Who this is for
Men whose work schedule runs against their body clock, with problems that have lasted at least three months:
- Fighting to stay alert on shift or on the drive home
- Trouble falling or staying asleep during the day
- Feeling worn down on days off, too
How it works
- Video consultation. Your schedule, sleep, symptoms, health history, and medications.
- Screening for other causes. Sleep apnea, low testosterone, thyroid problems, mood, and caffeine or alcohol use. Labs when your symptoms point to them.
- A plan built around your shifts. Light timing, sleep protection, naps, and caffeine timing first.
- Armodafinil if appropriate, with regular follow-up.
Where armodafinil fits
Armodafinil (the generic of Nuvigil) is FDA-approved for excessive sleepiness from shift work disorder. Taken about an hour before your shift, it helps you stay alert through the night. It's a close relative of modafinil and lasts a bit longer, which suits long shifts. It doesn't replace sleep, and it isn't a focus or productivity drug. We prescribe it only for shift work disorder. Read more about shift work disorder →
Armodafinil may not be right if you have
- Heart disease or uncontrolled high blood pressure
- A history of serious psychiatric illness or stimulant misuse
- Possible sleep apnea that hasn't been tested. That needs its own workup first.
Which plan
Shift Work is its own plan. It covers the evaluation, your sleep plan, regular follow-up, and armodafinil when prescribed, up to 30 tablets a month.
Armodafinil is a controlled medication and requires an evaluation and regular follow-up visits.
Pricing goes to the waitlist first. HSA/FSA cards can be used for eligible medical services. Founding membership opens November 1.
Common questions
What is shift work disorder?
A sleep condition caused by working when your body expects to sleep. It shows up as excessive sleepiness at work and trouble sleeping when you're off, lasting at least three months and tied to your schedule.
Is armodafinil a stimulant?
It promotes wakefulness and works differently from amphetamines. It tends to feel smoother, but it is still a controlled medication and needs monitoring.
Can you prescribe armodafinil by telehealth?
Yes, for patients located in New York State, after a video evaluation that confirms shift work disorder and screens for other causes. Regular follow-up is required.
What if it turns out to be sleep apnea or low testosterone?
Then that's what we address, or we point you to the right next step. Treating sleepiness without finding the cause can hide a problem that needs a different fix.