Travelers crossing ≥5 time zones; night-shift workers
Core stack
Form: IR (jet lag) / MR (shift work trialed)
Dose: 2–5 mg
At local bedtime for 2–4 nights after eastbound travel (adjust per Cochrane guidance). For shift work: 3–6 mg pre-sleep after night shift (pilot data).
Short courses
Why: Effective for jet lag; feasibility/acceptability shown in shift-workers, evidence less consistent.
Form: coffee/tablet
Dose: 1–3 mg/kg as tolerated
For shift work: shortly after start of night shift; avoid within ~6–8 h of intended sleep. For westbound jet lag: morning/early day at destination.
Short-term countermeasure when needed
Why: Systematic reviews suggest caffeine improves cognitive performance/reduces errors in shift workers; recognized alertness claim in EU.
Adjuncts
Notes: Time bright light/avoidance alongside melatonin and caffeine for maximal effect.
Monitoring
- Jet lag symptom scores
- Daytime function