Shift Work Sleepiness and a Medication Most People Haven't Heard Of

Flipping between days and nights takes a real toll on the body. There's a medication that can help with the sleepiness that comes with it, and a lot of people, including many in healthcare, have never heard of it.

I'm Christopher Schuman, a board-certified psychiatric nurse practitioner serving patients in Texas, Washington, and New Mexico. Here's what it is, who it's for, and who it isn't for.

The Problem With "I'll Sleep When I'm Dead"

Shift workers know the saying. The trouble is that sleep doesn't just happen once you finally have time for it.

You come home from nights and someone starts mowing the lawn outside your window. The apartment is testing the fire alarms. There's an inspection today. The kids need to get to school, and the dog needs to go out. There are plenty of reasons people working nights can't get real sleep during the day.

Bouncing between days and nights is hard on the body. Research has linked years of shift work to a higher risk of conditions like heart disease, diabetes, and some cancers. When you read that, it makes you wonder whether a couple of extra dollars an hour for working nights is worth it.

But there is something you can do about the sleepiness.

What the Medication Is

The medication is called modafinil. The brand name is Provigil. There's also a closely related medication called armodafinil.

Modafinil has been around for a long time. It's approved by the Food and Drug Administration for a few conditions, including narcolepsy and shift work sleep disorder, a circadian rhythm problem that happens when your work schedule fights your body clock.

It works by increasing the dopamine and norepinephrine available in the brain, though the exact mechanism isn't fully understood. It's similar to caffeine in that it helps with alertness, but it isn't a true energy pill. One thing that sets it apart is that it's less likely to keep you from falling asleep when you're ready to.

It also has a long history in the military for keeping pilots alert on long missions. In studies with sleep-deprived pilots, those who took it performed better on thinking tasks.

Who It's For

It can be a good fit for people in critical jobs whose sleep is disrupted by shift work: nurses, physicians, emergency medical services, 911 dispatchers, firefighters. People who need to make good decisions at hours when their body would rather be asleep.

Who It Isn't For

It isn't for someone who wants to pull all-nighters. Your brain will always perform better when you're sleeping well, and medication doesn't replace sleep.

The first step is still getting more sleep wherever you can. Medication is worth considering when your schedule makes that hard, and it's a decision to make with a provider who knows your full health picture.

Rest Still Comes First

Some industries take sleepiness seriously enough to regulate it. The Department of Transportation limits how many hours truck drivers can drive, and its medical exams screen for sleep problems like sleep apnea. The idea is simple: nobody should be excessively sleepy behind the wheel of a semi.

That's the right attitude. You shouldn't need a steady drip of energy drinks to get through a shift. You need rest. But when the job itself disrupts your rest, it helps to know there are options beyond caffeine.