NEJM Evid

Wake up call: Solriamfetol boosts alertness in early morning shift workers

February 4, 2026

In a randomized, double-blind, placebo-controlled trial (NCT04788953) of 78 early‑morning shift workers (start times 3–7 a.m.) with shift work disorder, solriamfetol significantly reduced excessive sleepiness over 4 weeks. Compared with placebo, solriamfetol increased objective wakefulness on the Maintenance of Wakefulness Test by 9.4 minutes (P<0.001) and improved subjective sleepiness on the Karolinska Sleepiness Scale (1.2; 95% confidence interval, -1.7 to -0.7). Clinician- and patient-rated global improvement was also more likely with solriamfetol. Adverse events were common in both groups, consisting mainly of headache and nausea, with no major safety concerns.

Clinical takeaway: Consider solriamfetol for patients with early‑morning shift work disorder and persistent excessive sleepiness despite nonpharmacologic strategies.

Source:

Zitting KM, et al. (2026, January 27). NEJM Evid. Solriamfetol for Excessive Sleepiness in Early-Morning Shift Work Disorder. https://pubmed.ncbi.nlm.nih.gov/41590992/