A clinical trial led by Mass General Brigham researchers shows that the drug solriamfetol significantly improves wakefulness and performance for workers starting shifts before sunrise. Participants with shift work disorder stayed alert longer during simulated work hours after taking the medication. The findings address a gap in treatments for the most common type of shift schedule.
Researchers at Mass General Brigham conducted a four-week trial with 78 early-morning shift workers diagnosed with shift work disorder. Participants, who began work between 3 a.m. and 7 a.m., were randomly assigned solriamfetol or a placebo on workdays. Those receiving the drug reported less sleepiness, remained awake longer in low-stimulation settings matching their shifts, and showed better daily functioning and work performance, according to both participants and clinicians. Both participants and their doctors noted improvements in overall functioning, work performance, and daily tasks management after four weeks of treatment. Solriamfetol, branded as Sunosi and already approved for excessive sleepiness in obstructive sleep apnea and narcolepsy patients, promoted alertness without majorly disrupting later sleep. Charles A. Czeisler, senior author and chief of the Division of Sleep and Circadian Medicine at Mass General Brigham, said, '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.' Kirsi-Marja Zitting, first author and investigator in the same division, noted that early shifters face a double burden of sleepiness on the job and poor rest opportunities. Czeisler added, '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.' The study, published in NEJM Evidence, highlights risks like reduced productivity and safety issues from shift work disorder. Funded partly by Jazz Pharmaceuticals and Axsome Therapeutics, it calls for more research on long-term effects.
