STORY BYCoffee. No-Doze. Red Bull. Ginseng. Caffeine gum. Cold showers.
Students studying for exams will do almost anything to keep cramming into the wee morning hours. A few will even go to dangerous extremes to stay awake, using prescription drugs like Ritalin, Adderall or other-less legal-stimulants.
How old school.
The newest way to beat the clock doesn't give you the jitters, is not physically addictive and can keep you up for 10 to 15 hours at a stretch. The drug modafinil is so effective at staving off sleep, yet has so few side effects, that many doctors predict it will become enormously popular with type-A college students.
"Since the drug has fewer side effects than traditional stimulants, the concern is that more students may use it to get an edge over their peers, to stay up later and study harder so that they can get a better grade on a test," says Dr. Andrew Harper, associate professor of psychiatry and behavioral sciences at The University of Texas Medical School at Houston.
The drug is also gaining popularity with athletes wanting to train longer as well as harder. Six American track and field athletes have tested positive for modafinil, which is banned by the United States Olympic Committee.
"It is seen as a new type of performance-enhancing drug, not only for the body, but for the mind." says Harper who is also medical director of the UT Harris County Psychiatric Center.
Modafinal, sold under the name Provigil, targets a more specific area of the brain than stimulants, eliminating the "wired" feeling common with that class of drugs.
The drug works on the hypothalamus, the area of the brain that regulates sleep. Modafinal uses the opposite action of sleep-inducing drugs like antihistamines, found in cold medicines, and gabba agonists, found in alcohol and barbiturates.
Traditional stimulants also stimulate the pleasure centers of the brain, which can make them addictive. Modafinal's lack of a "high" coupled with its long onset of action (1-2 hours to take effect) make it less likely to be abused by late-night partiers.
"Modafinal doesn't really give you a buzz," says Dr. Richard Castriotta, professor of medicine and associate director of the Division of Pulmonary, Critical Care and Sleep Medicine. "You also don't crash like you do with amphetamines. You don't experience a sharp peak action and then a sharp decline."
Castriotta is studying the effects of modafinil as a treatment for patients with traumatic brain injury who can't stay awake. The drug is FDA-approved to treat narcolepsy, sleep apnea and sleep problems caused by shift work, and is being studied for non-sleep related problems including attention deficit hyperactivity disorder.
However, like any drug, doctors can prescribe modafinil for reasons not approved by the FDA, called off-label usage.
"I can envision it as a drug used by students and doctors," Castriotta says. "It is not the kind of drug people would use for pleasure, but it can be used for people who need to stay awake to study, to travel, or for those who need to accomplish more with less sleep."
While modafinil is not physically addicting, a person can become emotionally dependent on the drug.
"Some individuals are at greater risk for being psychologically addicted," Harper says. "If they think that the drug is helping their performance then they will be much less willing to give it up."
Continued use of the drug also can cause sleep deprivation, which can weaken the immune system, increasing the risk of illness. Lack of sleep also affects judgment, and can be dangerous if you are performing complicated tasks like driving a car. The feeling you get when don't get enough sleep is similar to drunkenness.
"College students tend to underestimate the risk of sleep deprivation," Harper says. "Ultimately, you can't go on forever. Even if you are awake for as short a period as 18 hours, your performance will suffer."
Is modafinil a Pandora's box for people seduced by the idea of living the 24-hour life? Or is it a true panacea for people with serious sleep problems? Castriotta believes it is a little of both.
"Modafinal is clearly the drug of choice for narcolepsy and excessive sleepiness due to brain injury," Castriotta says. "It is a Godsend to patients with these problems and has made a big difference in the treatment for serious sleepiness syndromes."
The drug's non-addictive quality, also makes it a good choice for people who would put themselves and others at risk if they fall asleep at the job, like truck drivers or pilots. For example, the pilots who flew the first bombing missions to Afghanistan took Provigil to stay awake on the long transatlantic flight.
But the drug has limits, he warns. No one can cheat sleep indefinitely.
"It would be dangerous to think that you could have a chemical substitute for sleep," Castriotta says. "We still don't know all the reasons we sleep and why it is important."
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Dr. Andrew Harper is associate professor of psychiatry and behavioral sciences at the UT Medical School and medical director of UT Harris County Psychiatric Center.
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Eating healthy
reverses metabolic syndrome
Dr. Tasnime Akbaraly of University College London and her colleagues were interested if healthy eating could actually turn-the-tide and reverse metabolic syndrome, which is having 3 or more of the following risk factors: excess abdominal fat; high triglycerides, hypertension, low levels of HDL the “good” cholesterol, or type 2 diabetes. Having metabolic syndrome doubles a persons’ risk of heart disease and greatly increases the odds of developing type 2 diabetes.
The researchers studied 339 British civil servants with metabolic syndrome, and how closely the adhered to the Alternative Healthy Eating Index (AHEI) to see if it could help reverse metabolic syndrome. The AHEI is a set of published nutritional guidelines by the Harvard School of Public Health in 2002 that emphasizes whole grains, fruits, vegetables and decreased red meat consumption.
Five years into the study, nearly 50% no longer had metabolic syndrome. People who followed the AHEI guidelines the closest were nearly twice as likely to have reversed their metabolic syndrome. The results of the study were published in Diabetes Care, online July 29, 2010.
Dr. Alice Lichtenstein, an expert on diet and heart health from Tufts University in Boston who was not involved in the study said, "It's not about focusing on individual components of the diet, it's really the whole package, and that becomes important because it means that if one of the components of a healthy diet is to eat more fruits and vegetables, just buying a pill saying that there's a concentrated extract of fruits and vegetables is probably not what's going to help you."
Call and make an appointment with Wellness Coach Sam Hester, CWC, CPT, LWMC, at 713-500-3327. It's confidential and free. For more information on the wellness services provided, visit UT Counseling and WorkLife Services.
