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expanded (drowsiness to lead, diff to wakefulness & vigilance to lead, caffeine-similar alkaloids, coca tea, note about modafinil & sleep, →‎Other approaches for increasing alertness: , →‎Biological pathways: , +1 cat), ce, rv (Undid 2 edits by 117.213.235.57)
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{{short description|State of active attention by high sensory awareness such as being watchful}}
{{short description|State of active attention by high sensory awareness such as being watchful}}
{{Mindfulness|Similar concepts}}
{{Mindfulness|Similar concepts}}
'''Alertness''' is the state of active [[attention]] by high [[Sensory perception|sensory]] [[awareness]] such as being watchful and prompt to meet danger or emergency, or being quick to perceive and act. It is related for psychology . A lack of alertness is a symptom of a number of conditions, including [[narcolepsy]], [[attention deficit disorder]], [[chronic fatigue syndrome]], [[Clinical depression|depression]], [[Addison's disease]], or [[sleep deprivation]]. Pronounced lack of alertness can be graded as an [[altered level of consciousness]]. The word is formed from "alert", which comes from the Italian "all'erta" (on the watch, literally, on the height; 1618)
'''Alertness''' is the state of active [[attention]] by high [[Sensory perception|sensory]] [[awareness]] such as being watchful and prompt to meet danger or emergency, or being quick to perceive and act. It is related to psychology as well as to physiology. A lack of alertness is a symptom of a number of conditions, including [[narcolepsy]], [[attention deficit disorder]], [[chronic fatigue syndrome]], [[Clinical depression|depression]], [[Addison's disease]], or [[sleep deprivation]]. Pronounced lack of alertness can be graded as an [[altered level of consciousness]]. States with low levels of alertness include [[drowsiness]].
The word is formed from "alert", which comes from the Italian "all'erta" (on the watch, literally, on the height; 1618).

[[Wakefulness]] refers mainly to differences between the [[sleep]] and the wake state, including for modulation or stimulation of these pathways, and [[Vigilance (psychology)|vigilance]] refers to sustained alertness and [[concentration]] but both terms are sometimes used synonymously with alertness.


==Physiological aspects==
==Physiological aspects==
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People who have to be alert during their jobs, such as [[air traffic controller]]s or [[pilot (aircraft)|pilot]]s, often face challenges maintaining their alertness. Research shows that for people "...engaged in attention-intensive and monotonous tasks, retaining a constant level of alertness is rare if not impossible." If people employed in safety-related or transportation jobs have lapses in alertness, this "may lead to severe consequences in occupations ranging from air traffic control to monitoring of nuclear power plants."<ref>{{Cite web |title=Alertness Monitoring |url=http://cnl.salk.edu/~jung/alert.html |website=salk.edu}}</ref>
People who have to be alert during their jobs, such as [[air traffic controller]]s or [[pilot (aircraft)|pilot]]s, often face challenges maintaining their alertness. Research shows that for people "...engaged in attention-intensive and monotonous tasks, retaining a constant level of alertness is rare if not impossible." If people employed in safety-related or transportation jobs have lapses in alertness, this "may lead to severe consequences in occupations ranging from air traffic control to monitoring of nuclear power plants."<ref>{{Cite web |title=Alertness Monitoring |url=http://cnl.salk.edu/~jung/alert.html |website=salk.edu}}</ref>

==Biological pathways==
{{See also|Stimulant#Mechanisms of action|Neuroenhancement}}
[[Neurotransmitter]]s that can initiate, promote, or enhance wakefulness or alertness are serotonin, (nor)epinephrine, dopamine (e.g. blockade of dopamine reuptake), glutamate, histamine and acetylcholine. [[Neuromodulator]]s that can do so include [[neuropeptide]] [[Orexin#Wakefulness|orexin]]. Similarly inhibition or reduction of alertness-inhibiting mechanisms such as certain cytokines and [[adenosine]] (as with caffeine) may also increase alertness.<ref name="10.3920/BM2021.0122">{{cite journal |last1=Haarhuis |first1=J.E. |last2=Kardinaal |first2=A. |last3=Kortman |first3=G.A.M. |title=Probiotics, prebiotics and postbiotics for better sleep quality: a narrative review |journal=Beneficial Microbes |date=3 August 2022 |volume=13 |issue=3 |pages=169–182 |doi=10.3920/BM2021.0122 |url=https://www.researchgate.net/publication/361911954}}</ref><ref name="10.1016/j.metabol.2006.07.007">{{cite journal |last1=Miller |first1=Diane B. |last2=O'Callaghan |first2=James P. |title=The pharmacology of wakefulness |journal=Metabolism |date=October 2006 |volume=55 |pages=S13–S19|doi=10.1016/j.metabol.2006.07.007 }}</ref><ref>{{cite journal |last1=Sakurai |first1=Takeshi |title=Roles of orexin/hypocretin in regulation of sleep/wakefulness and energy homeostasis |journal=Sleep Medicine Reviews |date=August 2005 |volume=9 |issue=4 |pages=231–241 |doi=10.1016/j.smrv.2004.07.007}}</ref> Wakefulness depends on the coordinated effort of multiple brain areas. These are affected by neurotransmitters and other factors.<ref name="10.1016/j.metabol.2006.07.007"/> Activating some specific neuronal populations was also found to increase wakefulness. Experiments indicate that none of these neurotransmitters or the neurons producing them are individually necessary for maintaining wakefulness. Research to map the wakefulness circuitry is ongoing.<ref>{{cite journal |last1=Grady |first1=Fillan S. |last2=Boes |first2=Aaron D. |last3=Geerling |first3=Joel C. |title=A Century Searching for the Neurons Necessary for Wakefulness |journal=Frontiers in Neuroscience |date=2022 |volume=16 |pages=930514 |doi=10.3389/fnins.2022.930514 |issn=1662-4548}}</ref>

