Stay Awake

Caffeine (oral, nonprescription) Avoid the use of oral caffeine-containing products to stay awake if tiiere is a history of heart disease high blood pressure, or stomach ulcers. These products are intended for occasional use and should not be used if heart palpitations, dizziness, or light-headedness occurs. 

Sensory and motor capabilities severely affected problems staying awake difficulty... 

A 7-year-old boy arrives at the emergency department asleep in his father s arms. The boy s mother explains that the boy spent the night throwing up and experiencing severe diarrhea. She is concerned about the vomiting and his inability to stay awake. History indicates the boy was healthy yesterday, but became ill at dinnertime after spending time playing in the... 

Paradoxical intention focuses on staying awake as a means of diminishing performance anxiety. 

We have things that help us to remain alert. Caffeine in coffee and in tablet form prevents dozing and sleep, as do some prescription drugs. Unexpected stimuli, including noise and even pain, can help, and sometimes aerobic exercise. A useful distinction here is between staying awake and enhancing awareness. 

Drugs that alter sleep produce their effects on the brain by altering the actions of neurotransmitters and consequently how neurons communicate with each other. However, different drugs can alter the actions of neurotransmitters in different ways. Stimulants such as amphetamine cause neurons to release excess amounts of neurotransmitters like dopamine and serotonin. Other drugs, such as the prescription sleeping pills Halcion or Ambien or antihistamines, can interact directly with the neurons receptors to either enhance or block the effects of the neurotransmitters. In later chapters, we will discuss how drugs that help you sleep or stay awake alter the chemistry of the brain. 

Most over-the-counter sleep aids are relatively mild and can be used effectively to treat temporary sleeping problems such as insomnia. However, when insomnia is persistent and results in sleepiness during the day that disrupts your ability to perform at work or stay awake in class, it may be necessary to obtain a doctor s prescription for a more potent sleep aid. Prescription sleep aids are often referred to as hypnotics and they decrease the time it takes to fall asleep and keep you asleep longer. 

Although most of this chapter has focused on prescription sleep aids, there are a few prescription medications available to help you stay awake. The most commonly used OTC stimulant is caffeine. However, people with the sleep disorder narcolepsy are very sleepy during the day (no matter how much sleep they get) and often require prescription stimulants to alleviate their sleepiness. Stimulants are also prescribed for the treatment of attention deficit/hyperactivity disorder (ADHD, sometimes called ADD), asthma, and obesity. 

The South American coca plant has been used by indigenous cultures for many years in religious ceremonies and as an aid to staying awake on long hunting trips. Leaves are either chewed or ground to a powder that is inhaled nasally. 

Body movement also supplies a type of loading, if you move your body, it has a certain feel to it. The kinesthetic feedback information on the relation of parts of your body and on muscle tensions as you move is within an anticipated range, if your arm suddenly felt three times as heavy as usual when you lifted it, this again would disrupt your ordinary d-SoC. Conversely, if you felt sleepy but did not want to enter the d-ASC of sleep, getting up and moving around would help you stay awake. 

While the drugs soothed children with the condition now known as attention deficit hyperactivity disorder (ADHD), most people experienced a completely different reaction to amphetamines. The drugs gave them more energy and helped them to stay awake. 

During the 1970s, amphetamines accounted for 8% of prescriptions in the United States. In addition to dieters, other amphetamine users included long-distance truck drivers and college students. Both groups took the pills to stay awake. 

Shift workers have a similar difficulty in trying to stay awake at a time when they would normally be asleep. Nurses working an evening shift may start to get sleepy while they are still at work, while those on the morning shift may have a great deal of difficulty getting up well before dawn. 

Another use of the hallucinatory experience is to help the victim of a crime find the perpetrator. For example, if a robbery has occurred, the curandero listens while another person ingests the plant. It is believed that the intoxicated person will divine the nature of the deed that was done. Shamans also use Salvia divinorum to find lost animals and objects. After taking a dose under the supervision of a curandero, the person who has lost something goes to sleep in the presence of one other person, who stays awake. The sleeper speaks in his sleep, while the other listens. It is believed that the sleeper will tell the other one the location of the lost item. The next day they go to find it. 

Sleep disorders are common, and are generally underdiagnosed. The two major complaints related to sleep are insomnia ( I can t sleep ) and excessive daytime sleepiness (EDS, I can t stay awake ). EDS is a relatively nonspecific symptom. It can be the end result of any factor that causes sleep disruption, and it can be caused by primary or intrinsic sleep disorders. Insomnia of any cause can result in sleep deprivation and subsequent EDS. The most common cause of EDS in the general population is self-imposed sleep deprivation, or insufficient sleep syndrome. By contrast, the most common causes of EDS seen in a sleep center are primary (intrinsic) disorders of EDS. The American Academy of Sleep Medicine (AASM, formerly the American Sleep Disorders Association) classification of sleep disorders includes over 80 diagnoses that are associated with EDS, but the majority of patients evaluated at sleep centers have sleep apnea, narcolepsy, idiopathic hypersomnia, or periodic limb movements of sleep. 

The Maintenance of Wakefulness Test (MWT) was developed as an alternative, physiologically based test of sleepiness (1). The test was designed for use with patients whose sleepiness during the day might adversely affect performance or safety. Reasoning on the basis of face validity, a person who has little difficulty with falling asleep inappropriately should be able to stay awake in a quiet, sedentary situation such as during MWT trails. Beyond the procedure s face validity, there are other rationales for the use of the MWT, as discussed below. 

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