to "wake enhancement" Sleep better than medicine? Ethical issues related

ABSTRACTThis paper deals with new pharmacological andtechnological developments in the manipulation andcurtailment of our sleep needs. While humans have usedvarious methods throughout history to lengthen diurnalwakefulness, recent advances have been achieved inmanipulating the architecture of the brain states involvedin sleep. The progress suggests that we will graduallybecome able to drastically manipulate our natural sleep-wake cycle. Our goal here is to promote discussion on thedesirability and acceptability of enhancing our control overbiological sleep, by illustrating various potential attendantethical problems. We draw attention to the risks involved,possible conflicts of interests underlying the developmentof wake enhancement, and the potential impact onaccountability for fatigue related errors.THE WAR ON SLEEPThis paper aims to explore ethical issues related toemerging forms of ‘‘wake enhancement’’. We usethis term to indicate those methods that enhancediurnal wakefulness by rendering more controlover when and how much (or rather, how little)we sleep. This includes a broad range of meansapplied by humans, ranging from meditation toartificial lighting, the consumption of cocaine andamphetamines, caffeine, alcohol, nicotine andincreasingly accurate pharmacological alterationsof the sleep-regulating areas in the brain.One stimulant that has attracted particularinterest in recent years is modafinil. Studiessuggest that this drug can help achieve up to48 hours of continued wakefulness, significantlyincreased vigilance, alertness and perceptual/cog-nitive performance.