Volunteers were selected for the study if they reported chronic excessive sleepiness during night shift work and were monitored by the Multiple Sleep Latency Test and Clinical Global Impression of Severity. All volunteers signed a written informed consent form approved by the New York State Psychiatric Institute’s Institutional Review Board.

How Does Modafinil Work?

Modafinil 200 Australia is a stimulant medication in the class of wakefulness-promoting agents. It works to increase the release of monoamines in the brain such as norepinephrine and dopamine.

Numerous studies have shown that promoting alertness with wakefulness medications improves night shift performance in individuals with SWS and narcolepsy. These drugs can help prevent drowsy driving accidents and workplace mistakes, as well as chronic diseases such as type 2 diabetes and heart disease.

A large randomized placebo-controlled study in patients with SWS found that 200 mg of modafinil significantly improved alertness and vigilance compared to placebo, as measured by sleep latency, clinical-impression rating, and sustained-attention performance.

The treatment also decreased patient-estimated sleepiness on work nights and in the morning commute home, and reduced caffeine use and the number of accidents or near-accidents on the drive home. The results were similar when the same dose was used in a smaller double-blind placebo controlled trial in patients with narcolepsy.

Dosage

Researchers in this randomized, placebo-controlled clinical study found that 200 mg of Modafinil (Provigil, Cephalon) improves alertness and performance in shift work sleep disorder. Modafinil is in a class of medications called wakefulness-promoting agents that differ from stimulants like amphetamines and methylphenidate because they have lower abuse potential.

Despite adjusting their internal schedule, people working on rotating shifts may continue to have trouble falling asleep and staying asleep at night, resulting in extreme sleepiness while they are at work. Modafinil is an effective treatment for this condition because it promotes wakefulness and improves alertness without the side effects of other wakefulness medications such as sedatives.

Abrupt shift changes produced cognitive performance and mood disruptions in the research participants. Therapeutic doses of modafinil (Modalert Tablet) reversed these shift change-related disruptions, although the largest dose of modafinil did produce some sleep alterations during the day. The improvement in performance and mood resulting from modafinil use was maintained over 12 weeks of therapy.

Side Effects

Sleep problems in shift workers lead to diminished performance and increased risk of work-related accidents, and long-term sleep deprivation leads to a host of health problems. Fortunately, medicines like modafinil and armodafinil (Nuvigil) promote wakefulness by stimulating the brain. These medications are effective in treating excessive daytime sleepiness in people with narcolepsy and obstructive sleep apnea, and they also help those with shift work sleep disorder.

In a recent study, researchers investigated the effects of modafinil on cognitive/psychomotor performance and mood during simulated shift work. Participants were randomly assigned to a single modafinil dose (0, 200, or 400 mg) administered 1 hour after awakening for three days under two shift conditions: night and day.

While the 400 mg dose significantly decreased ratings of drowsiness, there were no effects on other mood measures or sleep indices during the night shift. Interestingly, the results of this study were similar to those of Comer et al (2001), who found that methamphetamine decreased total sleep time and decreased sleep efficiency during a night shift but did not affect wakefulness.

Precautions

For best results, avoid sleep medications before your shift and limit the amount of caffeine you consume. Try to plan your shift schedule so you have time to nap before and during the night shift, and try to avoid driving if you’re too drowsy at work. If you’re taking wakefulness-promoting medication and experience chest pain, seek emergency care immediately.

Modafinil is a prescription-only drug and has been approved by the FDA to treat narcolepsy, shift work sleep disorder, and obstructive sleep apnea. It is also used off-label as a cognitive enhancer, helping people perform well on tasks that require alertness and concentration.

In this study, 200 mg of modafinil improved symptoms of excessive sleepiness in patients with shift work sleep disorder. However, it did not improve circadian adaptation to a nocturnal work schedule. Investigator-rated Clinical Global Impressions and patient-estimated sleepiness were not improved by treatment, but improvements in performance measures did occur. Whether or not this translates to real-world use of the drug remains unclear.