Cognitive enhancement: less sleep = more done?

In Make me… stay awake, the final part of an engaging series of three documentaries (following Make me… smart and Make me… live forever), Michael Mosley investigates the effects of sleep deprivation and ways in which these symptoms may be alleviated. As he puts it in the introduction to the film, he wants to know if there are ways of “conquering… my need and my urge for sleep” (01:40).

Several sections of the programme brought bioethical themes into sharp focus – including the use of model organisms in research (17:53-20:47) and the use of drugs to stay awake longer (26:42- end).

Mosley starts by seeing how long he can keep himself awake and the impact it will have his abilities. In New York, he meets Tony Wright who holds the world record for staying awake (11 days and nights without sleep, set in 2007) and sleep expert David Rappaport. The latter makes the rather alarming statement that when you have the sensation whilst driving that you are  fighting to stay awake, you have already had multiple microsleeps (04:30).

Moving on to Philadelphia (13:30), Mosely visits David Dinges who undertakes sleep deprivation research on human volunteers. Dinges, whose experiments are funded by both NASA and the American military, emphasises the question “What is sleep for and can we get by without it?” (13:55) as the fundamental challenge for work in the field. Volunteers in his research commit themselves to at least five days of tests, frequently longer, during which they undergo physical and mental testing. “Scientists have a hard time helping government and industry use what we know”, Dingle observes “because what we know is complicated and they want simple solutions” (15:40). Individuals, based presumably on their genes, have natural differences in both their sleep patterns and their ability to cope with sleep deprivation.

Having commented that ethical issues concerning the use of human subjects inevitably constrains the insights which Dinges is able to derive from his work, Mosely then considers the research of Professor Amita Sehgal at the University of Pennsylvania. Professor Sehgal, Mosely informs us, “not only pushes her subject to the very limit, but pushes them over the edge. Then she liquidises their brains” (18:03). This is permitted because her research is carried out on Drosophila fruit flies, not humans. In addition to being able to carry out highly invasive experiments, Sehgal can also carry out selective breeding of flies in order to characterise the effect of specific mutations. For example, she discusses a mutant they call sleepless which, they observe, is short-lived, staggers and may have difficulty reproducing.

This is a nice illustration of the research merit of studying lower organisms in biomedical research. Ethically, this is several steps removed from work on mammals, let alone humans – a point which seemed to evade Republican Vice-Presidential candidate Sarah Palin in her now notorious rant against spending research dollars on “pet projects”.

In the final section of the programme (from 26:42), Mosely considers the potential role of drugs in counteracting tiredness. Caffeine, he notes, is a popular stimulant but there is growing interest in other cognitive enhancing drugs, especially Modafinil. The alertness caused by Modafinil (Provigil) was discovered accidentally, but is now exploited both in the treatment of the sleep disorder narcolepsy and by the US Military to keep pilots awake on long flights. In the spirit of self-experimentation which marks much of Mosley’s work, he elects to try out the effects of Modafinil for himself (but not before he has a barrage of safety tests).

Mosley flies to Prince Edward Island, Canada, where he meets “Terry” (28:33), a graphic designer who has been taking Modafinil for about a year in order to allow him to work 100 hours a week, punctuated by occasional 20 minute power-naps. Terry’s motivation is financial – by working twice as many hours, he argues, he can earn twice the income.

Whilst visiting Terry, Mosley takes the opportunity to try the drug for himself. Initially he is very impressed by the effects; he stays mentally alert for 42 hours and then has a good night’s sleep unaffected by the “buzzy” side-effects associated with other stimulants.

In the morning, however, he has some concerns arising from widespread rashes on his body and lumps on his neck (36:10). Although he recognises that all drugs have side effects (37:03), these changes coupled with his knowledge that Modafinil can cause anaphylactic shock and ‘scalding’ of the skin make him reticent to try it again.

Make me… stay awake (TRILT identifier 00DF9530) was first transmitted on BBC at 22:35 on 24th February 2009. It is available on BBCi Player until March 3rd.

(CJRW)