[[Beta wave|Beta power]] has been used as an indicator of cortical arousal or alertness by several studies.<ref>{{cite journal |last1=Küssner |first1=Mats B. |title=Eysenck's Theory of Personality and the Role of Background Music in Cognitive Task Performance: A Mini-Review of Conflicting Findings and a New Perspective |journal=Frontiers in Psychology |date=2017 |volume=8 |doi=10.3389/fpsyg.2017.01991/full |issn=1664-1078}}</ref> A study also measured alertness with [[EEG]] data.<ref>{{cite journal |last1=Jagannathan |first1=Sridhar R. |last2=Ezquerro-Nassar |first2=Alejandro |last3=Jachs |first3=Barbara |last4=Pustovaya |first4=Olga V. |last5=Bareham |first5=Corinne A. |last6=Bekinschtein |first6=Tristan A. |title=Tracking wakefulness as it fades: Micro-measures of alertness |journal=NeuroImage |date=August 2018 |volume=176 |pages=138–151 |doi=10.1016/j.neuroimage.2018.04.046}}</ref>


==Drugs used to increase alertness==
==Drugs used to increase alertness==
Around the world, the [[stimulant]] [[adenosine receptor antagonist]] [[caffeine]] is widely used to increase alertness or [[wakefulness]] and improve [[Mood (psychology)|mood]] or [[performance-enhancing substance|performance]], typically in the form of drinks like [[green tea]] (where it is mixed with bioactive [[l-theanine]]), [[energy drink]]s (also containing high amounts of [[sugar]]/sugar-substitutes), or [[coffee]] (like teas also containing various [[polyphenol]]s). It is at least one of the world's most consumed drugs.<ref>{{Cite web |title=Caffeine |url=https://go.drugbank.com/drugs/DB00201#pharmacology |access-date=14 October 2020 |website=DrugBank.com}}</ref><ref>{{cite journal |last1=Fiani |first1=Brian |last2=Zhu |first2=Lawrence |last3=Musch |first3=Brian L |last4=Briceno |first4=Sean |last5=Andel |first5=Ross |last6=Sadeq |first6=Nasreen |last7=Ansari |first7=Ali Z |title=The Neurophysiology of Caffeine as a Central Nervous System Stimulant and the Resultant Effects on Cognitive Function |journal=Cureus |date=14 May 2021 |doi=10.7759/cureus.15032}}</ref><ref>{{cite journal |last1=Kennedy |first1=David O. |last2=Wightman |first2=Emma L. |title=Mental Performance and Sport: Caffeine and Co-consumed Bioactive Ingredients |journal=Sports Medicine |date=December 2022 |volume=52 |issue=S1 |pages=69–90 |doi=10.1007/s40279-022-01796-8}}</ref><ref>{{cite journal |last1=Plumber |first1=Noorine |last2=Majeed |first2=Maliha |last3=Ziff |first3=Shawn |last4=Thomas |first4=Sneha E |last5=Bolla |first5=Srinivasa Rao |last6=Gorantla |first6=Vasavi Rakesh |title=Stimulant Usage by Medical Students for Cognitive Enhancement: A Systematic Review |journal=Cureus |date=22 May 2021 |doi=10.7759/cureus.15163}}</ref><ref>{{cite journal |last1=Barcelos |first1=Rômulo P |last2=Lima |first2=Frederico D |last3=Carvalho |first3=Nelson R |last4=Bresciani |first4=Guilherme |last5=Royes |first5=Luiz FF |title=Caffeine effects on systemic metabolism, oxidative-inflammatory pathways, and exercise performance |journal=Nutrition Research |date=August 2020 |volume=80 |pages=1–17 |doi=10.1016/j.nutres.2020.05.005}}</ref>
Around the world, the [[stimulant]] [[adenosine receptor antagonist]] [[caffeine]] is widely used to increase alertness or [[wakefulness]] and improve [[Mood (psychology)|mood]] or [[performance-enhancing substance|performance]], typically in the form of drinks like [[green tea]] (where it is mixed with bioactive [[l-theanine]]), [[energy drink]]s (also containing high amounts of [[sugar]]/sugar-substitutes), or [[coffee]] (like teas also containing various [[Bioactive compounds|bioactive]] [[polyphenol]]s). It is at least one of the world's most consumed drugs.<ref>{{Cite web |title=Caffeine |url=https://go.drugbank.com/drugs/DB00201#pharmacology |access-date=14 October 2020 |website=DrugBank.com}}</ref><ref>{{cite journal |last1=Fiani |first1=Brian |last2=Zhu |first2=Lawrence |last3=Musch |first3=Brian L |last4=Briceno |first4=Sean |last5=Andel |first5=Ross |last6=Sadeq |first6=Nasreen |last7=Ansari |first7=Ali Z |title=The Neurophysiology of Caffeine as a Central Nervous System Stimulant and the Resultant Effects on Cognitive Function |journal=Cureus |date=14 May 2021 |doi=10.7759/cureus.15032}}</ref><ref>{{cite journal |last1=Kennedy |first1=David O. |last2=Wightman |first2=Emma L. |title=Mental Performance and Sport: Caffeine and Co-consumed Bioactive Ingredients |journal=Sports Medicine |date=December 2022 |volume=52 |issue=S1 |pages=69–90 |doi=10.1007/s40279-022-01796-8}}</ref><ref>{{cite journal |last1=Plumber |first1=Noorine |last2=Majeed |first2=Maliha |last3=Ziff |first3=Shawn |last4=Thomas |first4=Sneha E |last5=Bolla |first5=Srinivasa Rao |last6=Gorantla |first6=Vasavi Rakesh |title=Stimulant Usage by Medical Students for Cognitive Enhancement: A Systematic Review |journal=Cureus |date=22 May 2021 |doi=10.7759/cureus.15163}}</ref><ref>{{cite journal |last1=Barcelos |first1=Rômulo P |last2=Lima |first2=Frederico D |last3=Carvalho |first3=Nelson R |last4=Bresciani |first4=Guilherme |last5=Royes |first5=Luiz FF |title=Caffeine effects on systemic metabolism, oxidative-inflammatory pathways, and exercise performance |journal=Nutrition Research |date=August 2020 |volume=80 |pages=1–17 |doi=10.1016/j.nutres.2020.05.005}}</ref>


