Effects of Daytime Eszopiclone Administration in Shift Workers

The current study seeks to extend the currently available treatments for SWSD by addressing the putative root cause of the problem-the inability of night-shift workers with or without SWSD- to obtain adequate daytime sleep in the face of the circadian drive for alertness that increases across the biological day. Even healthy, young subjects who are sleep-deprived overnight exhibit daytime sleep marked by frequent awakenings and low sleep efficiency, less slow-wave sleep, and altered sleep architecture, e.g. earlier predominance of REM sleep. Many night-workers routinely report 3-6 hours of habitual sleep duration for daytime sleep. Pharmacological interventions to decrease awakenings and improve total sleep time during daytime sleep could improve subsequent alertness during a night shift. Improving the wakefulness of night-shift workers over the nighttime could result in substantial benefits for the individual workers, improve workplace productivity and safety, and improve public health.

Inclusion criteria

• Age 20-50 (men or women)
• Current shift worker (for at least 3 months, at least 5 overnights/month and 3 consecutive)
• A willingness and ability to comply with study procedures
• If of child-bearing potential, using a medically-accepted method of birth control, including abstinence, barrier method with spermicide, steroidal contraceptive (oral, transdermal, implanted, or injected) in conjunction with a barrier method, or intrauterine device [IUD]).

Exclusion criteria

• Current diagnosis of DSM-IV Axis I disorder (other than insomnia)
• Regular treatment (>1time/wk) with CNS-active medication within 1 month of first inpatient visit
• Uncontrolled medical illness that would interfere with participation in the study
• BMI>32 or < 19.8 kg/m2
• Current symptoms or diagnosis of any moderate to severe sleep disorder other than SWSD
• Periodic Leg Movement of Sleep Index (PLMSi)>20/hr of sleep or Respiratory Desaturation Index (RDI)>15 on polysomnography (PSG)
• Current alcohol or drug dependence/abuse
• Menopausal or peri-menopausal symptoms that disrupt sleep
• Pregnant, lactating, or planning to become pregnant
• Current smoking of more than 10 cigarettes per day
• Current use of over the counter sleep aids such as Benadryl or melatonin