Modalert Help Shift Workers Stay Awake at Night
Many shift workers struggle to stay awake at night. This is a result of their work schedules, which may interfere with sleep routines. This can lead to accidents, missed work days, and long-term health problems. Practicing good sleep hygiene and taking medications to facilitate sleeping can help. Shift workers should also try to catch up on sleep on their days off.
People with narcolepsy feel sleepy most of the time and have trouble functioning and concentrating. They may fall asleep easily, even while talking or when driving. They often wake up feeling refreshed, but then get sleepy again. They may experience automatic behaviors in which they perform a task, such as typing or writing, but don't remember doing it when they wake up. These habits can be dangerous. They also have trouble staying awake at night and may wake up several times each evening for short periods of 10-20 minutes. They may dream a lot or act out their dreams, a condition called REM sleep behavior disorder.
Narcolepsy causes problems with school, work, and relationships. It is a lifelong disease, and the symptoms can be disabling. The most common symptom is extreme daytime sleepiness, but others include cataplexy, hypnagogic hallucination, and sleep paralysis. The condition can be hard for family, friends, and co-workers to understand. They might mistake the symptoms for laziness or lack of ability. Educating these important people can help them better support the person with narcolepsy.
Most people with narcolepsy lack a chemical in their brain that controls alertness, hypocretin. This is most likely due to their genetics, but other factors can contribute to the problem. These include poor diet, excessive caffeine use and other stimulants, smoking, sleep deprivation, stress, and certain medications (including antidepressants and some anti-seizure drugs).
Treatment for narcolepsy involves medication to stimulate the central nervous system and keep the individual awake during the day. Modafinil Australia, Armodafinil, and pitolisant are medicines that keep people awake by interacting with different receptors in the brain. These medicines can reduce the onset of excessive daytime sleepiness, but they will not cure it. Your healthcare provider will determine if you are a good candidate for these medications.
Obstructive sleep apnea syndrome (OSA) is the most common form of sleep disorder. It occurs when the throat muscles relax during sleep and block the upper airway, leading to a decrease in oxygen flow to the blood and an increased carbon dioxide concentration. OSA is a complex disorder with a variety of symptoms, including snoring, chest pain, and fatigue. People with OSA are at risk of high blood pressure, arrhythmias (irregular heartbeat), heart failure, stroke, and depression.
During obstructive sleep apnea episodes, the breathing stops for 10 seconds or more and is usually followed by a slowed or shallow breath. These episodes are called hypopneas and occur in a cyclical manner. People with OSA may have a central or mixed type of sleep apnea. Central sleep apnea occurs when there is no signal from the brain to the muscles that control breathing, while mixed obstructive-central sleep apnea is characterized by beginning with central sleep apnea and ending with obstructive sleep apnea.
People with sleep apnea often wake up during the night and feel tired during the day. They may have trouble staying awake during work and can become irritable or angry. They may also have trouble thinking clearly and are prone to memory problems. In addition, sleep apnea is linked to a number of health problems, including high blood pressure, heart disease, vascular disease, depression, and obesity.
A study showed that modafinil can improve alertness and performance in shift workers with sleep apnea. The dose used in this study was 300 mg taken 30 to 60 minutes before regularly scheduled night shifts. In addition, the 300-mg dose improved aspects of quality of life measured with specific and general health questionnaires compared to placebo.
Many shift workers experience sleep problems, especially when they work night shifts. Working night shifts interrupts your circadian rhythm, which is the body's natural clock that regulates your sleep-wake cycle. Shift work schedules often clash with a person's normal sleep patterns, causing chronic fatigue and disrupting the full benefits of each stage of the sleep cycle. Fortunately, a combination of strategies and treatments can help you overcome the challenges of night shift work.
The most common symptoms of shift work sleep disorder are insomnia and excessive sleepiness while awake. You may also feel tired, lethargic, and irritable. These symptoms can impact your work, home, and social life. If you think you have SWSD, talk to your doctor or sleep specialist for diagnosis and treatment.
Your sleep doctor will ask you about your sleep habits, symptoms, and work schedule. They will also check your health history to make sure that you don't have an underlying condition that is contributing to your symptoms, such as sleep apnea or another illness. In addition to a sleep diary, your doctor may recommend that you take an actigraphy test and/or other tests to confirm a diagnosis of shift work sleep disorder.
Treatment options for SWSD are similar to those for other sleep disorders. For example, you should try to stick to a consistent sleep schedule and practice good sleep hygiene by turning off your phone ringer and putting it on 'do not disturb' mode during your sleep hours. It's a good idea to avoid exercising too close to bedtime or eating foods that are high in sugar, as these can cause energy levels to fluctuate.
You should also consider taking short naps during your day off or on days you're working the night shift, as these can improve alertness and mood. You can also use bright light therapy before your night shift to help adjust your internal body clock.
