Solriamfetol Boosts Alertness and Productivity in Early-Morning Shift Workers

A clinical trial conducted by researchers at Mass General Brigham has found that the wake-promoting drug solriamfetol can significantly increase alertness and improve job performance for early-morning shift workers struggling with shift work disorder.

The findings, published in NEJM Evidence, address a significant gap in medical research. While many studies on shift work have focused on overnight schedules, this trial specifically targeted individuals who begin their workdays between 3 a.m. And 7 a.m.

These workers often face severe fatigue because they must wake up during the body’s natural circadian low point, a time when the brain is biologically programmed to sleep.

Understanding Shift Work Disorder

Shift work disorder is a medical condition characterized by excessive daytime sleepiness and sleep disturbances. This condition can lead to impaired concentration, decreased job performance, and increased safety risks on the job.

According to researchers, about a quarter of the workforce operates outside the traditional 9-to-5 schedule. Many people starting very early morning shifts may not identify as shift workers, viewing their schedule as simply an early start to a normal day, yet they remain at risk for the disorder.

Early-morning shifts are reported to be three times more common than overnight shifts, yet this population has historically lacked evidence-based pharmacological treatments.

Trial Results and Drug Efficacy

Solriamfetol, marketed as Sunosi, is a selective dopamine and norepinephrine reuptake inhibitor. The trial demonstrated that the medication helps workers stay awake and function more effectively throughout their entire shifts.

Objective testing after four weeks of treatment revealed that patients receiving solriamfetol showed a 9.4-minute greater increase in sleep latency compared to those receiving a placebo, meaning they were able to stay awake significantly longer.

Participants also reported several subjective improvements in their daily lives and professional performance, including:

• A noticeable reduction in both acute and chronic sleepiness.
• Improvements in overall work productivity.
• A decrease in functional impairments affecting social and family responsibilities.
• Enhanced safety and a reduction in fatigue-related mistakes.

The study noted that the alerting effects of solriamfetol were sustained throughout a typical eight-hour work shift. Crucially, the drug did not negatively impact the length or quality of the sleep participants obtained after returning home.

Safety and Expert Perspective

The treatment was generally well-tolerated by participants. The most common side effects reported were nausea and headache, and the trial reported no serious adverse events.

Until now, no clinical trial had tested a treatment for shift work disorder in early-morning shift workers, even though Here’s the most common type of shift schedule,

Charles A. Czeisler, PhD, MD, chief and senior physician of the Division of Sleep and Circadian Medicine in the Mass General Brigham Department of Medicine

Dr. Czeisler stated that the study addresses a major gap by focusing on workers who start their day while most of the population is still asleep.