Sleep cycles simply put are a part of the body’s sleep mechanism that helps you sleep at the designated time interval. In reality, they cover a much wider spectrum and along with sleep, play an important role in mood regulation with cognitive function. Precisely why sleep disorders apart from sleep disturbance affect the working capacity and consequently professional ability of the patient. The diversity of sleep disorders covers a large spectrum from sleep apnea, and jet lag to narcolepsy and circadian rhythm disorder. Shift work sleep disorder is one such sleep disorder that has in recent years garnered a lot of attention.
What is Shift Work Sleep Disorder?
Shift Work Sleep Disorder (SWSD) occurs when the circadian rhythms regulating sleep-wake behavior are misaligned by night shift workers. SWSD disrupts the patient’s schedule to the extent of them experiencing clinically significant excessive sleepiness during night work and/or insomnia episodes when trying to sleep the following day. Not all people working the night shift suffer from shift work sleep disorder.
A majority of them adapt to their work schedules and are able to compensate for these temporal sleep-wake dysregulations. The 5-10% remaining workers cannot adjust their circadian rhythms and drive for sleep resulting in sleep complications that disrupt their work schedules. Already being at risk for a number of health-related and social outcomes, the impact of sleep disorders has a profound impact on their health, safety, and professional parameters.
Of the numerous treatment measures, sleep regulations medications are the safest, quick-acting, and most effective way out. WAKLERT is one such option.
Waklert – introduction, and strength
Waklert or generic Armodafinil is commonly regarded as a eugeroic medication used in the treatment of sleep disorders. Eugeroics or stimulants are commonly described as wakefulness-promoting drugs that do not have a high tolerance level or the increased risk of addiction like that of psychostimulants. Both Waklert and its active ingredient Armodafinil are used to improve wakefulness in people with sleep disorders like Narcolepsy, SWSD and as a combination medication for the treatment of Sleep Apnea.
Of them all, Waklert is most popular among Shift Work Sleep Disorder patients because of its wide range of effectiveness and comparatively safe nature in inducing wakefulness response.
How does Waklert work in Shift Work Sleep Disorder patients?
Though the exact mechanism of action is still under active research and evaluation, Waklert is said to exert its eugeroic effects on the dopamine receptors present in the CNS. Dopamine is a neurotransmitter found in the neurons of both the central and peripheral nervous systems. It possesses a number of receptors that in turn form the basis of its acting nature.
Waklert works on the D1 and D2 receptors of CNS to enable wakefulness through improved information processing and motor control. Being an indirect dopamine agonist it binds to the dopamine reuptake pump of the nervous system and works on inhibiting the reuptake of dopamine back into the system. This results in an increase in the production of extracellular dopamine that helps bring out its cognitive and behavioral nature.
Waklert is available in strengths of 50mg and 150mg. For SWSD patients, it is advised in doses of 150 mg once daily to be taken an hour before starting their work shift. Being a mild eugeroic, currently, it is one of the most popular medications for SWSD cases throughout Europe and other continents
Is Waklert better than other medications for SWSD?
Reference:- Click Here
Apart from Waklert, there are other medications that exert similar properties as that of Waklert for the treatment of sleep disorders. Yet Waklert is the most preferred of all. There are a number of factors that prove the superiority of Waklert over other medications for SWSD. Some of them are discussed below.
- a) Enantiopure nature
Both Armodafinil, the active ingredient of Waklert, and Modafinil, another equally potent wakefulness-promoting drug have been found to be effective in SWSD patients. Modafinil is a racemic mixture and contains equal amounts of R and S enantiomers. Waklert on the other hand is enantiopure. It contains only the active R enantiomer. This provides it with a longer half-life and enables its effects to last for a longer time period. Modafinil takes around 45 minutes-1 hour to start working and its effects last for 6-8 hours before getting eliminated from the system. In comparison, Waklert / Armodafinil starts working within 15-30 minutes of intake and lasts for around 12 hours or more.
- b) The feel-good factor
Other stimulants having a shorter duration of action have been observed by users to hit harder. Similar to the euphoric effect with a feel-good factor. Waklert has a comparatively clear and smooth effect of wakefulness sans the euphoria. This makes it better suited to the working environments of Night Shift Workers. Users have further recorded that Waklert makes them feel less distracted or jittery and enables them to concentrate better on their work. All of these factors make Waklert a better-suited medication for Night Shift Workers.
- c) Generic status
The growing demand for stimulants and their controlled substance status has made it very difficult to procure Armodafinil and Nuvigil, the branded versions of Waklert. Additionally, the high cost further makes it difficult for users to avail themselves and use them on a continuous basis. Waklert is a generic medication; it has the same properties and mechanism of action as that of Armodafinil but is cheaper and more readily available. This makes it easy to procure the medication with its refills along with increasing their availability for the general working population including night-shift workers.
