Working throughout the night: Beyond 'sleepiness' - impairments to critical decision making

► Wakefulness can last up to 24 h by the end on the first night of a 12 h night-shift. ► This causes impairments to critical decisions during unexpected, changing challenges. ► And the ability to engage in and keep abreast of protracted key negotiations. ► These effects are with 'supervisory executive functions' of the prefrontal cortex. ► Recent findings relevant to 24 h wakefulness are reviewed, with countermeasures.