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1st pill for obstructive sleep apnea could be around the corner
The first oral pill for obstructive sleep apnea (OSA) could be around the corner after pharmaceutical company Apnimed Inc. reported positive results from its stage III clinical trial. Currently, many people diagnosed with OSA patients require a machine that covers their nose or both the nose and mouth during sleep and delivers air through a mask to help keep their airways open. Apnimed's lead candidate AD109 showed "clinically meaningful and statistically significant reductions" in airway obstruction after 26 weeks, the company said in a press release. AD109, a once-a-day pill, is a neuromuscular modulator that increases upper airway muscle tone, which is how contracted the muscles are in the upper airway. OSA patients treated with the medication saw a nearly 50% reduction in the severity from baseline at week 26, compared to 6.8% of those in the placebo group. The reduction was "significant" at the end of the study period, which concluded at 51 weeks. At the end of the trial, nearly 23% of participants saw "complete disease control." The results were part of Apnimed's 12-month study looking at the safety and efficacy of AD109 in adults with mild, moderate and severe OSA. AD109 was well-tolerated among participants with only mild or moderate adverse events. Which was consistent with prior studies, according to Apnimed. No serious adverse events were reported in the trial. "With two large Phase 3 studies now demonstrating a consistent and significant efficacy profile for AD109, we are closer to delivering the first oral pharmacotherapy for over 80 million U.S. adults with OSA," Dr. Larry Miller, CEO of Apnimed, said in a statement. "Given the scale of unmet need in OSA, where the majority of patients remain untreated, we believe AD109, as a simple once-daily oral drug, has the potential to expand and reshape the treatment landscape, which would represent a significant commercial opportunity for Apnimed." OSA is a sleep disorder in which the airways become narrowed or blocked while sleeping, causing breathing to pause, according to MedlinePlus. Soon after falling asleep, people experience loud and heavy snoring. The snoring is often interrupted by a long silent period during which breathing stops and then followed by a loud snort and gasp as the patient attempts to breathe. This can cause excessive daytime sleepiness and affect quality of life, mental well-being and cardiovascular health. In addition to a CPAP machine, there are lifestyle changes that people with sleep apnea can make including avoiding alcohol or medications that cause drowsiness and losing excess weight. Recently, the U.S. Food and Drug Administration (FDA) expanded approval of Eli Lilly's obesity medication Zepbound to include treating moderate to severe obstructive sleep apnea for people with obesity. The clinical trial did examine patients with a wide range of "weight classes" and did not see differences in efficacy based on weight. Apnimed plans to file a New Drug Application with the FDA in early 2026, according to Miller.
Health Line
2 days ago
- Health Line
Dosage Details for Zepbound
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What strengths does Zepbound come in? Zepbound comes in six strengths: 2.5 mg/0.5 mL 5 mg/0.5 mL 7.5 mg/0.5 mL 10 mg/0.5 mL 12.5 mg/0.5 mL 15 mg/0.5 mL What are the usual dosages of Zepbound (tirzepatide)? Your doctor will likely start by prescribing a low dose and adjust it over time to reach the right amount for you. Starting with a low dose allows your body to get used to the medication and reduces the risk of digestive side effects from Zepbound. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect. The following information describes dosages that are commonly used or recommended. But be sure to inject the dosage your doctor prescribes for you. They'll determine the best dosage to fit your needs. Dosage for weight loss and weight management The typical starting dosage of Zepbound for weight loss is 2.5 mg once per week for 4 weeks. After this, your doctor will likely increase your dosage to 5 mg once per week for the next 4 weeks. 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You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
Medscape
17-07-2025
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Stay Alert to Sleep Apnea Burden in the Military
Obstructive sleep apnea (OSA) was associated with a significantly increased risk for adverse health outcomes and healthcare resource use among military personnel in the US, according to data from approximately 120,000 active-duty service members. OSA and other clinical sleep disorders are common among military personnel, driven in part by demanding, nontraditional work schedules that can exacerbate sleep problems, but OSA's impact in this population has not been well-studied, Emerson M. Wickwire, PhD, of the University of Maryland School of Medicine, Baltimore, and colleagues wrote in a new paper published in Chest . In the current health economic climate of increasing costs and limited resources, the economic aspects of sleep disorders have never been more important, Wickwire said in an interview. The data in this study are the first to quantify the heath and utilization burden of OSA in the US military and can support military decision-makers regarding allocation of scarce resources, he said. To assess the burden of OSA in the military, they reviewed fully de-identified data from 59,203 active-duty military personnel with diagnoses of OSA and compared them with 59,203 active-duty military personnel without OSA. The participants ranged in age from 18 to 64 years; 7.4% were women and 64.5% were white individuals. Study outcomes included new diagnoses of physical and psychological health conditions, as well as healthcare resource use in the first year after the index date. Approximately one third of the participants were in the Army (38.7%), 25.6% were in the Air Force, 23.5% were in the Navy, 5.8% were in the Marines, 5.7% were in the Coast Guard, and 0.7% were in the Public Health Service. Over the 1-year