What do clinical studies suggest?
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In a clinical study conducted to compare the efficiency of Armodafinil, the active ingredient of Waklert, and Modafinil, another eugeroic medication with the same mechanism of action, 211 subjects were enrolled in the study. It was a 12-week, randomized, competitive, double-blind study, and subjects working at least 5-night shifts weekly were selected. Armodafinil and its comparison drug Modafinil were administered an hour before the start of the night shift. Efficacy was assessed by change in sleepiness score and through a global assessment of efficacy.
The study proved that Armodafinil was safe and effective in use among SWSD patients. Both drugs were comparable in terms of usage and efficiency. Armodafinil is eligible for use among SWSD patients, its generic counterpart Waklert has equal potential for use as well with the safe efficiency and overall stability.
In another study conducted to evaluate the pharmacokinetics of Armodafinil (Waklert brand) and Modafinil after single and multiple doses in patients with SWSD, patients were subjected to randomized crossover sequences. The pattern was either of ABCD or BADC where
A – single Armodafinil 200 mg dose
B – Single Modafinil 200mg dose
C – Multiple daily Modafinil 200 mg dose
D – Multiple daily Armodafinil 200 mg dose
During multiple-dose administration, patients received 100 mg once daily for days 1 and 2 and 200 mg dose once daily from days 3-10. At the end of the study, plasma drug concentrations versus time curves showed higher systemic exposure with Armodafinil than Modafinil. The study proved that both Armodafinil and Waklert have the potential to be used for SWSD. But overuse or misuse can result in side effects or adverse reactions.
What are the side effects associated with the use of Waklert?
Because it is a pure enantiomer, the side effects of Waklert are comparatively less than that of racemic enantiomers. That said, side effects do exist and should be taken care of while using the medication.
Some of the common side effects associated with Waklert use are- nausea, vomiting, diarrhea, loss of appetite, headache, constipation, and stomach ache.
Other side effects – Uncontrollable shaking of a part of the body, numbness associated with burning or tingling of hands or feet, difficulty concentrating or paying attention, trouble falling asleep or staying asleep.
Rare side-effects- difficulty breathing or swallowing, pounding or irregular heartbeat, frenzied abnormally excited mood, hallucinations, anxiety, depression.
In such cases, it is important to discontinue the medication immediately and get medical help.
Other treatments available for SWSD
Apart from Waklert other treatment options available for SWSD are
Light therapy and light avoidance
Uses the concept of bright light to shift sleep cycles
Melatonin supplements
Sleep-promoting supplements used to stay awake and ward off sleep
Lifestyle changes
Active changes like a healthy diet, exercise, and practicing good sleep hygiene can help take care of the problem to a great extent
Counseling
If the disorder is severely impacting your life, counseling with a doctor or counselor for solutions to fit your situation can help deal with the repercussions.
None of these solutions provide as efficient or concrete results as Waklert or provide symptomatic relief to the patient. Waklert remains the best treatment mode for SWHD cases provided it is used with caution
Precautions
These are the precautions that need to be taken during the use of Waklert
- Eligibility criteria
You should not use the medication if you are allergic to it. Similarly, people with poor metabolic rates or pregnant women should not be using it.
- Drug interactions
Concomitant use of Waklert with other medications can result in adverse reactions or a decrease in the efficiency of either medication.
- Online ordering
Order from a reputed online site so you obtain genuine medication.
- Nootropic angle
Using Waklert without any sleep disorders for cognitive function is illegal and even dangerous for the body in the long run.
References
- https://www.sciencedirect.com/topics/medicine-and-dentistry/shift-work-sleep-disorder
- https://pubchem.ncbi.nlm.nih.gov/compound/Armodafinil
- https://www.nps.org.au/australian-prescriber/articles/dopamine-mechanisms-of-action#article
- https://www.medindia.net/drug-price/armodafinil/waklert-150-mg.htm
- https://www.singlecare.com/blog/armodafinil-vs-modafinil/#:~:text=Armodafinil%20may%20have%20a%20 longer,one%20 drug%20 versus%20the%20other.
- https://www.modafinil.com/armodafinil-vs-modafinil/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3135062/
- https://pubmed.ncbi.nlm.nih.gov/21118743/
- https://www.clinicaltherapeutics.com/article/S0149-2918(10)00371-1/pdf
- https://www.modafinil.com/waklert-review/
- https://www.sleepfoundation.org/shift-work-disorder/treatment
