Sustaining Executive Functions During Sleep Deprivation: A Comparison of Caffeine, Dextroamphetamine, and Modafinil
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OBJECTIVES: Stimulant medications appear effective at restoring simple alertness and psychomotor vigilance in sleep deprived individuals, but it is not clear whether these medications are effective at restoring higher order complex cognitive capacities such as planning, sequencing, and decision making. DESIGN: After 44 hours awake, participants received a double-blind dose of one of 3 stimulant medications or placebo. After 45-50 hours awake, participants were tested on computerized versions of the 5-Ring Tower of Hanoi (TOH), the Tower of London (TOL), and the Wisconsin Card Sorting Test (WCST). SETTING: In-residence sleep-laboratory facility at the Walter Reed Army Institute of Research. PARTICIPANTS: Fifty-four healthy adults (29 men, 25 women), ranging in age from 18 to 36 years. INTERVENTIONS: Participants were randomly assigned to 1 of 3 stimulant medication groups, including caffeine, 600 mg (n=12), modafinil, 400 mg (n=12), dextroamphetamine, 20 mg (n=16), or placebo (n=14). MEASUREMENTS AND RESULTS: At the doses tested, modafinil and dextroamphetamine groups completed the TOL task in significantly fewer moves than the placebo group, and the modafinil group demonstrated greater deliberation before making moves. In contrast, subjects receiving caffeine completed the TOH in fewer moves than all 3 of the other groups, although speed of completion was not influenced by the stimulants. Finally, the modafinil group outperformed all other groups on indices of perseverative responding and perseverative errors from the WCST. CONCLUSIONS: Although comparisons across tasks cannot be made due to the different times of administration, within-task comparisons suggest that, at the doses tested here, each stimulant may produce differential advantages depending on the cognitive demands of the task.
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Amphetamine restored executive functions and psychomotor vigilance test speed following continuous sleep deprivation.
“AMP restored executive functions (Killgore et al., 2009) and psychomotor vigilance test speed following continuous sleep deprivation (Killgore et al., 2006, 2008; Wesensten et al., 2005).”
From Systematic reviews of the acute effects of amphetamine on working memory and other cognitive performances in healthy individuals, with a focus on the potential influence of personality traits (2023) · cites this paper as Killgore et al., 2009
The Discussion reports that dextroamphetamine improved or sustained sleep-deprived performance on the Tower of London task relative to placebo. It also reports different effects across the executive-function tasks, so the unqualified claim that amphetamine restored executive functions is broader than the finding. The psychomotor-vigilance clause cites other papers, not this one; page numbers are unavailable in our copy. (LLM, conf=0.86)
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WHAT PHYSICIANS SHOULD KNOW ABOUT COFFEE
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- Authors
- Killgore, W. D. S., Kahn-Greene, E. T., Grugle, N. L., Killgore, D. B., & Balkin, T. J.
- Affiliations
- Walter Reed Army Institute of Research (US)
- Corresponding author
- Killgore, William D. S.
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-02
- Volume
- 32
- Issue
- 2
- Pages
- 205-216
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC2635585
- OpenAlex
- W2250865
- Cited by
- 132
- References
- 75
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 2 · 2023: 4 · 2022: 8 · 2021: 6 · 2020: 6 · 2019: 11 · 2018: 8 · 2017: 7 · 2016: 6 · 2015: 7 · 2014: 12 · 2013: 11 · 2012: 16
- FWCI
- 15.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- SLEEP (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Defense
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Health Sciences › Medicine › Pharmacology › Coffee research and impacts
- Keywords
- sleep deprivation, executive function, caffeine, d-amphetamine, modafinil, stimulant medication, cognitive performance, Tower of Hanoi, Tower of London, Wisconsin Card Sorting Test, perseverative responding, planning, decision-making
- MeSH terms
- Modafinil, Adolescent, Adult, Central Nervous System Stimulants, Arousal, Attention, Benzhydryl Compounds, Caffeine, Cognition Disorders, Decision Making, Dextroamphetamine, Discrimination Learning, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Male, Neuropsychological Tests, Pattern Recognition, Visual, Problem Solving, Psychomotor Performance, Sleep Deprivation, Young Adult
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