title: Pharmacological interventions for sleepiness and sleep disturbances caused by shift work.
abstract: BACKGROUND
  Shift work results in sleep-wake disturbances, which cause sleepiness during night shifts and reduce sleep length and quality in daytime sleep after the night shift. In its serious form it is also called shift work sleep disorder. Various pharmacological products are used to ameliorate symptoms of sleepiness or poor sleep length and quality.
  
  
  OBJECTIVE
  To evaluate the effects of pharmacological interventions to reduce sleepiness or to improve alertness at work and decrease sleep disturbances whilst of work, or both, in workers undertaking shift work.
  
  
  METHODS
  
  
  
  METHODS
  We searched CENTRAL, MEDLINE, EMBASE, PubMed and PsycINFO up to 20 September 2013 and ClinicalTrials.gov up to July 2013. We also screened reference lists of included trials and relevant reviews.
  
  
  METHODS
  We included all eligible randomised controlled trials (RCTs), including cross-over RCTs, of pharmacological products among workers who were engaged in shift work (including night shifts) in their present jobs and who may or may not have had sleep problems. Primary outcomes were sleep length and sleep quality while of work, alertness and sleepiness, or fatigue at work.
  
  
  METHODS
  Two authors independently selected studies, extracted data and assessed risk of bias in included trials. We performed meta-analyses where appropriate.
  
  
  RESULTS
  We included 15 randomised placebo-controlled trials with 718 participants. Nine trials evaluated the effect of melatonin and two the effect of hypnotics for improving sleep problems. One trial assessed the effect of modafinil, two of armodafinil and one examined caffeine plus naps to decrease sleepiness or to increase alertness.
authors: Juha
authors: J
authors: Liira
authors: Jos H
authors: JH
authors: Verbeek
authors: Giovanni
authors: G
authors: Costa
authors: Tim R
authors: TR
authors: Driscoll
authors: Mikael
authors: M
authors: Sallinen
authors: Leena K
authors: LK
authors: Isotalo
authors: Jani H
authors: JH
authors: Ruotsalainen
mesh_terms: D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008550:Melatonin / Q000627:therapeutic use*; D012890:Sleep / Q000187:drug effects*; D020178:Sleep Disorders, Circadian Rhythm / Q000188:drug therapy*; D064690:Wakefulness-Promoting Agents / Q000627:therapeutic use*
chemical_list: D006993:Hypnotics and Sedatives; D064690:Wakefulness-Promoting Agents; D008550:Melatonin
references: Cochrane Database Syst Rev. 2014 Aug 12;(8):CD009776
references: 25113164