intermediateinsomniashift work disordercaffeinesleep hygienecircadian rhythmsedative-hypnotics
A 42-year-old female presents with chronic insomnia, requesting a sleep medication. She reports difficulty falling and staying asleep for the past year. She works night shifts 3 days per week and day shifts 4 days per week. She drinks 4 cups of coffee daily, the last at 3 PM. She has tried melatonin with no benefit. What should the PMHNP assess before prescribing?