Sleep Deprivation: Effects on Behavior, Thinking, Motor Performance, and Biological Energy Transfer Systems

The effect of sleep deprivation on behavior, thinking, motor performance, and biological energy transfer systems was studied in a single subject who remained awake without drugs for 220 hours. Behavioral changes included irritability, paranoid thinking, expansiveness, grandiosity, hypnagogic states, visual hallucinations, and episodic rage. Deficits in thinking and visual-motor performance occurred cyclically across days of wakefulness, with gradual deterioration finally resulting in virtual untestability on the ninth day. Energy transfer systems responded to sleep deprivation as a stressor with a marked increase in the specific activities of ATP, AMP, and F-1,6-P; this was eviden on the fourth day. For the first time in out laboratories, radioactive phosphorus was observed in AMP, a reflection of increased synthesis of this substance from adenine ribose-I-phosphate, and phosphate. This emergency energy mobilization began to fail by the seventh day, when the specific activities of all the adenylic phosphates fell appreciably. Conceivably the energy transfer system respond to a stressor in a manner similar to the pituitary adrenal axis, passing through stages of alarm, resistance, and exhaustion. The relationship of disturbances in these systems (associated with the most fundamental cellular processes) to various disease mechanisms is under investigation in our laboratories.