Prolonged Wakefulness

Abstract

Even a single night without sleep, as with a first night-shift, causes subtle impairments to executive functions, only really evident under real-world settings, especially when one is confronted by sudden, unexpected changes. We are less capable of assessing risks, keeping track of protracted, difficult overnight negotiations having ‘false trails’ and ‘hidden agendas’, and we become more irritable, less able to suppress basic emotions, and ‘sense’ the feelings of others. With longer sleep loss we turn into automatons, lose spontaneity, have duller and stilted speech. Although caffeine and other stimulants help overcome ‘ordinary’ sleepiness, they have lesser benefits for these executive impairments. Similar, albeit temporary impairments can be seen when we are suddenly awoken from Slow Wave Sleep (SWS –‘deep sleep’), as the frontal area needs some minutes to fully engage with reality.