Remaining Questions and Research Needs

As the above brief review indicates, very little systematic study has been done to address any of the many countermeasures reported to be beneficial to individuals experiencing sleep loss. Studies comparing the effectiveness and duration of the various countermeasures are critical to defining their use. It is only after these two questions are answered that any particular countermeasure can be appropriately used. Will the countermeasure help the sleepy driver get to the next exit or all the way home  

It seems apparent that people adapt to shortened sleep times and fragmented sleep and the question is what countermeasures are being employed, how effective are they, and what risks remain To thoroughly understand these issues, parametric analyses of the various countermeasures would be quite helpful and 

The literature on countermeasures, while incomplete and limited, suggests that most of the countermeasures studied have small and time-limited capacities to counteract the impact of sleep loss. The most difficult problem for any of the various countermeasures is the inevitable adaptation that occurs to their alerting effects. Ultimately the most effective countermeasure to sleep loss is sleep. 

Second to sleep as a countermeasure is knowledge. People tend to underestimate the impairment and risks associated with sleep loss and to overestimate the effectiveness of any given countermeasure. Risks increase when individuals are sleepy, working and driving in isolation, in a quiet darkened environment, and on long, boring tasks and roads. When one is sleepy, the potential of any countermeasure is limited in effectiveness and duration but knowledge about these facts can be a countermeasure. 

This study was supported by National Institutes of Health grants R01AA07147, R01-DA05086 awarded to Dr. T. Roehrs and R01-MH59338 awarded to Dr. T. Roth. 

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