Drug Curbs Sleep, Raises Concerns

Provigil Makes Staying Awake Easier, But At What Cost?

(CBS)  In our 7-day-a-week, 24-hour-a-day world, sleep is sometimes in short supply. CBS News Correspondent Mika Brzezinski reports on a drug designed to treat only the most severe sleep disorders that may make staying awake easier than ever. But at what cost?

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It's morning at Evans Parker's house. For Parker, a night shift supervisor at a California 911 center, night magically turns into day.

He began taking Provigil, which he calls, "my new best friend."

It keeps him, he says, from nodding off, which he watches people do every night.

"I cannot keep my eyes open," says Parker.

For him, it's a wonder drug, without side effects.

"It just makes me more alert," he says. "I still feel tired, I just don't feel sleepy."

Dr. Jed Black, of the Stanford Sleep Disorders Clinic, says Parker tried everything, including caffeine.

Black says Parker fit perfectly into his recent study: To see if the drug, approved to treat narcolepsy, could also help shift workers stay awake. It did, but this "miracle drug" is also a bit of a mystery.

"We don't know exactly how the medication works," says Black

Even so, the FDA is now considering approving Provigil for shift workers, which would open the door for many more people to pop one of these pills and just keep going, and going and going.

"I think probably we will end up using it more than we had anticipated using it because, despite our best attempts at educating people on the need for sleep, people are still cheating," says Dr. Joanne Getsy, director of the Medical College of Pennsylvania's sleep clinic.

Getsy sees desperately sleepy patients who want to beat the clock.

"And they're out there driving trucks and buses and taxis, and I don't want them to crash," she says. "Is it worse to let a sleepy truck driver drive, or is it worse to give him Provigil?"

Sometimes she's tempted by Provigil herself.

"I've never taken it, but I have also had days where I've thought, 'It's either four cups of coffee or one pill,'" she says.

Even Provigil's manufacturer Cephalon admits that as much as 75 percent of its $200 million in Provigil sales last year were for so-called "off-label" use - not for treatment of narcolepsy.

"It's not for people who don't have a sleep disorder," says Paul Blake, who works in Cephalon's clinical research and regulatory affairs. "It's not just any truck driver who wants to extend his hours for a couple of extra bucks, (and) it's not for the pilot who's being asked to double up duty."

Does he worry that this drug could prevent people from getting the sleep that they need?

"I think all of us here worry about that," he says.

But after years of dreaming of sleep, Parker says Provigil makes it possible to concentrate on the job instead of on the sleep he's missing.

"Most people fantasize about money and sex," says Parker. But because they don't get it, "Midnight shift workers fantasize about sleep."

He's using Provigil to turn night to day. The question is: How many others will try to use this pill to fill their already overscheduled lives?