The bright young 33-year-old doctor had just finished a hard night on duty at his Suffolk England hospital, adored by his department. Dr. Ronak Patel was looking forward to finally getting some well-deserved rest after three long grueling night shifts in a row. The young doctor got behind the wheel of his automobile just before 9:00 a.m. to begin the 40-mile commute home.
Ronak used his hands-free phone to contact his wife Helen, who was exhausted after his all-nighters. Ronak and Helen began singing to each other over the phone to keep him from falling asleep at the wheel, despite the fact that he was only a few kilometers from home. Ronak's voice abruptly halted due to Helen's singing in time. Helen tried to contact him 14 times after the phone line went dead. She grabbed her keys and started driving the road from their house to Ronak's hospital. She was stopped by police who were erecting barriers at the scene of a car accident about 3 miles from her home.
Even while singing to his wife, the young doctor had slipped out of his lane, colliding head-on with an incoming transport truck in his little Volkswagen Gulf. Despite actively singing aloud to his wife while negotiating the serpentine bends of the road, the young doctor succumbed to sleep barely minutes from his house, according to the results of the inquiry into the young doctor's death.
Nothing else matters when the brain requires rest. The capacity of the brain to "pull its own plug" is a crucial adaptation for human survival - if darkly ironic in the instance of falling asleep behind the wheel. Life may be fascinating and thrilling, and we can readily believe that it was also perilous for our forefathers. The capacity to stay awake for long periods of time in order to ward off predators, eat, locate mates, or care for children would be a huge evolutionary benefit. Yet it is precisely for this reason – our desire to never fall asleep – that the brain has developed the necessary physiological adaption to perform a self-shutdown.
As we all know, sleep starts with a sensation of drowsiness or grogginess, which is often triggered by natural circadian rhythms that follow the regular cycles of night and day. The optic nerve detects the start of darkness and sends messages to the hypothalamus in our brain, which then sends signals to the small pineal gland, which triggers the production of melatonin. Melatonin, in turn, triggers a series of signals (and reactions) that begin the process of putting the brain and body into sleep mode. Once we get these subtle sleep signals, we, like our predecessors before us, begin to feel the need to shift into a comfortable posture for our nightly slumber.
This exquisite chemical cascade is all but fiction for the 9.5 million American shift workers and many more who suffer from disrupted circadian rhythms. Our modern-day environment and sleep deficiencies are leading in genuinely nightmare-like outcomes as life and work get in the way of flawless fairy-tale circadian rhythms that follow sunsets and sunrises.
The need for sleep is not a difficult idea to grasp. We grow increasingly weary the longer we remain up. It starts with astrocytes, which produce adenosine, a neurotransmitter that decreases alertness and wakefulness while making us sleepy. The link between adenosine and the urge to sleep is thus linear, meaning that the longer we stay awake, the more adenosine accumulates in our brain and the stronger our want to sleep. Adenosine levels drop fast after we sleep, diminishing our urge to sleep.
Our homeostatic sleep drive is a basic connection that is one of the most powerful systems in the body, so powerful that our brain will not accept "no" for an answer when it comes to our desire for sleep. When we try to disregard our homeostatic sleep drive by staying awake, our brain might start to act like a sputtering engine, "stalling" for a brief while as it tries to keep functioning in a damaged condition. These brief "stalling" episodes are known as microsleeps, and they last 1–2 seconds, during which we fall asleep while fighting to stay awake.
Surprisingly, we may not even be aware that we are having microsleeps since our conscious self is too cognitively "damaged" to recognize what is going on. In the wrong atmosphere, like in the instance of young Dr. Patel, this might have devastating effects. Consider the consequences of a 1–2 second slumber. A automobile moving at 65 miles per hour on the highway will cover 190 feet in 2 seconds. In most cases, a car lane offers only a few feet between one vehicle and opposing traffic, making even a 1-second microsleep deadly. Despite our brain's capacity to shut down on its own, many of us believe we have control over our drowsiness.
Much of this myth may be based on the "necessity of the moment" concept, which holds that life-or-death duties that need a lot of concentration (such as driving a car) would outweigh any urge to sleep. Despite our want to assume that we can keep ourselves awake at any costs, the evidence suggests otherwise.
Over a third of automobile drives home following night shifts ended in near-collisions, according to a study by the National Academy of Sciences. Half of the shift workers in the study (who were assessed after a night shift) were eventually stopped by the researcher's backup passenger-seat floor brake and were unable to continue the driving session due to a brief loss of vehicle control. The findings of this research are noteworthy. Not only does pushing through sleep deficit endanger shift workers, but it also endangers everybody who shares the road with them.
Result
To be true, we have a long history with sleep and wake aids, but we don't appear any closer to a readiness to learn from our mistakes, unless that desire includes developing better pharmaceuticals. However, the nature of medications themselves acts as a counterforce to such pharmacological illumination. With the introduction of new, less addictive forms, our acceptance of drug-induced (low and high) energy may become more widespread.
Our ancient physiology requires little tweaking at its core – and when we fail to respect that, whether driving home from an all-nighter while singing to stay awake, forcing ourselves out of bed for early school bell times, or sleeping with our glowing and buzzing phones beside our pillow, our hardwired brain and bodies will tolerate only so much interference before taking control of our biological needs and forcing us to shut down.
Long-term performance isn't something you can take in pill form. Despite this, our short attention spans, exacerbated by our world of immediate information, have resulted in a slew of new modern health risks that we must confront head-on.