Press Release

The American Academy of Sleep Medicine's Sleep Deprivation and Stimulant Task Force will publish a review outlining appropriate circumstances and uses of stimulants when sleep loss is inevitable in its September issue of the journal Sleep, a publication of the Associated Professional Sleep Societies, which is a partnership of the AASM and Sleep Research Society.

The Task Force reports "judicious use of a stimulant under appropriate medical supervision may be warranted" in emergency situations when sleep loss cannot be avoided. It goes on to say, "In such situations, the use of a stimulant to maintain alertness and performance should be the result of informed decisions in which the potential risks and benefits are understood and accepted."

The Task Force reviewed 239 published papers to better understand what is known about how caffeine and prescribed medications modify or affect performance during sleep loss; to specifically address different dosages and circumstances where they are helpful; and to identify the risks and side effects associated with using stimulants on a regular basis.

Michael H. Bonnet, PhD, of Wright State University and Kettering Medical Center (Dayton, OH), lead author of the article, states that while getting adequate sleep is essential to maintaining alertness and optimum performance there are instances where "sleep loss is unavoidable and a supplemental way of staying awake may be necessary."

The study indicates "about one-third of normal young adults can be considered too sleepy by various criteria. Significant sleepiness is also associated with a number of sleep disorders, night shift work, and jet lag." The report concludes that "in situations in which extended wakefulness is necessary and sleep must be curtailed, limited use of stimulant medication may be appropriate on a voluntary basis."

The report provides findings regarding the use of three specific categories of stimulants:

-- Caffeine: considered the first stimulant option at doses of 100 mg to 200 mg (the equivalent of about eight ounces of brewed coffee). Increased levels of tolerance due to its common and often habitual use, however, may reduce caffeine's effectiveness when suffering from sleep deprivation. Side effects include increased heart rate and jitteriness at high doses of 600+ mg.

-- Amphetamines and methylphenidate (Ritalin^®): both classified as having a high potential for abuse. Amphetamines in particular may cause dependence and side effects, although they do promote alertness, performance and mood at doses of 10 mg to 20 mg. Ritalin^® may also reduce the effects of sleep loss in doses of 10 mg to 20 mg and in higher doses of 60 mg for people with narcolepsy.

-- Modafinil (Provigil^®): has been found to improve performance measures such as reaction time, alertness and memory over extended periods of sleep deprivation at repeated doses of 100 mg to 300 mg. Although modafinil is classified as having a low potential for abuse and has shown no severe side effects, safety data for this relatively new stimulant are lacking.

The American Academy of Sleep Medicine (AASM) is a professional membership organization dedicated to the advancement of sleep medicine and related research.

The AASM's mission is to assure quality care for patients with sleep disorders, promote the advancement of sleep research and provide public and professional education. Visit www.aasmnet.org for more information.