WASHINGTON: Merrill Mitler travels frequently, often sleeping consecutive days in different time zones. When his body clock feels out of sync with his schedule, he swallows a medicine that was approved to treat sleepiness associated with a rare disorder he doesn’t have.

Americans last year bought $150 million worth of the drug modafinil, which was approved to treat narcolepsy, an unusual disorder that causes people to fall asleep suddenly. Three-quarters of the pills were swallowed by people who did not have narcolepsy. Doctors are prescribing the drug to patients with other disorders and, increasingly, to people with no disorder at all.

Three years after it was approved, the medicine is raising questions about how many healthy Americans might soon want it simply to sleep less - yet another example of a medicine being used not to treat illness, but to support a lifestyle choice.

Unlike amphetamines and conventional stimulants, modafinil does not give people a jolt. Doctors believe it is not addictive and say it is generally safe, with only occasional side effects such as headache or nausea. But no one knows what might happen if people use the drug to do away with sleep for prolonged periods.

“The biggest questions are societal,” said Thomas Scammell, a neurologist at Harvard Medical School. “What’s to keep us from working 24-7? ... To take a drug and try to counter this natural necessity of sleep is to defy nature. It’s like if I can give you a pill to take away your appetite - does it mean it’s OK not to eat?”

Americans have long been fascinated by sleep - or rather, with not sleeping: Students glorify in tales of all-nighters; sleeping on the job has often been grounds for getting fired; and the ultimate capitalist utopia is the 24-hour workday. Treating sleepiness can blur the line between medical disorders and lifestyle problems, since sleepiness is not a disorder. Night shift workers for example, are known to be at heightened risk for accidents and to have increased medical problems associated with their irregular sleep. But there may not be anything intrinsically wrong with them since their problems often go away when they resume normal schedules. —Dawn/LAT-WP News Service (c) The Washington Post.