Shift Work Sleep Case Study

SHIFT WORK CONCLUSION Melatonin improved sleep length but not other parameters. Modafinil and armodafinil increased alertness but had adverse effects. Caffeine plus preshift naps increased alertness but with low-quality proof. Hypnotics did not improve sleep length. Hypnotic medications did not produce significantly longer daytime sleep, nor did they improve any other parameters. Melatonin improved sleep length by 24 minutes but did not affect other parameters. Modafinil boosted alertness 1 point and reaction time, but skin reactions, headache, nausea, and blood pressure spikes were reported. Armodafinil increased alertness by 1 point (KSS)* and reaction time by 50 milliseconds in a simple reaction test. OVERVIEW This meta-analysis of 15 randomized, placebo-controlled trials of 718 night shift workers tested efficacy of melatonin and hypnotics at improving sleep after night shift work, as well as modafinil, armodafinil, or caffeine plus preshift naps for increasing alertness during shifts. With the preshift naps plus caffeine study, subjects reported that alertness increased 0.63 on a scale of 1 to 10. * Karolinska Sleep Scale Source: Verveek LJ et al. Pharmacological interventions for sleepiness and sleep disturbances caused by shift work (Review). Cochrane Database of Systematic Reviews. 2014; 8. DOI: 10.1002/14651858.CD009776.pub2.