Behavioral measures, eg, exercise and improved sleep hygiene, can enhance sleep 
quality and combat insomnia and excessive sleepiness (ES) in shift workers and 
individuals with shift-work disorder (SWD). Napping before a shift followed by 
consumption of a caffeinated drink and, if appropriate, scheduled naps at work, 
may improve ES in patients with SWD. Use of bright light therapy to partially 
re-entrain the circadian clock should be explored for all night-shift 
workers-particularly those with SWD. The wakefulness-promoting agents 
armodafinil and modafinil are FDA approved for the treatment of ES in patients 
with SWD. Alongside nonpharmacologic interventions, they can be included in a 
comprehensive management plan for SWD. Melatonin or other sleep-promoting agents 
may help shift workers achieve sleep during required rest periods and when 
adjusting to night-shift work; studies are needed in patients with SWD to better 
evaluate the utility of these agents in this population.