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American Morning
Interview with Dr. John Byrne, Dr. Martin Moore-Ede
Aired May 07, 2002 - 07:49 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
ANDERSON COOPER, CNN ANCHOR: The "Big Question" this hour: Can staying awake make you sick? Doctors are increasingly prescribing medication for narcolepsy to otherwise healthy patients. According to "The Washington Post," Americans bought $150 million worth of the narcolepsy drug, Modafinel, last year. The drug is designed to treat a rare sleeping disorder.
Now, 75 percent of the users were not narcoleptics. But should the new wake-up pill trigger a wake-up call?
Well joining us now, from Houston, Dr. John Byrne, a neurobiologist with the University of Texas-Houston Medical Center, and from Washington, Dr. Martin Moore-Ede of Circadian Technologies, a company that helps businesses and workers better cope with long hours -- thank you both for being with us this morning.
Dr. Byrne, I want to start off with you. What do we know about this drug? How does it work? Is it addictive? Is it effective?
DR. JOHN BYRNE, UNIVERSITY OF TEXAS-HOUSTON MEDICAL CENTER: Well, it was originally designed and approved by the FDA several years ago to treat narcolepsy, which is a disease associated with excessive daytime sleep. And it has proven to be quite effective for that. It has also been used to treat patients with neurological diseases, such as multiple sclerosis, that are associated with excessive daytime fatigue.
The fact that it has been used to help people stay awake that have excessive sleep problems has led naturally to the idea that it could be used to promote wakefulness in normal, healthy individuals.
COOPER: Dr. Moore-Ede, is that an idea that worries you at all? I mean, ethically are we going to territory that's sort of unexplored? Getting people to stay -- I mean, this sounds like a company's dream, getting workers to stay awake with a non-addictive pill.
DR. MARTIN MOORE-EDE, PRESIDENT, CIRCADIAN TECHNOLOGIES: Well, we've got a world that is now 24/7, a world where 15 million Americans are working shifts around the clock. And the dangers here are that if we take a very powerful medicine, very effective for something like narcolepsy, a serious sleeping disorder, and we turn it into a lifestyle pill, and that is truly scary.
COOPER: Is this something -- I mean, you must get calls from people asking about this drug. Is this something you would recommend for, you know, a night-shift worker?
MOORE-EDE: No, I wouldn't right now. The reason is the number. First of all, it has only really been tested in short-term situations. We don't have any long-term information about the drug.
Secondly, there is evidence showing that it causes overconfidence. In other words, you feel great, but you tend to be overconfident. And you've got someone driving a truck or operating a nuclear power plant, the last thing you want is overconfidence. So there are some pretty serious questions we have to address, not to mention the long-term health effects that we may be facing that no one knows about yet.
COOPER: Dr. Byrne, I want to read you something. When this drug was first released in 1999, the manufacturer warned that it -- quote: "May alter judgment, cognitive or motor skills. Patients should be cautioned about operating an automobile or other hazardous machinery." Doesn't it worry you that, you know, a truck driver may be using this thing to stay awake?
BYRNE: Well, it certainly does, and there have been studies, of course, showing that the drug is effective in promoting wakefulness. But at the same time, those studies indicate that there are side effects of the drug, such as nausea, dizziness and headaches, so one needs to be cautious about its use certainly.
And the other thing that one needs to be aware of is the fact that prolonged sleep deprivation can have very negative physiological consequences. So people who are deprived of sleep have a rebound period, where they try to make up for the sleep. There have been some very dramatic studies in laboratory animals. So for example, if rats are deprives of sleep for two weeks, they die, even if you deprive them of a certain phase of sleep called REM sleep, which constitutes only about 10 percent of the sleep period, they still die.
So as Dr. Moore-Ede indicated, we really need to study the functional significance of sleep and the consequences of prolonged wakefulness.
COOPER: And, Dr. Moore-Ede, what is your advice to a night-shift worker or to someone who has to work, you know, these terrible hours, truckers, police officers, security guards? What should they do?
MOORE-EDE: Well, it's very tempting to look at a pill, but in fact, there are very safe ways to manage this issue. We work right now with over half of the Fortune 500, and there are solutions to do with how you schedule people that work rest hours, how you train people, the lighting conditions at the workplace, and how treatment for sleep disorders -- very effective ways of managing the problem of 24/7. And that going to medication is a dangerous thing.
And the problem is that we have this rule for off-label prescribing. In other words, a physician can write this for any disorder, and you call it something like shift-work sleep disorder, and off you go. So it's a very dangerous world, and we are seeing this pill leak into that world now, and I think that is something that is really pretty scary in the long run.
COOPER: All right. Dr. Martin Moore-Ede, Dr. John Byrne, thanks very much for joining us this morning. As someone who used to work the night shift, myself, the subject hits very close to home, so I appreciate you coming in this morning -- thanks.
BYRNE: Thank you very much.
MOORE-EDE: Thank you.
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