Effectiveness of bright light exposure, modafinil and armodafinil for improving alertness during working time among nurses on the night shift: A systematic review

Objective We aimed to evaluate the effectiveness of bright light exposure, modafinil, and armodafinil for improving alertness during working time among nurses on the night shift. Methods We carried out a literature search using the PubMed, Scopus, and Web of Science electronic databases regarding articles pertaining to workplace interventions for improving wakefulness among nurses working the night shift using the following medical subject headings: ((((Bright light exposure) OR wakefulness medications) AND Nurses AND Night Shift-work)). Results The searches generated a total of 34 records on the PubMed database, 130 on the Scopus database, and 32 on the Web of Science database. A total of 95 studies were identified after removal of duplicates. Nevertheless, the 95 articles were screened, 75 studies were excluded based on the review of titles and abstracts, and further 15 full-text articles were excluded because the studies did not meet the selection criteria. A total of 632 subjects from 5 studies were included. Conclusion Bright light exposure is beneficial in improving alertness during the night shift. On the other hand, armodafinil or modafinil taken before the commencement of night shift work is effective in the treatment of excessive sleepiness associated with shift work sleep disorder.