Shift-work sleep disorder

Dear Dr. P,

I hope you are well. I am writing because I have quite irregular working hours and would like to get a prescription for modafinil to help with my work-time sleepiness.

I’m asking for this medication specifically because I read that it is prescribed for shift-work sleep disorder, and it appears to be non-habit forming. Of course, I’m not a doctor. My body just hasn’t gotten used to my odd schedule over the last year, and I think it’s time I got some help.

I was disappointed because I went to two other doctors who did not seem to recognize shift-work sleep disorder as a real condition. They just told me to change my schedule, which, of course, I can’t. I appreciate your advice, and if this is something your clinic could help me with, I would be happy to schedule an appointment.

Dear sender,

You have already visited two Korean psychiatrists, but couldn’t get any useful information on shift-work sleep disorder from them and couldn’t get the medicine, modafinil, either.

In Korea, people don’t usually think that you have to take medicine to control the sleepiness caused by an irregular working schedule. Even doctors would say, “Why don’t you try to change your working schedule.” But sometimes there are some jobs where you cannot change working schedules, such as night nurses, stewardesses or firefighters.

Originally, modafinil was developed for the treatment of narcolepsy, which makes the sufferers fall asleep without warning, anywhere and at any time. But it can also be used for people who work at night time or early mornings as mentioned, in case they are too sleepy to perform their jobs normally.

If you really need to get modafinil, please visit my clinic and I will help you get it after an evaluation.

Thank you.

I am an American English teacher in Gangwon Province. I have been teaching in Korea for just slightly over a year now (and I have six months left here, at least).

Over the past few months I have been suffering from what I think may be generalized anxiety (daily) and sudden panic episodes (only occasionally, during extremely stressful situations), as well as some level of depression. I often have difficulty falling and staying asleep due to persistent thoughts (they are often just random thoughts), but my mind just seems to always stay active despite being exhausted, when I need to sleep.

I would like to schedule an appointment with your clinic, and I am curious if we can make an appointment on any upcoming Saturday. Even though I am in Gangwon Province, there is an express train that gets to Seoul in under an hour, so the distance is not a big issue. I am curious as to the expense for a consultation and possible medications. I am confused about using my national insurance at a psychiatric clinic, and whether my employer can view the treatments I have received and paid through my insurance, as I would like to keep this somewhat discreet, as you can imagine. I appreciate your expertise and advice, and I hope to make an appointment to see you soon!

It is very painful and anxious to suffer generalized anxiety or panic episodes in unfamiliar foreign countries. In that sense it is a wise and good choice for you to decide to visit a psychiatrist.

Sometimes, some foreign patients like you worry about the confidentiality of the Korean national insurance if they use it at psychiatric clinics. They are scared that their employers could view the record of their treatments. But I think that is not possible. It is illegal for the Korean national insurance company to give any information about a patient’s psychiatric illness to their employer without permission.

There were some holes in confidentiality at the beginning of the Korean national insurance program, but these days the government has started to recognize the importance of it and is trying to keep to principles.

However, you need to be cautious when you have an official job like a teacher in a public school, if you are having treatment for serious psychotic illness such as schizophrenia or bipolar affective disorder.

Dr. Park Jin-seng is a psychiatrist who runs a clinic for foreigners in Seoul and operates personal therapist forums on www.lifeinkorea.com. Please submit questions to him, either in English or Korean, to mdoctor@korea.com or call the hotline at 02-563-0678. Those who have their questions selected will be presented with a copy of his book “Finding Yourself within Love” (Korean e-Book).