New Drug May Help Keep Shift Workers Awake

A new drug may work better than a jolt of java to keep shift workers awake and alert.

Researchers at Baylor College of Medicine are participating in a national study on the effectiveness of modafinal on night shift workers who have problems staying awake. A study published recently in the American Journal of Critical Care Medicine showed that the drug helped patients with sleep apnea stay awake and alert during the day, without interfering with their sleep at night.

"Unlike coffee, modafinal promotes wakefulness without stimulating most of the nervous system," said Dr. Max Hirshkowitz, associate director of Baylor’s Sleep Disorders Center. "As a result, it doesn’t cause that jittery feeling associated with high doses of caffeine."

Modafinal targets the hypothalamus, the area of the brain that regulates sleep.

It works using the opposite action of sleep inducing drugs like antihistamines, found in cold medicines, and gabba agonists, found in alcohol and barbituates. Traditional stimulants also stimulate the pleasure centers of the brain.

"Abuse and addiction can be a problem with traditional stimulants like caffeine and amphetamines," Dr. Hirshkowitz said. "They give such a rush of pleasure that people want to use them again and again."

When shifts fall during the night, from 11 p.m. to 7 a.m., the worker is fighting the natural wake-sleep pattern. Night workers get less sleep than daytime workers do, and the sleep is less restful. The National Sleep Foundation reports that 10 to 20 percent of night shift workers say they fall asleep on the job, usually during the second half of the shift. As a result, shift workers who work all night may have a hard time sleeping during the day, even though they are tired.

The American Sleep Foundation offers the following tips to help shift workers stay alert:

• Take short breaks throughout the shift.
• Try to work with a "buddy." Talking with co-workers can help keep you alert. And co-workers can be on the lookout for signs of drowsiness in each other.
• Exercise during breaks. Do sit-ups in the employee lounge, take a walk, play basketball in the parking lot, or climb stairs.
• Eat three normal meals per day. Eat healthy snacks, avoiding foods that may upset your stomach.
• If you drink a caffeinated beverage (coffee, tea or cola), do so early in the shift – this means before 3 a.m. for the night worker.
• Don’t leave the most tedious or boring tasks to the end of your shift when you are apt to feel the drowsiest. Night shift workers hit their lowest period around 4 a.m.
• Exchange ideas with your colleagues on ways to cope with the problems of shift work. Set up a support group at work so that you can support and learn from each other.

For more information on Baylor’s sleep disorders studies, contact the Sleep Disorders Center at (713) 794-7563.

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