Various natural biochemicals and herbs are investigated for similar or antifatigue effects, as well as other potentially negative as well as positive effects, such as [[rhodiola rosea]].<ref>{{cite journal |last1=Chiang |first1=Hsiu-Mei |last2=Chen |first2=Hsin-Chun |last3=Wu |first3=Chin-Sheng |last4=Wu |first4=Po-Yuan |last5=Wen |first5=Kuo-Ching |title=Rhodiola plants: Chemistry and biological activity |journal=Journal of Food and Drug Analysis |date=September 2015 |volume=23 |issue=3 |pages=359–369 |doi=10.1016/j.jfda.2015.04.007}}</ref><ref>{{cite journal |last1=Khanum |first1=Farhath |last2=Bawa |first2=Amarinder Singh |last3=Singh |first3=Brahm |title=Rhodiola rosea: A Versatile Adaptogen |journal=Comprehensive Reviews in Food Science and Food Safety |date=July 2005 |volume=4 |issue=3 |pages=55–62 |doi=10.1111/j.1541-4337.2005.tb00073.x |language=en |issn=1541-4337}}</ref> Various [[psychostimulant]]s like [[bromantane]] are also investigated as a potential treatment (or complementary component of such) of numerous neurological disorders.<ref>{{cite journal |last1=Gill |first1=G |title=Performance-Enhancing Drugs: A Review |journal=UNM Orthopaedic Research Journal |date=1 January 2017 |volume=6 |issue=1 |url=https://digitalrepository.unm.edu/unm_jor/vol6/iss1/16/ |issn=2167-4760}}</ref>
Various natural biochemicals and herbs are investigated for similar or antifatigue effects, as well as other potentially negative as well as positive effects, such as [[rhodiola rosea]].<ref>{{cite journal |last1=Chiang |first1=Hsiu-Mei |last2=Chen |first2=Hsin-Chun |last3=Wu |first3=Chin-Sheng |last4=Wu |first4=Po-Yuan |last5=Wen |first5=Kuo-Ching |title=Rhodiola plants: Chemistry and biological activity |journal=Journal of Food and Drug Analysis |date=September 2015 |volume=23 |issue=3 |pages=359–369 |doi=10.1016/j.jfda.2015.04.007}}</ref><ref>{{cite journal |last1=Khanum |first1=Farhath |last2=Bawa |first2=Amarinder Singh |last3=Singh |first3=Brahm |title=Rhodiola rosea: A Versatile Adaptogen |journal=Comprehensive Reviews in Food Science and Food Safety |date=July 2005 |volume=4 |issue=3 |pages=55–62 |doi=10.1111/j.1541-4337.2005.tb00073.x |language=en |issn=1541-4337}}</ref> Various [[psychostimulant]]s like [[bromantane]] are also investigated as a potential treatment (or complementary component of such) of numerous neurological disorders.<ref>{{cite journal |last1=Gill |first1=G |title=Performance-Enhancing Drugs: A Review |journal=UNM Orthopaedic Research Journal |date=1 January 2017 |volume=6 |issue=1 |url=https://digitalrepository.unm.edu/unm_jor/vol6/iss1/16/ |issn=2167-4760}}</ref> [[Alkaloid]]s [[theacrine]] and [[methylliberine]] (Dynamine) are structurally similar to caffeine and are less commonly also used as energizers (e.g. both in combination with [[liberine]]),<ref>{{cite journal |last1=Sheng |first1=Yue-Yue |last2=Xiang |first2=Jing |last3=Wang |first3=Ze-Shi |last4=Jin |first4=Jing |last5=Wang |first5=Ying-Qi |last6=Li |first6=Qing-Sheng |last7=Li |first7=Da |last8=Fang |first8=Zhou-Tao |last9=Lu |first9=Jian-Liang |last10=Ye |first10=Jian-Hui |last11=Liang |first11=Yue-Rong |last12=Zheng |first12=Xin-Qiang |title=Theacrine From Camellia kucha and Its Health Beneficial Effects |journal=Frontiers in Nutrition |date=2020 |volume=7 |doi=10.3389/fnut.2020.596823/full |issn=2296-861X}}</ref> and, like l-theanine, may potentiate and synergize with caffeine in ways some may consider beneficial.<ref>{{cite journal |last1=Auxtero |first1=Maria D. |last2=Chalante |first2=Susana |last3=Abade |first3=Mário R. |last4=Jorge |first4=Rui |last5=Fernandes |first5=Ana I. |title=Potential Herb–Drug Interactions in the Management of Age-Related Cognitive Dysfunction |journal=Pharmaceutics |date=19 January 2021 |volume=13 |issue=1 |pages=124 |doi=10.3390/pharmaceutics13010124}}</ref>


