• Posted February 2, 2026

Non-Stimulant Pill Helps Early-Bird Workers Remain Awake And Alert

A non-stimulant pill might replace a cup of coffee as the chosen wake-up boost for early-morning shift workers, a new study says.

Early-bird workers who took solriamfetol (Sunosi) were less sleepy and more alert than those who got a placebo, researchers reported Jan. 27 in the journal NEJM Evidence.

"The improvement we saw is clinically meaningful. These workers were able to stay awake and alert throughout a full eight-hour shift, which has real implications for performance, safety and quality of life," senior researcher Dr. Charles Czeisler said in a news release. He’s chief of sleep and circadian medicine at Mass General Brigham in Boston.

The U.S. Food and Drug Administration (FDA) approved solriamfetol in 2019 to help people with sleep apnea or narcolepsy improve their daytime wakefulness.

Solriamfetol works by increasing the activity of two brain chemicals linked to alertness and wakefulness, dopamine and norepinephrine, according to the drug’s manufacturer Axsome Therapeutics.

Because it’s not a stimulant, the drug helps people stay awake for hours without costing them sleep later, researchers said.

Researchers thought the drug might also prove useful in helping workers whose shifts start in the wee hours of the morning.

"People who start work between 3 a.m. and 7 a.m. are waking up at a time when the brain is biologically programmed to sleep. That makes staying alert extraordinarily difficult, even when they are highly motivated," lead researcher Kirsi-Marja Zitting said in a news release. She’s an investigator of sleep and circadian medicine at Mass General Brigham in Boston.

"They are often dealing with a double burden — excessive sleepiness during work hours and difficulty sleeping enough when they have the chance to rest,” Zitting said.

To test their theory, researchers recruited 78 early-morning shift workers suffering from excessive sleepiness due to their work schedule.

Half took solriamfetol each workday for four weeks, and half took a placebo, researchers said.

The team tracked how long the workers could stay awake in a quiet, dark environment during times when they would normally be working.

Results showed that workers taking solriamfetol were about four times less likely to feel sleepy on the job, based on both their self-reports and the judgement of doctors monitoring their health.

The workers on the drug reported better overall functioning and work productivity, researchers said.

"Until now, no clinical trial had tested a treatment for shift work disorder in early-morning shift workers, even though this is the most common type of shift schedule," Czeisler said, adding that the study addressed a major gap by focusing on workers whose day begins when most people are still asleep.

"Shift workers are essential to how our society functions, yet they often pay a hidden biological cost,” Czeisler added. "This study shows we can do better for them."

Axsome Therapeutics provided funding for the clinical trial.

More information

The Cleveland Clinic has more on shift work sleep disorder.

SOURCE: Mass General Brigham, news release, Jan. 28, 2026