“Until now, no clinical trial had tested a treatment for shift work disorder in early-morning shift workers, even though this is the most common type of shift schedule,” said senior aiutor of the study, Charles A. Czeisler, PhD., chief and senior physician of the Division of Sleep and Circadian Medicine in the Mass General Brigham Department of Medicine in a press release.
“This study addresses a major gap by focusing on the workers who start their day when most people are still asleep,” he added.
Around a quarter of workers operate outside the standard 9 to 5 schedule, including those who start work in the early morning. The brain is still biologically programmed to sleep between 3am and 7am, said study author Kirsi-Marja Zitting, PhD, an investigator in the Mass General Brigham Department of Medicine, in a press release. People who start work during these hours, she said, often deal with excessive sleepiness while working and difficulty falling asleep when they have time to rest.
Solriamfetol has already been approved for treating excessive sleepiness in people with obstructive sleep apnea and narcolepsy. The researchers behind the current study wanted to investigate the drug for early shift workers as it can promote alertness without disrupting sleep later on.
To test the drug, they recruited 78 morning shift workers who had been diagnosed with shift work disorder for a randomized, double-blind, placebo-controlled trial. The participants were randomly assigned either solriamfetol or a placebo on workdays for four weeks.
Ultimately, patients taking solriamfetol were significantly less sleepy than those treated with placebo and could stay awake for longer during simulated work hours. They also experienced better overall functioning, improved work performance, and better ability to manage daily tasks.
"The improvement we saw is clinically meaningful. These workers were able to stay awake and alert throughout a full eight-hour shift, which has real implications for performance, safety, and quality of life. Shift workers are essential to how our society functions, yet they often pay a hidden biological cost. This study shows we can do better for them,” said Czeisler.
More research is needed to understand the treatment’s long-term effects. The researchers are now recruiting for a follow-up clinical trial to study the drug in overnight shift workers, which could eventually support broader approval for treating shift work disorder.
Sources: Science Daily, NEJM Evidence