During the Second World War, US soldiers and aviators were given [[benzedrine]], an [[amphetamine]] drug, to increase their alertness during long periods on duty. While air force pilots are able to use the drug to remain awake during combat flights, the use of amphetamines by commercial airline pilots is forbidden. British troops used 72 million amphetamine tablets in the second world war<ref>{{Cite book |last=Mondenard De Monie |first=Jean-Pierre |url=http://worldcat.org/oclc/997463239 |title=Dopage : l'imposture des performances : mensonges et vérités sur l'école de la triche |year=2000 |isbn=978-2-7027-0639-8 |oclc=997463239}}</ref> and the RAF used so many that "[[Methedrine]] won the Battle of Britain" according to one report.<ref>Grant, D.N.W.; ''Air Force, UK, 1944''</ref> American bomber pilots use amphetamines ("go pills") to stay awake during long missions. The [[Tarnak Farm incident]], in which an American [[F-16 Fighting Falcon|F-16]] pilot killed several friendly Canadian soldiers on the ground, was blamed by the pilot on his use of amphetamine. A nonjudicial hearing rejected the pilot's claim.
During the Second World War, US soldiers and aviators were given [[benzedrine]], an [[amphetamine]] drug, to increase their alertness during long periods on duty. While air force pilots are able to use the drug to remain awake during combat flights, the use of amphetamines by commercial airline pilots is forbidden. British troops used 72 million amphetamine tablets in the second world war<ref>{{Cite book |last=Mondenard De Monie |first=Jean-Pierre |url=http://worldcat.org/oclc/997463239 |title=Dopage : l'imposture des performances : mensonges et vérités sur l'école de la triche |year=2000 |isbn=978-2-7027-0639-8 |oclc=997463239}}</ref> and the RAF used so many that "[[Methedrine]] won the Battle of Britain" according to one report.<ref>Grant, D.N.W.; ''Air Force, UK, 1944''</ref> American bomber pilots use amphetamines ("go pills") to stay awake during long missions. The [[Tarnak Farm incident]], in which an American [[F-16 Fighting Falcon|F-16]] pilot killed several friendly Canadian soldiers on the ground, was blamed by the pilot on his use of amphetamine. A nonjudicial hearing rejected the pilot's claim.
Amphetamines are used by college and high-school students as a study and test-taking aid.<ref>{{Cite web |last=Twohey |first=Megan |date=2006-03-25 |title=Pills become an addictive study aid |url=http://www.jsonline.com/story/index.aspx?id=410902 |url-status=dead |archive-url=https://web.archive.org/web/20070815200239/http://www.jsonline.com/story/index.aspx?id=410902 |archive-date=2007-08-15 |access-date=2007-12-02 |publisher=JS Online}}</ref> Amphetamine increases energy levels, concentration, and motivation, allowing students to study for an extended period of time. These drugs are often acquired through ADHD prescriptions to students and peers, rather than illicitly produced drugs.<ref>{{Cite book |url=http://www.cmc.qld.gov.au/data/portal/00000005/content/63420001125986217865.pdf |title=The Illicit Market for ADHD Prescription Drugs in Queensland |date=April 2002 |publisher=Queensland Crime and Misconduct Commission |access-date=2008-01-13 |archive-url=https://web.archive.org/web/20090515072103/http://www.cmc.qld.gov.au/data/portal/00000005/content/63420001125986217865.pdf |archive-date=2009-05-15 |url-status=dead}}</ref> [[Cocaine]] is also used to increase alertness.<ref>{{Cite web |date=4 July 2014 |title=Cocaine use rising among Hawaii workers, job applicants, lab says |url=http://www.bizjournals.com/pacific/news/2014/07/04/cocaine-use-rising-among-hawaii-workers-job.html |website=Pacific Business News}}</ref>
Amphetamines are used by college and high-school students as a study and test-taking aid.<ref>{{Cite web |last=Twohey |first=Megan |date=2006-03-25 |title=Pills become an addictive study aid |url=http://www.jsonline.com/story/index.aspx?id=410902 |url-status=dead |archive-url=https://web.archive.org/web/20070815200239/http://www.jsonline.com/story/index.aspx?id=410902 |archive-date=2007-08-15 |access-date=2007-12-02 |publisher=JS Online}}</ref> Amphetamine increases energy levels, concentration, and motivation, allowing students to study for an extended period of time. These drugs are often acquired through ADHD prescriptions to students and peers, rather than illicitly produced drugs.<ref>{{Cite book |url=http://www.cmc.qld.gov.au/data/portal/00000005/content/63420001125986217865.pdf |title=The Illicit Market for ADHD Prescription Drugs in Queensland |date=April 2002 |publisher=Queensland Crime and Misconduct Commission |access-date=2008-01-13 |archive-url=https://web.archive.org/web/20090515072103/http://www.cmc.qld.gov.au/data/portal/00000005/content/63420001125986217865.pdf |archive-date=2009-05-15 |url-status=dead}}</ref> [[Cocaine]] is also used to increase alertness,<ref>{{Cite web |date=4 July 2014 |title=Cocaine use rising among Hawaii workers, job applicants, lab says |url=http://www.bizjournals.com/pacific/news/2014/07/04/cocaine-use-rising-among-hawaii-workers-job.html |website=Pacific Business News}}</ref> as is [[coca]] in the form of [[coca tea]].<ref>{{cite journal |last1=Chen |first1=Cheng |last2=Lin |first2=Ligen |title=Alkaloids in Diet |journal=Handbook of Dietary Phytochemicals |date=2019 |pages=1–35 |doi=10.1007/978-981-13-1745-3_36-1 |publisher=Springer |language=en}}</ref>

