What is the maximum time duration to stay awake without sleep?

Randy Gardner set a record when, at age 17, he became the longest sleeper, staying awake for 11 days and 25 minutes, on a high school project in California in 1963.

Other people have reportedly broken this record, with Robert MacDonald going for 18 days and nearly 22 hours without sleep in 1986, but none of them were monitored as closely or by a doctor like Gardner.

The Guinness Book of World Records no longer covers this work. In 1997 they stopped accepting new applications because of the “inherent dangers associated with sleep deprivation”.

What are these dangers? What happens to people who suffer from prolonged sleep deprivation?

Sleep is essential for executive, emotional, and physical functions, and insufficient sleep may increase your risk of many health conditions, including diabetes, heart disease, obesity, and depression, according to the Centers for Disease Control and Prevention.

Experts say humans need a consistent six to eight hours of sleep in the same 24-hour period.

But it is not uncommon for some, especially students, to stay up all night or even for 24 hours.

In this stage of sleep deprivation, it can be difficult to distinguish between sleep and wakefulness, said Dr. Oren Cohen, a sleep medicine fellow at Mount Sinai Hospital in New York City.

Cohen said that when someone approaches going 24 hours without sleep, their brain activity is already showing signs that they are on the verge of falling asleep and awake, even though they appear to be awake.

This is called sleep intrusion or partial sleep.

“People who skip hours of sleep appear awake, but their brains involuntarily go into a type of abnormal sleep, which can include periods of inattention or Hallucinations. But sleep takes over, and the brain inevitably goes to sleep. And when someone tells me they haven’t slept in weeks, it’s almost impossible.”

Cohen noted that it can be difficult to determine exactly how long people can go without sleep and the timeline for side effects that unfold.

Avedon reported that chronic sleep deprivation, when an individual does not sleep for a prolonged period, is so devastating that it would be unethical to research it in humans. It was even used as a form of psychological torture.

Although prolonged sleep deprivation cannot be studied, we do have data on people with a rare genetic disease called fatal familial insomnia (FFI). These patients have a genetic mutation that causes an abnormal protein to build up in the brain and gradually worsens sleep.

Their bodies begin to deteriorate and eventually they die because the abnormal protein builds up and damages brain cells. The disorder kills most patients within 18 months, on average.

In animals, a 1989 rat study showed that animals can only go without sleep for 11 to 32 days before it kills them.

And a 2019 human study published in the journal Nature and Science of Sleep found that participants’ alertness was relatively normal up to 16 hours of sleep deprivation. But after 16 hours, the rate of attention lapses increased significantly and was worse for the participants with chronic insomnia.

A study from 2000 also found that staying awake for 24 hours reduces hand-eye coordination on a par with a blood alcohol content of 0.1%.

The effects of 24-hour sleep deprivation included reduced reaction time, slurred speech, impaired decision-making, decline in memory and attention, irritability, visual impairment, and hearing and hand-eye coordination, according to the Cleveland Clinic.

And the “Cleveland Clinic” reported that within 36 hours, people who suffer from sleep deprivation may record an increase in inflammatory markers in their blood and even develop hormonal disorders and slow metabolism.

There is little research on what happens in 72 hours, but people can experience anxiety, depression, hallucinations and problems with executive function.

Research conducted on US physicians showed that poor sleep increases fatigue and self-reported medical error.

A 2021 study published in the Journal of Medical Education showed “greater impulsiveness, slower cognitive processing, and impairment in executive function” compared to before their 26-hour shift.

Shift workers are also at high risk of the consequences of poor sleep because they tend to get insufficient sleep, cannot always fall asleep at the same time, and must often fall asleep while the lights are on, which interferes with the normal human sleep-wake cycle.

It is important to know that you cannot make up for sleep deprivation the next day or over the weekend.

Sleep deprivation is cumulative, so those who don’t sleep incur a kind of sleep debt. For every hour of sleep lost, Avedon said, it takes a full eight hours of sleep to recover.