Maintenance of Mental Alertness During Total Sleep Deprivation of Short Duration: A Double Blind, Placebo Controlled, Comparative Study Between Modafinil 100 mg and 200 mg

Introduction: Short duration sleep deprivation is a more practical eventuality in military air operations. Efficacy of oral administration of single dose of 100 and 200 mg Modafinil, on maintenance of mental alertness following 18-h of continuous wakefulness extending to 24-h was examined. Methods: In a double blind, crossover, placebo-controlled, repeated measure design, seven healthy male participants (with each 'case' serving as his own 'control'), were assessed for their mental alertness and subjective perception of sleepiness and fatigue in an extended period of wakefulness of 24 hours. In addition, feedback was obtained on known untoward effects of Modafinil through a questionnaire. Results: A significant main effect of sleep deprivation was observed on mean reciprocal reaction time with a significant interaction effect between the two main effects (sleep deprivation x drug intervention). There was a significant increase in the number of lapses with sleep deprivation, which was not found significant with administration of Modafinil. These effects were more observable with 200 mg Modafinil than 100 mg. Subjective perception of sleepiness and fatigue were significantly increased with Placebo and 100 mg Modafinil, which was not found significant with 200 mg Modafinil. The occurrence of untoward effects with Modafinil was no more than that with Placebo. Discussion: Several researchers have expressed the requirement of exploring the possibility that a lower dose of Modafinil, which will be relatively free from side effects, may also be effective in the maintenance of performance. Whereas, this may be true for long duration sleep deprivation requiring multiple doses of drug intervention, for mission demanding forced wakefulness of 24 h, single dose of 200 mg Modafinil appears to be a better option. Conclusion: Administration of Modafinil in a dosage of 200 mg is more effective than 100 mg in maintaining mental alertness and improving subjective sleepiness and fatigue during short duration total sleep deprivation.