Modafinil for Excessive Sleepiness Associated with Shift-Work Sleep Disorder
Summary
This three-month randomized controlled trial evaluated modafinil in 209 night-shift workers diagnosed with Shift-Work Sleep Disorder. Participants took 200 mg modafinil or placebo before each night shift. Compared with placebo, modafinil modestly increased objective wakefulness on lab sleep tests, improved attention and reduced lapses on vigilance tasks, and lowered the proportion of workers reporting accidents or near-misses during their commute home (29% vs 54%). Clinical condition ratings also improved. Daytime sleep was not affected, and side effects were generally mild, with headache the most common. Despite these benefits, many participants continued to experience significant sleepiness at night.
Why It Matters For Night Shift Workers and Night Owls
This study shows that modafinil can reduce—but not eliminate—dangerous levels of sleepiness in workers with diagnosed Shift-Work Sleep Disorder. It improved alertness, attention, and commuting safety, making it a useful option when fatigue remains severe despite efforts to manage sleep and schedules. For workers, this highlights that persistent night-shift sleepiness is a recognized medical condition with treatments available. For employers and clinicians, it reinforces that medication may play a supportive role but should be combined with scheduling, sleep, and light-based strategies.
Notes
PubMed: https://pubmed.ncbi.nlm.nih.gov/16079371/