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what is Shift Work Disorder or Sleep Disorder? Why Modafinil is used to treat Shift Work Disorder or sleep Disorder

What is shift work disorder (SWD) or sleep disorder?

Shift work disorder or sleep disorder (SWSD) is a condition characterized by the misalignment of the circadian rhythm that regulates sleep-wake behaviour as a result of night-shift work or working long or irregular hours. A circadian rhythm, or circadian cycle, is a natural, internal process that regulates physical, mental, and behavioural changes and the sleep-wake cycle, within 24 hours.

Shift work refers to a work schedule that falls outside the conventional working hours of 7 am – 6 pm. This condition can affect all shift workers but primarily affects those who work night, rotating and early morning shifts.

SWSD presents as increasing difficulty in adjusting to a new sleep or wake schedule or an inability to fall asleep when you want or stay asleep.

Symptoms of shift work disorder or sleep disorder (SWD)

The most common symptoms of SWSD include:

  1. Insomnia:

Insomnia is a state of habitual sleeplessness or inability to sleep. The effects of this condition vary from not falling asleep to not being able to stay asleep. People with shift work sleep disorder often lose 1-4 hours of sleep per night and have recurrent bouts of headache and fatigue, impaired social functioning and are easily irritable.

  • Excessive sleepiness:

People with shift work sleep disorder often feel the need to catch a nap. This constant napping leads to increased fatigue and reduced alertness while working which can impair their performance and increase the risks of workplace accidents.

When it’s left untreated, shift work sleep disorder (SWSD) can negatively impact the everyday life of a person. This condition can lead to serious health problems (including gastrointestinal, cardiovascular and metabolic problems). It can also alter the worker’s ability to perform maximally and impair their perception and efficiency. Prompt identification of the symptoms or presenting signs of SWSD and the right treatment regimen can prevent any long-term damage and improve a person’s health, wellbeing, and safety.

How modafinil works and why it is described for sleep disorder

What is Modafinil?

Modafinil is a central nervous system stimulant that promotes wakefulness in people. This drug is used to treat excessive sleepiness caused by sleep apnea, narcolepsy, shift work sleep disorder and other conditions that cause excessive daytime sleepiness. It is a non-amphetamine (amphetamines are synthetic, addictive, mood-altering CNS stimulants, used illegally as stimulants, e.g., Adderall) based, FDA- approved drug and is considered safe for use. It is also a prescription-based medication and it has no permanent or curative effects. The effects of this drug only last as long as drug concentrations in the body are enough to produce desired effects.

How does modafinil work?

Modafinil affects several parts of the brain, including the hypothalamus, hippocampus, and amygdala. Though Modafinil and other psycho-active drugs have similar effects, they act through different brain systems and neurotransmitters to exert their enhancing effects.

Modafinil is a weak inhibitor of dopamine reuptake. Dopamine which is dubbed the “happy hormone,” is a neurotransmitter that plays a major role in making people feel pleasure, and motivation and drives the brain’s reward system. It is known to increase extracellular concentrations of dopamine which increases the concentration of norepinephrine (NE) and serotonin (5HT) in the blood. These increased levels of NE and 5HT increase activity in the pre-frontal cortex of the brain. The result of this action is an enhanced state of wakefulness.

A major difference between modafinil and other psychostimulants is that there is no “high” associated with the use of modafinil, i.e., it doesn’t produce or result in a state of euphoria like in other psycho-stimulating drugs such as Adderall, and has been shown to reduce the euphoric states of some of the psycho-stimulating drugs.

Metabolism of Modafinil

 Upon ingestion, the drug is absorbed from the gastrointestinal tract. The maximum concentration of the drug is achieved after 2-4 hours and its effects last up to 15 hours. The drug is then metabolized by the liver and excreted in urine by the kidneys.

Why Modafinil is called a smart drug?

Smart drugs, also called nootropics, are substances that are known to boost cognitive performance. Usually, these drugs are a type of psycho-stimulant that can be used to treat narcolepsy, ADHD, excessive sleepiness, etc., by improving brain function.

Modafinil is one of the prescription medications that is considered a smart drug. Modafinil increases wakefulness and has been shown to improve cognitive function, improve focus, and memory, and enhance concentration and goal achievement.

These effects of modafinil which are similar to those of other psychoactive drugs are the reason it’s called a smart drug.

These effects are, however, dose-dependent and can only be experienced for as long as drug concentrations are optimal in the body. There are no long-term or curative effects of modafinil and while it improves brain function, it does not improve brain capacity.

How it is safe and non-addictive?

Most people consider drugs like modafinil the new Cocaine or Adderall. Though the mechanism of action of the drug isn’t completely known, research has shown that it acts through a different pathway than cocaine and Adderall. Rather than increase the chemical composition of the brain like most psycho-stimulants, modafinil is known to reduce the chemical composition and is an indirect CNS stimulant.

The notable effects of modafinil include increased cognition, improved memory, focus and alertness, which are all similar to the actions of the other drugs. However, modafinil does not induce a state of euphoria in its users and Modafinil is a much milder stimulant and can be used in various situations with little risk. It produces all the effects of psycho-stimulants with few side effects.

Cocaine and Adderall are known to get their users high or induce euphoria, as well as alter mood, thinking, perception, and feelings but these are notably absent in those who use modafinil. Nonetheless, modafinil has the potential for abuse and addiction which is why it is a controlled substance, but this singular difference between modafinil and other psychoactive substances reduces the potential for abuse of the drug and the likelihood of addiction.

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