The FDA approved Provigil first for narcolepsy and later for shift work sleep disorder (SWSD). You might ask: is “shift work sleep disorder” a real condition, or just mean somebody has trouble sleeping when they work swing shift or graveyard shift? The sleep medicine establishment has defined SWSD as a real disorder, but it remains to individual doctors to diagnose the condition. It could be argued that this disorder is vastly underdiagnosed because people with it don’t think to talk to a doctor about it. More than 6 million Americans regularly work night shifts or are on a rotation that moves them into the night shift often, so SWSD is a widespread condition and can increase the risk of health problems.
Medication for SWSD?
Like many other sleep disorders, SWSD is often best addresses by behavioral changes rather than medicine. Napping before the night shift helps many people, as does taking breaks during the shift and getting plenty of sleep on days off. Exposure to bright light can also help people stay awake. In severe situations, with the consultation and approval of a doctor, workers may seek out Provigil, which is a stimulant. The advantage of Provigil over street drugs is low side effects. And it works. Controlled scientific studies have shown that Provigil reduces sleepiness for shift workers. Anecdotal evidence also indicates that Provigil helps many people. The medicine helps in activities for which alertness is important (e.g. working, driving), overall health, and better memory. A typical regimen calls for the person to take the pill about an hour before alertness is needed. Blood concentration peaks in 2 to 4 hours. One advantage of Provigil is that people can still get to sleep after their shift is over.
A task force of experts put together by the American Academy of Sleep Medicine issued a guideline in 2007 for doctors treating patients with sleep work disorder. They said modafinil could be prescribed to such patients.
Harvard Medical School press release on Provigil for SWSD