⚫
The [[eugeroic]] [[modafinil]] has recently gained popularity with the [[US Military]]<ref>{{Cite web |title=Defense Technical Information Center Compilation Part Notice ADPO 11050 |url=http://apps.dtic.mil/dtic/tr/fulltext/u2/p011050.pdf |url-status=live |archive-url=https://web.archive.org/web/20160304042132/http://www.dtic.mil/dtic/tr/fulltext/u2/p011050.pdf |archive-date=March 4, 2016 |website=dtic.mil |publisher=[[Defense Technical Information Center]]}}</ref>{{Vague|reason=Popularity at what level?|date=October 2020}} and [[List of psychoactive drugs used by militaries|other militaries]]. It increases alertness but, having a long [[half-life]], delays or impairs sleep-onset, with there being no marketed shorter-acting version.


==Other approaches for increasing alertness==
⚫
The [[eugeroic]] [[modafinil]] has recently gained popularity with the [[US Military]]<ref>{{Cite web |title=Defense Technical Information Center Compilation Part Notice ADPO 11050 |url=http://apps.dtic.mil/dtic/tr/fulltext/u2/p011050.pdf |url-status=live |archive-url=https://web.archive.org/web/20160304042132/http://www.dtic.mil/dtic/tr/fulltext/u2/p011050.pdf |archive-date=March 4, 2016 |website=dtic.mil |publisher=[[Defense Technical Information Center]]}}</ref>{{Vague|reason=Popularity at what level?|date=October 2020}} and [[List of psychoactive drugs used by militaries|other militaries]].
Beyond good sleep, physical activity and [[healthy diet]], a review suggests uses of odours, [[Neuroscience of music|music]] and extrinsic [[motivation]] may have the potential to increase alertness or decrease mental fatigue.<ref>{{cite journal |last1=Proost |first1=Matthias |last2=Habay |first2=Jelle |last3=De Wachter |first3=Jonas |last4=De Pauw |first4=Kevin |last5=Rattray |first5=Ben |last6=Meeusen |first6=Romain |last7=Roelands |first7=Bart |last8=Van Cutsem |first8=Jeroen |title=How to Tackle Mental Fatigue: A Systematic Review of Potential Countermeasures and Their Underlying Mechanisms |journal=Sports Medicine |date=September 2022 |volume=52 |issue=9 |pages=2129–2158 |doi=10.1007/s40279-022-01678-z}}</ref> Short rest periods and selected lighting (level and type of) may also be useful.<ref>{{cite journal |last1=Bonnefond |first1=Anne |last2=Tassi |first2=Patricia |last3=Roge |first3=Joceline |last4=Muzet |first4=Alain |title=A Critical Review of Techniques Aiming at Enhancing and Sustaining Worker's Alertness during the Night Shift |journal=INDUSTRIAL HEALTH |date=2004 |volume=42 |issue=1 |pages=1–14 |doi=10.2486/indhealth.42.1}}</ref> Various types of [[neurostimulation]] are being researched,<ref>{{cite journal |last1=Bagary |first1=Manny |title=Epilepsy, Consciousness and Neurostimulation |journal=Behavioural Neurology |date=2011 |volume=24 |issue=1 |pages=75–81 |doi=10.3233/BEN-2011-0319}}</ref>{{elucidate|date=January 2023}} as is the [[microbiome]] and related interventions.<ref name="10.3920/BM2021.0122"/>


==After waking==
==Alertness after waking==
A study suggests non-genetic determinants of alertness after [[Sleep#Awakening|waking up from sleep]] are:<ref>{{cite news |title=What are the factors that affect how alert we feel in the morning? |url=https://www.medicalnewstoday.com/articles/feeling-tired-in-the-morning-4-factors-are-key-to-alertness-levels |access-date=13 December 2022 |work=www.medicalnewstoday.com |date=29 November 2022 |language=en}}</ref><ref name="10.1038/s41467-022-34503-2">{{cite journal |last1=Vallat |first1=Raphael |last2=Berry |first2=Sarah E. |last3=Tsereteli |first3=Neli |last4=Capdevila |first4=Joan |last5=Khatib |first5=Haya Al |last6=Valdes |first6=Ana M. |last7=Delahanty |first7=Linda M. |last8=Drew |first8=David A. |last9=Chan |first9=Andrew T. |last10=Wolf |first10=Jonathan |last11=Franks |first11=Paul W. |last12=Spector |first12=Tim D. |last13=Walker |first13=Matthew P. |title=How people wake up is associated with previous night's sleep together with physical activity and food intake |journal=Nature Communications |date=19 November 2022 |volume=13 |issue=1 |pages=7116 |doi=10.1038/s41467-022-34503-2 |pmid=36402781 |pmc=9675783 |bibcode=2022NatCo..13.7116V |language=en |issn=2041-1723|doi-access=free}}</ref>
A study suggests non-genetic determinants of alertness after [[Sleep#Awakening|waking up from sleep]] are:<ref>{{cite news |title=What are the factors that affect how alert we feel in the morning? |url=https://www.medicalnewstoday.com/articles/feeling-tired-in-the-morning-4-factors-are-key-to-alertness-levels |access-date=13 December 2022 |work=www.medicalnewstoday.com |date=29 November 2022 |language=en}}</ref><ref name="10.1038/s41467-022-34503-2">{{cite journal |last1=Vallat |first1=Raphael |last2=Berry |first2=Sarah E. |last3=Tsereteli |first3=Neli |last4=Capdevila |first4=Joan |last5=Khatib |first5=Haya Al |last6=Valdes |first6=Ana M. |last7=Delahanty |first7=Linda M. |last8=Drew |first8=David A. |last9=Chan |first9=Andrew T. |last10=Wolf |first10=Jonathan |last11=Franks |first11=Paul W. |last12=Spector |first12=Tim D. |last13=Walker |first13=Matthew P. |title=How people wake up is associated with previous night's sleep together with physical activity and food intake |journal=Nature Communications |date=19 November 2022 |volume=13 |issue=1 |pages=7116 |doi=10.1038/s41467-022-34503-2 |pmid=36402781 |pmc=9675783 |bibcode=2022NatCo..13.7116V |language=en |issn=2041-1723|doi-access=free}}</ref>
* sleep quantity/[[sleep quality|quality]] the night before
* sleep quantity/[[sleep quality|quality]] the night before
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*[[Consciousness]]
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[[Category:Attention]]
[[Category:Attention]]
[[Category:Cognitive neuroscience]]
[[Category:Mental states]]
[[Category:Mental states]]

