tells WebMD: "It's easy to imagine people using it casually. One of our real concerns is that people will start taking it to make up for the fact that they're not getting enough sleep."
The average person needs eight hours of sleep, yet the average American gets about seven hours. "Many, many people get far less than that," says Scammel. "Sleep serves a very important purpose. Sleep deprivation causes serious changes in endocrine and immune systems. To patch up that sleep loss is to do our bodies a real injustice."
"If people are having sleep problems, they need to get to the underlying problem," says Walsleben. "The drug can only serve people well if their underlying condition is first treated."