study period, military personnel with OSA diagnoses were significantly more likely to experience new physical and psychological adverse events than control individuals without OSA, based on proportional hazards models. The physical conditions with the greatest increased risk in the OSA group were traumatic brain injury and cardiovascular disease (which included acute myocardial infarction, atrial fibrillation, ischemic heart disease, and peripheral procedures), with hazard ratios (HRs) 3.27 and 2.32, respectively. The psychological conditions with the greatest increased risk in the OSA group vs control individuals were posttraumatic stress disorder (PTSD) and anxiety (HR, 4.41, and HR, 3.35, respectively). Individuals with OSA also showed increased use of healthcare resources compared with control individuals without OSA, with an additional 170,511 outpatient visits, 66 inpatient visits, and 1,852 emergency department visits. Don't Discount OSA in Military Personnel 'From a clinical perspective, these findings underscore the importance of recognizing OSA as a critical risk factor for a wide array of physical and psychological health outcomes,' the researchers wrote in their discussion. The results highlight the need for more clinical attention to patient screening, triage, and delivery of care, but efforts are limited by the documented shortage of sleep specialists in the military health system, they noted. Key limitations of the study include the use of an administrative claims data source, which did not include clinical information such as disease severity or daytime symptoms, and the nonrandomized, observational study design, Wickwire told Medscape Medical News . Looking ahead, the researchers at the University of Maryland School of Medicine and the Uniformed Services University, Bethesda, Maryland, are launching a new trial to assess the clinical effectiveness and cost-effectiveness of telehealth visits for military beneficiaries diagnosed with OSA as a way to manage the shortage of sleep specialists in the military health system, according to a press release from the University of Maryland. 'Although the association between poor sleep and traumatic stress is well-known, present results highlight striking associations between sleep apnea and posttraumatic stress disorder, traumatic brain injury, and musculoskeletal injuries, which are key outcomes from the military perspective,' Wickwire told Medscape Medical News . 'Our most important clinical recommendation is for healthcare providers to be on alert for signs and symptoms of OSA, including snoring, daytime sleepiness, and morning dry mouth,' said Wickwire. 'Primary care and mental health providers should be especially attuned,' he added. Results Not Surprising, but Research Gaps Remain 'The sleep health of active-duty military personnel is not only vital for optimal military performance but also impacts the health of Veterans after separation from the military,' said Q. Afifa Shamim-Uzzaman, MD, an associate professor and a sleep medicine specialist at the University of Michigan, Ann Arbor, Michigan, in an interview. The current study identifies increased utilization of healthcare resources by active-duty personnel with sleep apnea, and outcomes were not surprising, said Shamim-Uzzaman, who is employed by the Veterans' Health Administration, but was not involved in the current study. The association between untreated OSA and medical and psychological comorbidities such as cardiovascular disease, diabetes, and mood disorders such as depression and anxiety is well-known, Shamim-Uzzaman said. 'Patients with depression who also have sleep disturbances are at higher risk for suicide — the strength of this association is such that it led the Veterans' Health Administration to mandate suicide screening for Veterans seen in its sleep clinics,' he added. 'We also know that untreated OSA is associated with excessive daytime sleepiness, slowed reaction times, and increased risk of motor vehicle accidents, all of which can contribute to sustaining injuries such as traumatic brain injury,' said Shamim-Uzzaman. 'Emerging evidence also suggests that sleep disruption prior to exposure to trauma increases the risk of developing PTSD. Therefore, it is not surprising that patients with sleep apnea would have higher healthcare utilization for non-OSA conditions than those without sleep apnea,' he noted. In clinical practice, the study underscores the importance of identifying and managing sleep health in military personnel, who frequently work nontraditional schedules with long, sustained shifts in grueling conditions not conducive to healthy sleep, Shamim-Uzzaman told Medscape Medical News . 'Although the harsh work environments that our active-duty military endure come part and parcel with the job, clinicians caring for these individuals should ask specifically about their sleep and working schedules to optimize sleep as best as possible; this should include, but not be limited to, screening and testing for sleep disordered breathing and insomnia,' he said. The current study has several limitations, including the inability to control for smoking or alcohol use, which are common in military personnel and associated with increased morbidity, said Shamim-Uzzaman. The study also did not assess the impact of other confounding factors, such as sleep duration and daytime sleepiness, that could impact the results, especially the association of OSA and traumatic brain injury, he noted. 'More research is needed to assess the impact of these factors as well as the effect of treatment of OSA on comorbidities and healthcare utilization,' he said. This study was supported by the Military Health Services Research Program. Wickwire's institution had received research funding from the American Academy of Sleep Medicine Foundation, Department of Defense, Merck, National Institutes of Health/National Institute on Aging, ResMed, the ResMed Foundation, and the SRS Foundation. Wickwire disclosed serving as a scientific consultant to Axsome Therapeutics, Dayzz, Eisai, EnsoData, Idorsia, Merck, Nox Health, Primasun, Purdue, and ResMed and is an equity shareholder in Well Tap.
