The Effects of Armodafinil on Objective Sleepiness and Performance in a Shift Work Disorder Sample Unselected for Objective Sleepiness

Apr 11, 2014Journal of clinical psychopharmacology

Armodafinil's effects on sleepiness and performance in shift work disorder without selecting for sleepiness levels

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Abstract

Armodafinil significantly improved mean multiple sleep latency test (MSLT) scores from 5.3 ± 3.25 minutes to 11.1 ± 4.79 minutes in night workers with shift work disorder.

Participants with shift work disorder reported excessive sleepiness, achieving a mean score of 14.8 on the Epworth Sleepiness Scale.
Armodafinil administration at 10:30 pm was associated with improved subjective alertness, as indicated by visual analog scale scores.
Cognitive performance enhancements were observed in reaction times to central and peripheral stimuli.
Free recall memory performance showed improvement following armodafinil treatment.

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BACKGROUND: Armodafinil is a medication used to treat excessive sleepiness in individuals with shift work disorder (SWD). In the present study, we investigate whether armodafinil can normalize nocturnal sleepiness in a group of typical SWD patients.

METHODS: Participants were 12 night workers (aged 33.8 ± 8.57 years, 7 female subjects) with excessive sleepiness (≥10 on the Epworth Sleepiness Scale; mean, 14.8 ± 3.16), meeting the International Classification of Sleep Disorders, Second Edition criteria for SWD, with no other sleep or medical disorders verified by polysomnogram. The multiple sleep latency test (MSLT) was not used as an entry criteria. Armodafinil was administered at 10:30 pm in a randomized, double-blind, placebo-controlled, crossover design with experimental nights separated by 1 week. Primary end point was the MSLT, with naps at 1:30, 3:30, 5:30, and 7:30 am. Other study measures included a sleepiness-alertness visual analog scale administered before each nap, and 2 computer-based performance tests evaluating attention and memory.

RESULTS: Subjects with SWD had a mean MSLT of 5.3 ± 3.25 minutes, indicating a mean level of pathological sleepiness. Armodafinil significantly improved MSLT score to 11.1 ± 4.79 minutes (P = 0.006). Subjective levels of alertness on the visual analog scale also improved (P = 0.008). For performance, reaction time to central (P = 0.006) and peripheral (P = 0.003) stimuli and free recall memory (P = 0.05) were also improved.

CONCLUSIONS: Armodafinil 150 mg administered at the beginning of a night shift normalizes nocturnal sleepiness in individuals with SWD unselected for objective sleepiness. Subjective measures of sleepiness and cognitive performance are also improved. This suggests that armodafinil can improve levels of nocturnal alertness to within normal daytime levels in the majority of patients with SWD.

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The Effects of Armodafinil on Objective Sleepiness and Performance in a Shift Work Disorder Sample Unselected for Objective Sleepiness

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