January 10, 2006
We Really Are Out Of It The First 10 Minutes After Waking

In the first minutes after waking up our brains function worse than when drunk or severely sleep deprived.

A new University of Colorado at Boulder study shows that people who awaken after eight hours of sound sleep have more impaired thinking and memory skills than they do after being deprived of sleep for more than 24 hours.

The study showed test subjects had diminished short-term memory, counting skills and cognitive abilities during the groggy period upon awakening known as sleep inertia, said CU-Boulder Assistant Professor Kenneth Wright, lead study author. The new study has implications for medical, safety and transportation workers who are often called upon to perform critical tasks immediately after waking, since cognitive deficiencies following 24 hours of sleep deprivation have previously been shown to be comparable to the effects of alcohol intoxication, he said.

The study appears in the Jan. 11 issue of the Journal of the American Medical Association. Study authors included Wright and Adam Wertz of CU-Boulder's integrative physiology department and Joseph Ronda and Charles Czeisler of Brigham and Women's Hospital in Boston, which is affiliated with Harvard Medical School.

"This is the first time anyone has quantified the effects of sleep inertia," Wright said. "We found the cognitive skills of test subjects were worse upon awakening than after extended sleep deprivation. For a short period, at least, the effects of sleep inertia may be as bad as or worse than being legally drunk."

Following six nights of monitored sleep lasting eight hours per night, the study participants were given a performance test that involved adding randomly generated, two-digit numbers, said Wright. Based on the results, the researchers concluded the subjects exhibited the most severe impairments from sleep inertia within the first three minutes after awakening, he said.

The most severe effects of sleep inertia generally dissipated within the first 10 minutes, although its effects are often detectable for up to two hours, according to the study authors.

Studies conducted by Dr. Thomas Balkin and colleagues at the Walter Reed Army Institute of Research in Washington, D.C., have shown cortical areas of the brain like the prefrontal cortex take longer to come "on-line" following sleep than other areas of the brain, Wright said. The prefrontal cortex is thought to be responsible for problem solving, emotion and complex thought.

People who have to suddenly do critical work upon waking are prone to making potentially lethal mistakes in those first minutes.

The CU-Boulder study has implications for medical professionals who are often called on to tend patients in crisis on a moment's notice, often at odd hours, Wright said. Medical residents, for example, who may work 80 hours or more per week and who "catnap" at times, could be prone to make simple math mistakes when calculating dosages of medicine during bouts of sleep inertia, he said.

The results also have implications for emergency medical technicians and firefighters who may be hastily awakened and called upon to drive a vehicle to an emergency scene, putting themselves and others at risk, said Wright. The study also has implications for commercial truck drivers, who frequently pause for quick naps in their vehicles' sleeping berths during cross-country excursions, he said.

We should avoid having intellectually difficult problems to solve upon awaking. We should also structure our immediate environments around beds to not require any great cognitive effort to safely navigate.

Share |      Randall Parker, 2006 January 10 10:10 PM  Brain Sleep


Comments
Sleepy said at January 11, 2006 8:35 AM:

I'm thinking you must have written that first line in your first ten minutes awake. :)

Jake said at January 11, 2006 9:13 AM:

Everyone on the planet knows that. Why are the authors surprised at the results? Haven't they heard of people drinking coffee when they awaken?
Another blinding flash of the obvious.

fub said at January 11, 2006 10:04 AM:

We should avoid having intellectually difficult problems to solve upon awaking. We should also structure our immediate environments around beds to not require any great cognitive effort to safely navigate.

Um, how about we should avoid having to solve intellectually difficult problems that have potential for bad results if not well solved? Maybe trying, say, to prove Goldbach's conjecture immediately upon wakening would bring all those cognitive areas of the brain on-line more quickly.

I can't disagree about having a safely navigable area for sleeping though. Nothing like waking and stumbling over one's own houseslippers on the way to the coffee pot.

Robert Schwartz said at January 11, 2006 10:57 AM:

And how many taxpayer dollars went into that little tid-bit of knowledge?

crush41 said at January 11, 2006 2:04 PM:

The most severe effects of sleep inertia generally dissipated within the first 10 minutes, although its effects are often detectable for up to two hours, according to the study authors.

While the findings are plainly intuitive, the retarded cognitive functioning that lasts for two hours has implications for primary schooling. 'Office hours' for junior high and high school teachers should be structured by the intellectual rigor required for their respective subjects. All physical ed teachers should have class first and second hour--presumably physical activity would, if anything, attenuate the just-awakened effect. Conversely, give math and science teachers at least the first hour of the day off for office time so that they aren't lecturing to zombies.

curious george said at January 12, 2006 1:03 PM:

I knew I wasn't just being a baby about how terrible I feel right after waking up! I can't stand it when someone wakes me up and immediately asks me to make decisions. It makes me so grouchy! Now, I have science on my side to be left alone when I first wake up :)

momochan said at January 12, 2006 1:30 PM:

Robert, I agree that we taxpayers shouldn't have to pay for the obvious. But if a fancy scientific report is what it takes to bring some sanity to the schedule of health care professionals, particulary physicians in training, then so be it. If even only a few of the stories about interns working for 3 days straight are true, then lives are at stake.

John S said at January 12, 2006 8:23 PM:

If people who just woke up made much more critical mistakes that others, this should have shown up ages ago in workplace safety studies and dealt with appropriately. Maybe it did, maybe it didn't, I just don't see how this study could have added anything that's both new and true...

Randall Parker said at January 12, 2006 9:38 PM:

John S,

Lots of studies have shown that medical doctors deprived of sleep make fatal decisions. Heck, one such study even showed they get into more fatal accidents on the way home. In spite of this teaching hospitals oppose ending the practice of having doctors work for whole days. Of course these same places are going to expect catnapping doctors to immediately make decisions on rising.

So I agree with momochan on the necessity of these sorts of studies. Lives really are at stake and vested interests oppose changing practices based on the truth. We need lots more evidence to make it hard to deny the obvious.

Gerard Eichner said at January 16, 2006 2:45 AM:

Nothing like an upsurge of adrenalin (or epinephrine as it is re-baptised) triggered by a crash-call to bring the brain on-line; it's definitely uptime! Training and repetition ensures the 'autopilot' can kick in and runs adequately and the suspension of critical functions is compensated(if neccessary) by a team approach. If the intern's brain can't wake up : change job; pathologist comes to mind...Who needs this piece of research and are they critically sure it's not just 7 minutes ( or maybe 12) before the green light is on? I intuit there may be inter-individual as well as intra-individual differences.
The fatal accidents on the way home were not after 8 hours of sleep, but prolonged sleep-deprivation...http://www.portfolio.mvm.ed.ac.uk/studentwebs/session4/23/doctors.htm
Bonne nuit

Maria Tobia said at November 23, 2009 7:08 AM:

Hi all I am an attorney and I have a case during which this issue may come up as part of our defense; the issue actually came to me when I was awoken out of a deep sleep a few nights- ago and I had one of these non-cognitive or dimished congnitive moments; afterwards I though about my client and his case and now today I did a google search and found this brief article- ANY ADDITIONAL INFORMATION- including scholarly articles and links to them (preferably for free as my client is indigent and I am assigned to represetn him) and the names and contact information for experts in this field.
ANY help at all would be greatly appreciated.
Thanks-
Maria Tobia
p.s. If you would like to learn about me at all my website is www.acquittalverdicts.com

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