Revision as of 16:50, 30 January 2023

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Alertness is the state of active attention by high sensory awareness such as being watchful and prompt to meet danger or emergency, or being quick to perceive and act. It is related to psychology as well as to physiology. A lack of alertness is a symptom of a number of conditions, including narcolepsy, attention deficit disorder, chronic fatigue syndrome, depression, Addison's disease, or sleep deprivation. Pronounced lack of alertness can be graded as an altered level of consciousness. States with low levels of alertness include drowsiness.

The word is formed from "alert", which comes from the Italian "all'erta" (on the watch, literally, on the height; 1618).

Wakefulness refers mainly to differences between the sleep and the wake state, including for modulation or stimulation of these pathways, and vigilance refers to sustained alertness and concentration but both terms are sometimes used synonymously with alertness.

Physiological aspects

Domenico Tintoretto, Allegory of Vigilance

People who have to be alert during their jobs, such as air traffic controllers or pilots, often face challenges maintaining their alertness. Research shows that for people "...engaged in attention-intensive and monotonous tasks, retaining a constant level of alertness is rare if not impossible." If people employed in safety-related or transportation jobs have lapses in alertness, this "may lead to severe consequences in occupations ranging from air traffic control to monitoring of nuclear power plants."[1]

Biological pathways

See also: Stimulant § Mechanisms of action, and Neuroenhancement

Neurotransmitters that can initiate, promote, or enhance wakefulness or alertness are serotonin, (nor)epinephrine, dopamine (e.g. blockade of dopamine reuptake), glutamate, histamine and acetylcholine. Neuromodulators that can do so include neuropeptide orexin. Similarly inhibition or reduction of alertness-inhibiting mechanisms such as certain cytokines and adenosine (as with caffeine) may also increase alertness.[2][3][4] Wakefulness depends on the coordinated effort of multiple brain areas. These are affected by neurotransmitters and other factors.[3] Activating some specific neuronal populations was also found to increase wakefulness. Experiments indicate that none of these neurotransmitters or the neurons producing them are individually necessary for maintaining wakefulness. Research to map the wakefulness circuitry is ongoing.[5]

Beta power has been used as an indicator of cortical arousal or alertness by several studies.[6] A study also measured alertness with EEG data.[7]

Drugs used to increase alertness

Around the world, the stimulant adenosine receptor antagonist caffeine is widely used to increase alertness or wakefulness and improve mood or performance, typically in the form of drinks like green tea (where it is mixed with bioactive l-theanine), energy drinks (also containing high amounts of sugar/sugar-substitutes), or coffee (like teas also containing various bioactive polyphenols). It is at least one of the world's most consumed drugs.[8][9][10][11][12]

Various natural biochemicals and herbs are investigated for similar or antifatigue effects, as well as other potentially negative as well as positive effects, such as rhodiola rosea.[13][14] Various psychostimulants like bromantane are also investigated as a potential treatment (or complementary component of such) of numerous neurological disorders.[15] Alkaloids theacrine and methylliberine (Dynamine) are structurally similar to caffeine and are less commonly also used as energizers (e.g. both in combination with liberine),[16] and, like l-theanine, may potentiate and synergize with caffeine in ways some may consider beneficial.[17]

During the Second World War, US soldiers and aviators were given benzedrine, an amphetamine drug, to increase their alertness during long periods on duty. While air force pilots are able to use the drug to remain awake during combat flights, the use of amphetamines by commercial airline pilots is forbidden. British troops used 72 million amphetamine tablets in the second world war[18] and the RAF used so many that "Methedrine won the Battle of Britain" according to one report.[19] American bomber pilots use amphetamines ("go pills") to stay awake during long missions. The Tarnak Farm incident, in which an American F-16 pilot killed several friendly Canadian soldiers on the ground, was blamed by the pilot on his use of amphetamine. A nonjudicial hearing rejected the pilot's claim. Amphetamines are used by college and high-school students as a study and test-taking aid.[20] Amphetamine increases energy levels, concentration, and motivation, allowing students to study for an extended period of time. These drugs are often acquired through ADHD prescriptions to students and peers, rather than illicitly produced drugs.[21] Cocaine is also used to increase alertness,[22] as is coca in the form of coca tea.[23]

The eugeroic modafinil has recently gained popularity with the US Military[24][vague] and other militaries. It increases alertness but, having a long half-life, delays or impairs sleep-onset, with there being no marketed shorter-acting version.

