The effect of combining sleep deprivation and moderate alcohol consumption in male college students differed from the effects of each treatment alone. Following either alcohol or sleep deprivation, there was mild performance impairment, decreased alertness and reduced amplitude and increased latency of cortical evoked potential (EP) components. Heart rate increased after alcohol and anxiety increased after sleep deprivation. When alcohol and sleep deprivation were combined, antagonistic effects were found for most measures (reaction time, heart rate, alertness, anxiety, latency of early EP components), but synergistic effects also occurred (performance accuracy, latency of late EP components). These effects were found in a double-blind experiment using 24 subjects. The experimental treatments were alcohol doses of 0, 0.45 and 0.90 ml/kg of 95% ethanol and 0 and 26 h of sleep deprivation.