New Drug Helps Early Shift Workers Beat Dangerous Sleepiness

Millions of people who wake up at 3 a.m. for work have just gotten their first real treatment option for the crushing sleepiness that endangers their lives.

A new clinical trial from Mass General Brigham tested a drug called solriamfetol on 78 early morning shift workers suffering from shift work disorder. The results were remarkable: workers stayed awake throughout their entire eight-hour shifts and reported dramatically better functioning in their daily lives.

About a quarter of American workers labor outside the traditional 9-to-5 schedule. Many start their days between 3 a.m. and 7 a.m., including nurses, bakers, warehouse workers, and transit operators.

"People who start work between 3 a.m. and 7 a.m. are waking up at a time when the brain is biologically programmed to sleep," said lead researcher Dr. Kirsi-Marja Zitting. "That makes staying alert extraordinarily difficult, even when they are highly motivated."

The problem goes beyond feeling tired. Shift work disorder causes excessive sleepiness during work hours and makes it nearly impossible to sleep enough during rest periods. Workers face higher risks of car crashes, workplace accidents, and serious mistakes on the job.

Until now, no clinical trial had ever tested a treatment specifically for early morning shift workers. Previous studies only looked at overnight workers, even though early morning shifts are far more common.

Half the study participants took solriamfetol each workday for four weeks while the other half received a placebo. Researchers measured how long workers could stay awake in quiet, dark rooms during their normal work hours.

The results were striking. Workers taking the medication stayed awake significantly longer and reported feeling far less sleepy. Both the workers and their doctors noticed improvements in work productivity, daily activities, and overall quality of life.

The Ripple Effect

The implications extend far beyond individual workers. When shift workers can stay alert, everyone benefits from safer hospitals, more reliable transportation, and fewer accidents on roads and in workplaces.

"The improvement we saw is clinically meaningful," said senior author Dr. Charles Czeisler. "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."

What makes this drug especially promising is that it keeps people awake for hours without costing them sleep later in the day. Other wake-promoting drugs can make it even harder to rest during off hours, creating a vicious cycle.

The study focused on otherwise healthy adults over four weeks, so researchers acknowledge that longer-term effects still need exploration. The team is now recruiting overnight shift workers for a follow-up trial to support the drug's approval as a formal treatment for shift work disorder.

For the millions who keep our society running while most people sleep, this research represents the first time science has truly acknowledged their struggle and offered a real solution.