Pharmacological interventions for sleepiness and sleep disturbances caused by shift work.

CLINICAL QUESTION: Are pharmacological interventions associated with better-quality sleep and alertness in shift workers? BOTTOM LINE: Low-quality evidence shows that melatonin is associated with 24 minutes longer daytime sleep after the shift but not with faster falling asleep compared with placebo. There is no association between hypnotics, such as zopiclone, and sleep outcomes, alertness, or harms. The alertness-promoting medications armodafinil and modafinil are associated with improved alertness during shift work but are also associated with headache and nausea.