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Drug May Help Keep Night-Shift Workers Alert

Study: Provigil Eased but Didn't Erase Shift Workers' Sleep Woes
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WebMD Health News

Aug. 3, 2005 -- In a recent test, a drug called Provigil made night-shift workers less sleepy on the job, but it didn't wipe out the workers' sleep problems.

Provigil "reduced extreme sleepiness" and made a "small but significant" improvement in the workers' job performance when compared with a fake drug (placebo), write the researchers in The New England Journal of Medicine.

"However, the residual sleepiness that was observed in the treated patients underscores the need for the development of interventions that are even more effective," they write.

The study was sponsored by Cephalon, which makes Provigil. The researchers included Charles Czeisler, MD, PhD, of the sleep medicine divisions of Harvard Medical School and Boston's Brigham and Women's Hospital.

Provigil is used to treat excessive sleepiness caused by sleep disorders like narcolepsy and obstructive sleep apnea.

Night-Shift Sleepiness

"Nearly 6 million Americans work at night on a permanent or rotating basis," write the researchers. They estimate that 5% to 10% of night-shift workers have shift-work sleep disorder.

Symptoms include excessive sleepiness during night work and insomnia when trying to fall asleep during the day.

The study included 209 night-shift workers. They were randomly given 200 milligram doses of Provigil or a placebo for three months. The workers didn't know which pill they got; 153 workers finished the study.

Patients were asked to report any use of over-the-counter sleep aids. Five of the 96 people taking Provigil reported using over-the-counter sleep aids, compared with one of the 108 patients taking the placebo.

Less Sleepiness on the Job

Symptoms improved in nearly 75% of patients taking Provigil, compared with 36% of those taking the placebo.

Workers taking Provigil had fewer and shorter lapses of attention on the job. They also fell asleep a bit quicker when they tried to fall asleep, but only by about two minutes, write the researchers.

Sleepiness can be a major hazard for commuters. The number of patients who had accidents on the way home from work was 25% lower in the Provigil group.

Side Effects

There were no reports of serious side effects. Headaches were the most common side effect in both groups.

The 12-week study didn't check Provigil's long-term effects.

Provigil "is of some value in the clinical management of sleepiness associated with shift-work sleep disorder," write the researchers.

"Concern remains that even with treatment with 200 milligrams of [Provigil], the excessive sleepiness observed in this underrecognized population requires the development of yet more effective therapies," they note.

Second Opinion

The study was “narrowly focused,” writes Robert Basner, MD, in the same issue of the journal.

Basner works at the Columbia University College of Physicians and Surgeons. He didn’t work on the Provigil study. Instead, he wrote an editorial about it.

Several brain systems are probably involved in wakefulness, vigilance, and sleep inhibition, notes Basner. “It is reasonable to postulate that other wakefulness-promoting agents would show similar efficacy in a comparison with placebo, [Provigi], or both in shift workers,” writes Basner.

Basner also points out that the study didn’t use Provigil as part of a larger strategy to help shift-work sleep disorder.

Provigil has “a reasonable safety profile to date, and it may well be that it will be shown to be an effective and safe [addition] to comprehensive treatment strategies for shift-work sleep disorder,” writes Basner.

The study serves as a wake-up call for the design and implementation of further scientific studies to address in a comprehensive manner the serious health and safety issues that surround us by virtue of our having become, to a large extent, a shift-working society, he adds.

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You say you are able to function well with fewer than seven hours of sleep. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

Since you usually get too little sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia or other conditions affecting your sleep.

Sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's not surprising you feel that you're not functioning at your best today. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

Since you usually get too little sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have difficulty sleeping, have insomnia, or have other sleep disorders.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's not surprising you feel that you're not functioning at your best today. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

It's good that you usually do get more sleep, since sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. And if you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

You say you are able to function well with fewer than seven hours of sleep. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

It's good that you usually do get more sleep because sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. And if you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's not surprising you feel that you're not functioning at your best today. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

Since you usually get less sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have difficulty sleeping or have insomnia or other sleep disorders.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's wonderful that you got a good night's sleep last night. Many people struggle to do so. Having a good sleep routine often is the key to getting the quality sleep night after night that your body needs for optimal health. Whether your sleep routine involves taking a warm bath, reading a book, or meditating, it's important to keep your bedtime and routine consistent every night and wake up around the same time every morning.

Click here to read more about the importance of sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's unfortunate you're not functioning at your best today. You say you had a good quantity of sleep last night, but maybe the quality of your sleep is not as good as it could be? Having a good sleep routine — including a consistent bedtime and wake time — often is the key to getting the quality sleep night after night that your body needs for optimal health. Since you usually sleep this amount, if you often aren't feeling your best, you should consider talking to your doctor. Could you have an underlying condition? Are you feeling anxious or depressed? Have you taken medication that disrupted your sleep? Do you or could you have sleep apnea? Or do you naturally require a little bit more sleep?

Although sleep is crucial for optimal health, some research suggests that sleeping too much can also have negative consequences. Learn more about sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's unfortunate you're not functioning at your best today. You say you had a good quantity of sleep last night, but maybe the quality of your sleep is not as good as it could be? Having a good sleep routine — including a consistent bedtime and wake time — often is the key to getting the quality sleep night after night that your body needs for optimal health. Since you usually sleep longer, if you often aren't feeling your best, you should consider talking to your doctor. Could you have an underlying condition? Are you feeling anxious or depressed? Have you taken medication that disrupted your sleep? Do you or could you have sleep apnea? Or do you naturally require a little bit more sleep?

Although sleep is crucial for optimal health, some research suggests that sleeping too much can also have negative consequences. Learn more about sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's wonderful that you got a good night's sleep last night. Many people struggle to do so. Having a good sleep routine often is the key to getting the quality sleep night after night that your body needs for optimal health. Whether your sleep routine involves taking a warm bath, reading a book, or meditating, it's also important to keep bedtime consistent and wake up around the same time every morning.

Although sleep is crucial for optimal health, some research suggests that sleeping too much can have negative consequences. Learn more about sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's unfortunate you're not functioning at your best today. You say you had a good quantity of sleep last night, but maybe the quality of your sleep is not as good as it could be? Having a good sleep routine — including a consistent bedtime and waking up at the same time — often is the key to getting the quality sleep night after night that your body needs for optimal health.

Since you usually get less sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia, another sleep disorder, or conditions affecting your sleep.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's wonderful that you got a good night's sleep last night. Many people struggle to do so. Having a good sleep routine often is the key to getting the quality sleep night after night that your body needs for optimal health.

Since you usually get less sleep, talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia or another sleep disorder or conditions affecting your sleep.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

SOURCES:

Centers for Disease Control and Prevention (CDC). Effect of short sleep duration on daily activities--United States, 2005-2008. MMWR Morb Mortal Wkly Rep 2011; 60:239.

Carskadon, MA, Dement, WC. Normal Human Sleep: An Overview. In: Principles and Practices of Sleep Medicine, Fifth, Kryger, MH, Roth, et al. (Eds), Elsevier Saunders, St. Louis, MO 2011. p.16.

Harvard University: "Sleep, Performance, and Public Safety."

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