Other approaches for increasing alertness

Beyond good sleep, physical activity and healthy diet, a review suggests uses of odours, music and extrinsic motivation may have the potential to increase alertness or decrease mental fatigue.[25] Short rest periods and selected lighting (level and type of) may also be useful.[26] Various types of neurostimulation are being researched,[27][further explanation needed] as is the microbiome and related interventions.[2]

Alertness after waking

A study suggests non-genetic determinants of alertness after waking up from sleep are:[28][29]

The baseline of daily alertness is related to the quality of their sleep (currently measured only by self-reported quality), positive emotional state (specifically self-report happiness), and age.[29] There are genes that enable people to be apparently healthy and alert with little sleep. Nevertheless, twin-pair analyses indicated that the genetic contribution in daytime alertness is quantifiably small overall.[29] Other factors such as the natural light exposure[29] and synchronicity with the circadian rhythm may matter as well.

Behavioral ecology

Vigilance is an important trait for animals in order to watch out for predators. Typically a reduction in alertness is observed for animals that live in larger groups. Studies on vigilance have been conducted on various animals including the scaly-breasted munia.[33]

See also

References

  1. ^ "Alertness Monitoring". salk.edu.
  2. ^ a b Haarhuis, J.E.; Kardinaal, A.; Kortman, G.A.M. (3 August 2022). "Probiotics, prebiotics and postbiotics for better sleep quality: a narrative review". Beneficial Microbes. 13 (3): 169–182. doi:10.3920/BM2021.0122.
  3. ^ a b Miller, Diane B.; O'Callaghan, James P. (October 2006). "The pharmacology of wakefulness". Metabolism. 55: S13–S19. doi:10.1016/j.metabol.2006.07.007.
  4. ^ Sakurai, Takeshi (August 2005). "Roles of orexin/hypocretin in regulation of sleep/wakefulness and energy homeostasis". Sleep Medicine Reviews. 9 (4): 231–241. doi:10.1016/j.smrv.2004.07.007.
  5. ^ Grady, Fillan S.; Boes, Aaron D.; Geerling, Joel C. (2022). "A Century Searching for the Neurons Necessary for Wakefulness". Frontiers in Neuroscience. 16: 930514. doi:10.3389/fnins.2022.930514. ISSN 1662-4548.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  6. ^ Küssner, Mats B. (2017). "Eysenck's Theory of Personality and the Role of Background Music in Cognitive Task Performance: A Mini-Review of Conflicting Findings and a New Perspective". Frontiers in Psychology. 8. doi:10.3389/fpsyg.2017.01991/full. ISSN 1664-1078.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  7. ^ Jagannathan, Sridhar R.; Ezquerro-Nassar, Alejandro; Jachs, Barbara; Pustovaya, Olga V.; Bareham, Corinne A.; Bekinschtein, Tristan A. (August 2018). "Tracking wakefulness as it fades: Micro-measures of alertness". NeuroImage. 176: 138–151. doi:10.1016/j.neuroimage.2018.04.046.
  8. ^ "Caffeine". DrugBank.com. Retrieved 14 October 2020.
  9. ^ Fiani, Brian; Zhu, Lawrence; Musch, Brian L; Briceno, Sean; Andel, Ross; Sadeq, Nasreen; Ansari, Ali Z (14 May 2021). "The Neurophysiology of Caffeine as a Central Nervous System Stimulant and the Resultant Effects on Cognitive Function". Cureus. doi:10.7759/cureus.15032.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  10. ^ Kennedy, David O.; Wightman, Emma L. (December 2022). "Mental Performance and Sport: Caffeine and Co-consumed Bioactive Ingredients". Sports Medicine. 52 (S1): 69–90. doi:10.1007/s40279-022-01796-8.
  11. ^ Plumber, Noorine; Majeed, Maliha; Ziff, Shawn; Thomas, Sneha E; Bolla, Srinivasa Rao; Gorantla, Vasavi Rakesh (22 May 2021). "Stimulant Usage by Medical Students for Cognitive Enhancement: A Systematic Review". Cureus. doi:10.7759/cureus.15163.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  12. ^ Barcelos, Rômulo P; Lima, Frederico D; Carvalho, Nelson R; Bresciani, Guilherme; Royes, Luiz FF (August 2020). "Caffeine effects on systemic metabolism, oxidative-inflammatory pathways, and exercise performance". Nutrition Research. 80: 1–17. doi:10.1016/j.nutres.2020.05.005.
  13. ^ Chiang, Hsiu-Mei; Chen, Hsin-Chun; Wu, Chin-Sheng; Wu, Po-Yuan; Wen, Kuo-Ching (September 2015). "Rhodiola plants: Chemistry and biological activity". Journal of Food and Drug Analysis. 23 (3): 359–369. doi:10.1016/j.jfda.2015.04.007.
  14. ^ Khanum, Farhath; Bawa, Amarinder Singh; Singh, Brahm (July 2005). "Rhodiola rosea: A Versatile Adaptogen". Comprehensive Reviews in Food Science and Food Safety. 4 (3): 55–62. doi:10.1111/j.1541-4337.2005.tb00073.x. ISSN 1541-4337.
