http://www.scientificamerican.com/askexpert/biology/biology60/

How long can humans stay awake?

J. Christian Gillin, a professor of psychiatry at the University of
California, San Diego, conducts research on sleep, chronobiology and
mood disorders. He supplies the following answer.

The easy experimental answer to this question is 264 hours (about 11
days). In 1965, Randy Gardner, a 17-year-old high school student, set
this apparent world-record for a science fair. Several other normal
research subjects have remained awake for eight to 10 days in carefully
monitored experiments. None of these individuals experienced serious
medical, neurological, physiological or psychiatric problems. On the
other hand, all of them showed progressive and significant deficits in
concentration, motivation, perception and other higher mental processes
as the duration of sleep deprivation increased. Nevertheless, all
experimental subjects recovered to relative normality within one or two
nights of recovery sleep. Other anecdotal reports describe soldiers
staying awake for four days in battle, or unmedicated patients with
mania going without sleep for three to four days.

The more difficult answer to this question revolves around the
definition of "awake." As mentioned above, prolonged sleep deprivation
in normal subjects induces altered states of consciousness (often
described as "microsleep"), numerous brief episodes of overwhelming
sleep, and loss of cognitive and motor functions. We all know about the
dangerous, drowsy driver, and we have heard about sleep-deprived British
pilots who crashed their planes (having fallen asleep) while flying home
from the war zone during World War II. Randy Gardner was "awake" but
basically cognitively dysfunctional at the end of his ordeal.

In the case of rats, however, continuous sleep deprivation for about two
weeks or more inevitably caused death in experiments conducted in Allan
Rechtschaffen�s sleep laboratory at the University of Chicago. Two
animals lived on a rotating disc over a pool of water, separated by a
fixed wall. Brainwaves were recorded continuously into a computer
program that almost instantaneously recognized the onset of sleep. When
the experimental rat fell asleep, the disc was rotated to keep it awake
by bumping it against the wall and threatening to push the animal into
the water. Control rats could sleep when the experimental rat was awake
but were moved equally whenever the experimental rat started to sleep.
The cause of death was not proven but was associated with whole body
hypermetabolism.

In certain rare human medical disorders, the question of how long people
can remain awake raises other surprising answers, and more questions.
Morvan�s fibrillary chorea or Morvan�s syndrome is characterized by
muscle twitching, pain, excessive sweating, weight loss, periodic
hallucinations, and severe loss of sleep (agrypnia). Michel Jouvet and
his colleagues in Lyon, France, studied a 27-year-old man with this
disorder and found he had virtually no sleep over a period of several
months. During that time he did not feel sleepy or tired and did not
show any disorders of mood, memory, or anxiety. Nevertheless, nearly
every night between 9:00 and 11:00 p.m., he experienced a 20 to
60-minute period of auditory, visual, olfactory, and somesthetic (sense
of touch) hallucinations, as well as pain and vasoconstriction in his
fingers and toes. In recent investigations, Morvan�s Syndrome has been
attributed to serum antibodies directed against specific potassium (K+)
channels in cell and nerve membranes.

Another rare disorder, Fatal Familial Insomnia (FFI), is an autosomal
dominate disease that is invariably fatal after about six to 30 months
without sleep. FFI is probably misnamed because death results from
multiple organ failure rather than sleep deprivation. The pathological
processes include degeneration of the thalamus and other brain areas,
over-activity of the sympathetic nervous system, hypertension, fever,
tremors, stupor, weight loss, and disruption of the body's endocrine
systems. FFI belongs to a class of infectious prion diseases that
include Mad Cow Disease.

To return to the original question, "How long can humans stay awake?"
the ultimate answer remains unclear. Despite the rat studies in Chicago,
I am unaware of any reports that sleep deprivation per se has killed any
human (excluding accidents and so forth). Indeed, the U.S. Department of
Defense has offered research funding for the goal of sustaining a fully
awake, fully functional "24/7" soldier, sailor, or airman. Future
warriors will face intense, around-the-clock fighting for weeks at a
time. Will bioengineering eventually produce genetically-cloned soldiers
and citizens with a variant of Morvan�s syndrome who need no sleep but
remain effective and happy? I hope not. A good night�s sleep is one of
life�s blessings. As Coleridge wrote years ago, "Oh sleep! It is a
gentle thing, beloved from pole to pole," and Wilse Webb, a prominent
sleep researcher, more recently called sleep the gentle tyrant: It can
be delayed but not defeated.

RELATED LINKS:

Ask the Experts: What do we know about the evolution of sleep--when it
arose and why?
Study Links Longer Night's Sleep to Increased Death Rate
Behavioral Therapy Puts Insomniacs to Sleep
Astronauts Sleep Better in Space, a New Study Shows


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