What medications help people with shift work stay awake?
Many people who work shifts frequently complain that they are sleepy at work and have problems with sleeping in-between work shifts. This is an area of great clinical importance because millions of people work varying shifts and lack of sleep can affect performance.
So are there any drugs that can improve shift workers sleep after shift work?
Over the years, several studies have looked at the effects of hypnotics and melatonin on sleep after shift work. In addition, other studies have looked at the effects of caffeine, modafinil and armodafinil on prevention of sleep during shift work.
When it comes to melatonin, research shows that it only slightly increases the duration of sleep during the day time after night shift but had no other benefits. The only good thing was that melatonin was not associated with adverse effects.
When it came to hypnotics, there were no large randomized studies to determine their effects on sleep after shift work.
What about alertness during shift work?
Individuals who took modafinil and armodafinil had a slight reduction in sleep and increased alertness during the night shift. However, side effects like nausea and headache were common.
One clinical trial also showed that individuals who consumed caffeine plus a short nap before the night shift had increased alertness during the night shift.
It is important to understand that the majority of the studies that looked at the above agents were of low quality and involved a small number of participants.
Overall melatonin only mildly increased sleep slightly after shift work. Modafinil did increase alertness and reduced sleep during the night shift but it was also associated with adverse effects. For people who fall asleep during the night shift, perhaps caffiene plus a nap before the shift may be beneficial.