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October/November 2014 (vol. 11/3)
Improving sleep after nightwork
There is low-quality evidence from nine studies that taking melatonin improves sleep length after nightshift work, but does not alter other sleep parameters, including length of time needed to fall asleep and objective sleep quality, this Cochrane systematic review finds. Sleep length increased with melatonin by about 25 minutes for daytime sleep and 15 minutes for night sleep following the nightshift. There were no differences in reported side effects due to melatonin compared to placebo. There is moderate-quality evidence that the vigilance-promoting drugs modafinil and armodafinil – both approved in the US to treat shiftwork disorder – improve alertness and reduce sleepiness, but they are also associated with adverse effects, such as headaches and nausea. There is low-quality evidence, from one trial, that pre-shift caffeine and pre-shift naps increase alertness on the nightshift. Evidence on the use of hypnotic drugs was unclear or insufficient (low-quality evidence). Fifteen randomised placebo-controlled studies were included.
Liira1 J, Verbeek JH et al. Pharmacological interventions for sleepiness and sleep disturbances caused by shift work. Cochrane Database of Systematic Reviews 2014; 8: CD009776.
Occupational Health at Work October/November 2014 (vol. 11/3) pp45