From the FDA Drug Label
The effectiveness of modafinil tablets in improving wakefulness in patients with excessive sleepiness associated with SWD was demonstrated in a 12-week placebo-controlled clinical trial. A total of 209 patients with chronic SWD were randomized to receive modafinil tablets 200 mg/day or placebo. Patients treated with modafinil tablets showed a statistically significant prolongation in the time to sleep onset compared to placebo-treated patients, as measured by the nighttime MSLT at final visit. A statistically significant greater number of patients treated with modafinil tablets showed improvement in overall clinical condition as rated by the CGI-C scale at final visit.
Modafinil is effective in improving wakefulness in patients with Shift Work Sleep Disorder (SWD). The recommended dose is 200 mg/day. Patients treated with modafinil tablets showed a statistically significant improvement in sleep latency and overall clinical condition compared to placebo-treated patients 1.
From the Research
The most effective treatment for shift work sleep disorder is a combination of behavioral strategies and medications, with a focus on establishing a consistent sleep schedule, using melatonin or modafinil, and implementing light therapy and regular exercise. This approach is supported by the most recent and highest quality study, which found that behavioral therapy adapted for shift work disorder can improve shift workers' sleep, sleepiness, and mental health 2.
Key Components of Treatment
- Establishing a consistent sleep schedule, even on days off
- Creating a dark, quiet sleep environment using blackout curtains and white noise machines
- Using melatonin (1-3 mg taken 30 minutes before bedtime) to regulate the sleep cycle
- Implementing light therapy using bright light boxes during early work hours to reset the circadian rhythm
- Regular exercise, but not within 3 hours of sleep
- Limiting caffeine to early in the shift and avoiding it within 6 hours of planned sleep time
Medications
- Modafinil (Provigil, 200 mg once daily) or armodafinil (Nuvigil, 150 mg once daily) can improve alertness during work hours
- Short-acting sleep medications such as zolpidem (Ambien, 5-10 mg) or eszopiclone (Lunesta, 1-3 mg) may help initiate sleep after night shifts
Supporting Evidence
- A 2024 study found that behavioral therapy for shift work disorder can improve shift workers' sleep, sleepiness, and mental health 2
- A 2014 study found that melatonin can improve sleep length after a night shift, and modafinil and armodafinil can increase alertness and reduce sleepiness 3
- A 2025 study found that shift work sleep disorder can be prevented and treated with collective measures such as optimizing shift schedules and individual strategies such as sleep/circadian hygiene, light therapy, melatonin use, and prescription medications 4