Managing the patient with shift-work disorder.

Behavioral measures can enhance sleep quality and combat excessive sleepiness in shift workers.

• Napping before a shift and consuming caffeine may improve excessive sleepiness in individuals with shift-work disorder.
• Bright light therapy is suggested to help re-entrain the circadian clock for night-shift workers, especially those with shift-work disorder.
• Armodafinil and modafinil are FDA approved for treating excessive sleepiness in patients with shift-work disorder.
• A comprehensive management plan for shift-work disorder may include both pharmacologic and nonpharmacologic interventions.
• Melatonin and other sleep-promoting agents could assist shift workers in achieving sleep during designated rest periods.

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