I have heard of medical students and soldiers in war who go for weeks without solid sleep. How do they do this?

Those in residency are actually sleep deprived, and there’s lot of debate over whether continuing to have a program that forces them to be so sleep deprived is really a good idea, because they do have diminished mental abilities.

Maybe they take something like drug/stimulant to get them going without enough sleep. Who knows?

Amphetamines?

Lots of caffeine. Some become drug addicts. They are sleep deprived and do not function at their best.

They do catch cat naps usually. Being on a long shift does not mean necessarily they can’t dose off during down times. It’s important to cycle through all stages of sleep for good rest, usually that is in 1.5 hour time spans for adults, but getting all the sleep atonce in a 24 hour period is not critical. If they can sleep for 3–6 hours and then nap again, they can do that for a long time. Still difficult, but parents with new infants or sick children (God Forbid) do it for months. If they are forced to stay awake more than 36 hours it is a hazard for them and others. Not letting people sleep is used to torture and coerce people in other circustances.

They only do that out of sheer necessity and incentive “to live” (in the case of the soldiers fighting in war) and “to succeed” (in the case of the interns). There’s also group pressure: you don’t want to let your comrades down. If you sleep in or take a day off, the work still needs to be done, only someone else has to pick up your load.

Sailors do this all the time when working watches: four hours on, then four hours off.

As has been noted, there are definite and sometimes severe drawbacks to working this way long term. No one performs optimally when working for long stretches without adequate sleep / rest.

This was the situation for my first combat tour. We pushed ourselves and each other, lots of caffeine. There were lots of drawbacks. Men were making the simplest of mistakes that could have very serious repercussions. I saw guys collapse from exhaustion. Many times I fell asleep standing up.

Some civilian complain our training is too hard, but the hardest training I had was a cakewalk compared to combat.

GA @rts486 When I was in the service the saying was the harder you sweat in training, the less you will bleed in combat. One of the prime reasons to train hard is to instill the SOPs into you so you can do them in your sleep.

Speaking as a former medical student, most of the time when I went with lack of sleep it was because I was at a party.

There is a brain chemistry that allows one to go without sleep for long periods of time. It is associated with bipolar disorder, among other disorders. It is possible to train your mind to experience the world differently and to work differently.

I have no doubt that putting people into situations where they have to do without sleep will change their brain chemistry in a way that makes it easier to do without sleep. If you were bipolar it would throw you into a manic episode. You’d have to hope your mission was over before you crashed.

I was doing 90+ hours a week regularly in the Navy, and let me begin by saying that many Navy people were often less than lucid;often intelligent, but not entirely sane or rational.

How do we perform so well for so long? Not well at all, actually. It often starts with irritability and/or absent-mindedness, and it’s no coincidence that a lot of military people are alcoholics, and drug use isn’t unheard of. My first ship lost most of the Air department to crystal meth.

The only difference between your feelings of fatigue and what I felt for most of my time in the Navy is that you acknowledge that you are fatigued.

Age plays an interesting role in sleep patterns as well. I was never a good sleeper but now I do not seem to be able to sleep for more than a 2 hour increment. I wake up just about every 1.5 to 2 hours. I go back to sleep quickly however and it must be enough to sustain me because I seem to function quite well. As I recall, when I was younger, I felt a lot worse when I didn’t have an 8 hour sleep.