Practice Point
Further research is necessary before we can recommend a medication that will reliably promote alertness and vigilance through the night shift and on the drive home the following morning
CLICK HERE for subscription information about this journal. 0
1 2 3
Acknowledgments
The synopsis was written by Christine Kyme, Assistant Editor, Nature Clinical Practice.
Reprint Address
Correspondence: Johns Hopkins University, School of Medicine, 4940 Eastern Avenue, Box 151, Baltimore, MD 21224, USA. Email: neubauer@jhmi.edu
Nat Clin Pract Neurol. 2006;2(3):134-135. © 2006 Nature Publishing Group Commentary Czeisler and colleagues have focused welcome attention on the serious effects shift workers might experience owing to diminished alertness and vigilance when working a night shift and driving home the following morning. For many people who work through the night, excessive sleepiness during the shift and subsequent morning is predictable because of their inability to achieve sufficient sleep during off-work hours, and from the influence of the endogenous circadian system, which promotes night-time sleepiness. [ 1 ] Most people experience some difficulty with rotating shifts or permanent night-work schedules, but some appear to experience greater impairment than others. [ 2 , 3 ] Overall, shift-work-associated impairment remains a significant public health problem because of the risk of mistakes and accidents, and possible long-term metabolic sequelae. [ 4 ] This 3-month, placebo-controlled study asks whether modafinil (200 mg) given before the night shift results in less sleepiness and improved psychomotor performance in a population of shift workers complaining of problematic sleepiness while working at night. The data showed a statistically significant improvement in sleepiness and vigilance. The clinical significance is limited, however: the modafinil-treated subjects still experienced worrisome levels of sleepiness and psychomotor impairment. Ironically, the modafinil-treated subjects were still sufficiently sleepy to meet the entrance criteria to participate in the study. Although the treated subjects did report fewer accidents and near-accidents on the morning drive home, the rates were still high. Perhaps this is not surprising, as the sleepiness, as measured by the Multiple Sleep Latency Test, was distinguishable from placebo at the 2 am and 4 am […]
Does Modafinil Safely and Effectively Treat Shift-work Sleep Disorder?
