Sleep When You're Dead

A new drug promises productivity in a pill

| January / February 2004

Americans aren't getting enough sleep. The simple solution would be to get more rest, but another response to the problem is being offered by the pharmaceutical industry. It's called Provigil, a drug that's been used for several years to treat serious sleep disorders like narcolepsy and now has been approved for wider use.

Provigil's claim to fame is that it keeps you awake. Marketed in the United States by Cephalon, the drug is said to be a stimulant with fewer side effects than amphetamines, Ritalin, or even the old over-the-counter standby, caffeine. The word is that Provigil (short for 'promotes vigilance') has virtually no impact other than the desired alertness. Lacking any euphoric buzz or kick, it is not expected to become a recreational drug. But it could become a lifestyle drug, prescribed for nonmedical conditions -- like 'curing' sleep.

Provigil was first approved in 1998 for treating narcolepsy, a serious disorder marked by a debilitating tendency to fall asleep without warning. In the fall, the U.S. Food and Drug Administration added two new syndromes for which doctors can prescribe the drug: One is sleep apnea, which can wake people up so often at night that they're fatigued during the day. The other is known as 'shift work sleep disorder,' which according to one description 'consists of symptoms of insomnia or excessive sleepiness that occur as transient phenomena in relation to work schedules.'

Provigil has not yet been approved as an all-purpose pick-me-up that doctors can prescribe as they see fit, but that could be on the way. Then what? In a busy society that already views all idleness as a waste of time, if not a disease, it will become even harder to appreciate that rest and sleep are often cures themselves.

Given its stimulant effect, Provigil is also being touted as a possible treatment for attention deficit hyperactivity disorder (ADHD). But according to Jason Williams in Psychology Today (July 2003), a Brown University study revealed that sleep deprivation may result in ADHD-like symptoms. 'Reducing hyperactivity and impulsivity in some children may be as simple as putting them to bed,' notes Williams. With between 4 and 12 percent (3.8 million) of school-age children estimated to have ADHD, something as simple as more sleep may be the key.

But the real market for Provigil may be not as a treatment but as an en-hancement -- a substance that makes well people even better. The drug is already being called one of the first in a new class that promotes 'wakefulness.' David Plotz, writing for the online magazine Slate, tested the drug and kept a daily diary. On Day 1 he went from alert to incredibly attentive to grinning like a 'feral chipmunk.' He ended the day dreaming of 'Getting Things Done.'

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