The Need to Sleep versus The Need to be Awake

Though most shiftworkers are focused on getting sleep, time and resources are being expended on how to keep people awake and perhaps even forgo sleep completely.

Obviously, being alert at work and while driving is critical. Fatigue and lapses in alertness greatly increase the risk of errors and accidents and these exact a huge cost in accidents and medical care. Workers, therefore, are encouraged to get quality sleep in sufficient quantities to ensure that they remain alert and safe.

In some occupations, however, the need to be alert extends beyond the usual 8 or 12 hours of a shift. International and military pilots fall into this category. Unusual efforts are made in these instances to ensure that they maintain alertness and in the case of US military pilots, amphetamine use has been endorsed. Currently, the US military is also experimenting with the possibility of staying awake for a week at a time. This is an effort to entirely overcome the body’s need for sleep and the restorative effects it offers.

Is it possible that shiftworkers in more ordinary circumstances will be required to undertake the same extraordinary measures to maintain alertness? Perhaps not yet. We have not yet been able to overcome our need for sleep, as was shown by the soldiers in the Iraqi war who were subjected to long periods of sleep deprivation and who resorted to random napping to compensate. However, for the first time a drug has been approved in the United States for use in overcoming sleepiness associated with shift work sleep disorder.

This measure indicates that we are focusing our interventions away from finding the sources of the sleepiness and providing strategies to promote sleep. Instead, we are implementing strategies that simply overcome the sleepiness. Most shift workers are familiar with strategies for maintaining short term alertness, but is it advisable, in the long term, to maintain alertness through these methods? Or should getting enough sleep still be the best answer for ensuring alertness?