Restoration of risk-propensity during sleep deprivation: Caffeine, dextroamphetamine, and modafinil

William D.S. Killgore, Nancy L. Grugle, Desiree B. Killgore, Brian P. Leavitt, George I. Watlington, Shanelle McNair, Thomas J. Balkin

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Introduction: Sleep deprivation alters risk-related judgments, decision-making, and behavioral control. Stimulant medications are used to restore cognitive performance, but their effects on risk-taking and judgment in sleep-deprived subjects have not been explored. Methods: There were 54 healthy adults (29 men, 25 women; age range 18 to 36) who completed a test of cognitive ability and daily measures of risk-taking propensity, including the Brief Sensation Seeking Scale (BSSS), Evaluation of Risks (EVAR) scale, and the Balloon Analog Risk Task (BART). Following 44 h of continuous wakefulness, participants ingested caffeine 600 mg (N = 12), dextroamphetamine 20 mg (N = 16), modafinil 400 mg (N = 12), or a placebo (N = 14) in a double blind manner, and completed risk-taking measures 2 h later (i.e., 0535). Results: Relative to rested baseline, the placebo group showed a decline in risk-taking as measured by the BSSS (16% decline), EVAR Danger Seeking (32% decline) and Energy (22% decline), and BART (32% decline), consistent with previous reports of the effects of sleep deprivation. Comparisons among drug conditions showed that dextroamphetamine restored risk-taking propensity and risky behavior to baseline levels, an effect that was significantly greater than placebo or caffeine for several indices of risk-taking, but which did not differ from modafinil. Cognitive ability was significantly correlated with changes on some risk-taking indices following stimulant administration. Conclusions: Stimulant medications, particularly dextroamphetamine, sustained risk-related attitudes and behavior during continuous wakefulness. The extent to which stimulants restore other aspects of judgment during sleep loss remains to be determined.

Original languageEnglish (US)
Pages (from-to)867-874
Number of pages8
JournalAviation Space and Environmental Medicine
Issue number9
StatePublished - Sep 2008


  • Caffeine
  • Dextroamphetamine
  • Modafinil
  • Risk
  • Sleep deprivation
  • Stimulants

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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