  15. ^ Gill, G (1 January 2017). "Performance-Enhancing Drugs: A Review". UNM Orthopaedic Research Journal. 6 (1). ISSN 2167-4760.
  16. ^ Sheng, Yue-Yue; Xiang, Jing; Wang, Ze-Shi; Jin, Jing; Wang, Ying-Qi; Li, Qing-Sheng; Li, Da; Fang, Zhou-Tao; Lu, Jian-Liang; Ye, Jian-Hui; Liang, Yue-Rong; Zheng, Xin-Qiang (2020). "Theacrine From Camellia kucha and Its Health Beneficial Effects". Frontiers in Nutrition. 7. doi:10.3389/fnut.2020.596823/full. ISSN 2296-861X.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  17. ^ Auxtero, Maria D.; Chalante, Susana; Abade, Mário R.; Jorge, Rui; Fernandes, Ana I. (19 January 2021). "Potential Herb–Drug Interactions in the Management of Age-Related Cognitive Dysfunction". Pharmaceutics. 13 (1): 124. doi:10.3390/pharmaceutics13010124.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  18. ^ Mondenard De Monie, Jean-Pierre (2000). Dopage : l'imposture des performances : mensonges et vérités sur l'école de la triche. ISBN 978-2-7027-0639-8. OCLC 997463239.
  19. ^ Grant, D.N.W.; Air Force, UK, 1944
  20. ^ Twohey, Megan (2006-03-25). "Pills become an addictive study aid". JS Online. Archived from the original on 2007-08-15. Retrieved 2007-12-02.
  21. ^ The Illicit Market for ADHD Prescription Drugs in Queensland (PDF). Queensland Crime and Misconduct Commission. April 2002. Archived from the original (PDF) on 2009-05-15. Retrieved 2008-01-13.
  22. ^ "Cocaine use rising among Hawaii workers, job applicants, lab says". Pacific Business News. 4 July 2014.
  23. ^ Chen, Cheng; Lin, Ligen (2019). "Alkaloids in Diet". Handbook of Dietary Phytochemicals. Springer: 1–35. doi:10.1007/978-981-13-1745-3_36-1.
  24. ^ "Defense Technical Information Center Compilation Part Notice ADPO 11050" (PDF). dtic.mil. Defense Technical Information Center. Archived (PDF) from the original on March 4, 2016.
  25. ^ Proost, Matthias; Habay, Jelle; De Wachter, Jonas; De Pauw, Kevin; Rattray, Ben; Meeusen, Romain; Roelands, Bart; Van Cutsem, Jeroen (September 2022). "How to Tackle Mental Fatigue: A Systematic Review of Potential Countermeasures and Their Underlying Mechanisms". Sports Medicine. 52 (9): 2129–2158. doi:10.1007/s40279-022-01678-z.
  26. ^ Bonnefond, Anne; Tassi, Patricia; Roge, Joceline; Muzet, Alain (2004). "A Critical Review of Techniques Aiming at Enhancing and Sustaining Worker's Alertness during the Night Shift". INDUSTRIAL HEALTH. 42 (1): 1–14. doi:10.2486/indhealth.42.1.
  27. ^ Bagary, Manny (2011). "Epilepsy, Consciousness and Neurostimulation". Behavioural Neurology. 24 (1): 75–81. doi:10.3233/BEN-2011-0319.
  28. ^ "What are the factors that affect how alert we feel in the morning?". www.medicalnewstoday.com. 29 November 2022. Retrieved 13 December 2022.
  29. ^ a b c d Vallat, Raphael; Berry, Sarah E.; Tsereteli, Neli; Capdevila, Joan; Khatib, Haya Al; Valdes, Ana M.; Delahanty, Linda M.; Drew, David A.; Chan, Andrew T.; Wolf, Jonathan; Franks, Paul W.; Spector, Tim D.; Walker, Matthew P. (19 November 2022). "How people wake up is associated with previous night's sleep together with physical activity and food intake". Nature Communications. 13 (1): 7116. Bibcode:2022NatCo..13.7116V. doi:10.1038/s41467-022-34503-2. ISSN 2041-1723. PMC 9675783. PMID 36402781.
  30. ^ Liang, Yaping; Xu, Xiaojia; Yin, Mingjuan; Zhang, Yan; Huang, Lingfeng; Chen, Ruoling; Ni, Jindong (2019). "Effects of berberine on blood glucose in patients with type 2 diabetes mellitus: a systematic literature review and a meta-analysis". Endocrine Journal. 66 (1): 51–63. doi:10.1507/endocrj.EJ18-0109.
  31. ^ Ilyas, Zahra; Perna, Simone; Al-thawadi, Salwa; Alalwan, Tariq A.; Riva, Antonella; Petrangolini, Giovanna; Gasparri, Clara; Infantino, Vittoria; Peroni, Gabriella; Rondanelli, Mariangela (July 2020). "The effect of Berberine on weight loss in order to prevent obesity: A systematic review". Biomedicine & Pharmacotherapy. 127: 110137. doi:10.1016/j.biopha.2020.110137.
  32. ^ Xie, Wenting; Su, Fugui; Wang, Guizhong; Peng, Zichong; Xu, Yaomin; Zhang, Yi; Xu, Ningning; Hou, Kaijian; Hu, Zhuping; Chen, Yan; Chen, Rongping (16 November 2022). "Glucose-lowering effect of berberine on type 2 diabetes: A systematic review and meta-analysis". Frontiers in Pharmacology. 13: 1015045. doi:10.3389/fphar.2022.1015045.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  33. ^ Roche, Erin A.; Brown, Charles R. (December 2013). "Among-individual variation in vigilance at the nest in colonial Cliff Swallows". The Wilson Journal of Ornithology. 125 (4): 685–695. doi:10.1676/12-196.1. ISSN 1559-4491. S2CID 13865609.
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