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theory for circadian process C suggests a

Introduction control of an endogenous circadian


pacemaker, which affects thresholds for the
A person’s quality of life can be disrupted onset and offset of a sleep episode. The
due to many different reasons. One interaction of these two processes
important yet underestimated cause for that determines the sleep/wake cycle and can
is sleep loss (National Sleep Foundation be used to describe fluctuations in alertness
2007). Working hours are constantly and vigilance. Although revised “three-
increasing along with an emphasis on active process models” (eg, Akerstedt and Folkard 1995; Van
leisure. In certain jobs, people face sleep Dongen et al 2003b; Achermann 2004) have been

restriction. Some professions such as health suggested, this classical model is the
care, security and transportation require principal one used for study designs in SD
working at night. In such fields, the effect of research.
acute total sleep deprivation (SD) on
performance is crucial. Furthermore, people There are many unanswered questions
tend to stretch their capacity and regarding both the functions of sleep and
compromise their nightly sleep, thus the effects of sleep loss. Sleep is considered
becoming chronically sleep deprived. to be important to body restitution, like
energy conservation, thermoregulation, and
When considering the effects of sleep loss, tissue recovery (Maquet 2001). In addition, sleep
the distinction between total and partial SD is essential for cognitive performance,
is important. Although both conditions especially memory consolidation (Maquet
induce several negative effects including 2001; Stickgold 2005). Sleep loss, instead, seems to

impairments in cognitive performance, the activate the sympathetic nervous system,


underlying mechanisms seem to be which can lead to a rise of blood pressure
somewhat different. Particularly, results on (Ogawa et al 2003) and an increase in cortisol
the recovery from SD have suggested secretion (Spiegel et al 1999; Lac and Chamoux 2003).
different physiological processes. In this Immune response may be impaired and
review, we separately consider the effects metabolic changes such as insulin
of acute total and chronic partial SD and resistance may occur (for review, see Spiegel et
describe the effects on cognitive al 2005). People who are exposed to sleep loss

performance. The emphasis on acute total usually experience a decline in cognitive


SD reflects the quantity of studies carried out performance and changes in mood (for
compared with partial SD. The effects of meta-analyses, see Pilcher and Huffcutt 1996; Philibert
aging and gender, as well as interindividual 2005).

differences are discussed. We concentrate


on the studies that have been published Sleep deprivation is a study design to assess
since 1990. the effects of sleep loss. In acute total SD
protocols, the subjects are kept awake
Go to: continuously, generally for 24–72 hours. In
chronic partial SD, subjects are allowed
Sleep and sleep loss restricted sleep time during several
consecutive nights. Although chronic sleep
The need for sleep varies considerably restriction is more common in the normal
between individuals (Shneerson 2000). The population and thus offers a more accurate
average sleep length is between 7 and 8.5 h depiction of real life conditions, total SD has
per day (Kripke et al 2002; Carskadon and Dement been more thoroughly explored.
2005; Kronholm et al 2006). Sleep is regulated by two

processes: a homeostatic process S and Cognitive performances measured in SD


circadian process C (eg, Achermann 2004). The studies have included several domains. The
homeostatic process S depends on sleep most thoroughly evaluated performances
and wakefulness; the need for sleep include different attentional functions,
increases as wakefulness continues. The working memory, and long-term memory.
Visuomotor and verbal functions as well as during SD. According to the wake-state
decision-making have also been assessed. instability hypothesis, those fluctuations lead
Sleep deprivation effects on cognitive to variation in performance (Doran et al 2001).
performance depend on the type of task or
the modality it occupies (eg, verbal, visual, According to explanations on selective
or auditory). In addition, task demands and impact, SD interferes with the functioning of
time on task may play a role. The task certain brain areas and thus impairs
characteristics are discussed in more detail cognitive performance. This approach is
in following sections where the existing also referred to as the ‘sleep-based
literature on the cognitive effects of SD is neuropsychological perspective’ (Babkoff et al
2005). Perhaps the most famous theory in this
reviewed.
category is the prefrontal vulnerability
Go to: hypothesis, first proposed by Horne (1993). It
suggests that SD especially impairs cognitive
Mechanisms behind sleep loss effects performances that depend on the
prefrontal cortex. These include higher
Some hypotheses are proposed to explain functions, such as language, executive
why cognitive performance is vulnerable to functions, divergent thinking, and creativity.
prolonged wakefulness. The theories can be In order to show the SD effect, the tests
divided roughly in two main approaches, in should be complex, new, and interesting. A
which SD is assumed to have (1) general good performance would require cognitive
effects on alertness and attention, or (2) flexibility and spontaneity. This theory also
selective effects on certain brain structures assumes that the deterioration of subjects’
and functions. In addition, individual performance in simple and long tasks is
differences in the effects have been merely due to boredom (Harrison and Horne
reported. 1998; Harrison and Horne 1999; Harrison and Horne 2000 ). The

specific brain areas that are vulnerable to


The general explanation relies on the two- sleep loss have been explored using
process model of sleep regulation. functional magnetic resonance imaging
Cognitive impairments would be mediated (fMRI) and positron emission tomography
through decreased alertness and attention (PET). Those studies, however, have mainly
through lapses, slowed responses, and measured working memory or other
wake-state instability. Attentional lapses, attentional functions with the type of tasks
brief moments of inattentiveness, have been that are not traditionally emphasized in the
considered the main reason for the prefrontal vulnerability hypothesis (for
decrease in cognitive performance during summary, see Chee et al 2006).
sleep deprivation (on lapse hypothesis, eg,
Williams et al 1959, see Dorrian et al 2005; Kjellberg Individuals differ in terms of the length,
1977). The lapses are caused by microsleeps
timing, and structure of sleep. Therefore, it is
characterized by very short periods of sleep- logical to hypothesize that interindividual
like electro-encephalography (EEG) activity differences are also important in reaction to
(Priest et al 2001). Originally, it was thought that in SD. Studies have consistently found that
between the lapses, cognitive performance some people are more vulnerable to sleep
almost remained intact, but the slowing of loss than others (for review, see Van Dongen et al
cognitive processing has also been 2005). In reference to trait differential

observed independent of lapsing (Kjellberg vulnerability to SD, Van Dongen et al (2005) have
1977; Dorrian et al 2005). According to these
proposed the concept of the “trototype”, as
hypotheses, performance during SD would compared to the terms “chronotype” and
most likely deteriorate in long, simple, and “somnotype”, which define interindividual
monotonous tasks requiring reaction speed differences in the timing of circadian
or vigilance. In addition to the lapses and rhythmicity and sleep duration. Since a
response slowing, considerable fluctuations comprehensive review of the interindividual
in alertness and effort have been observed differences in sleep and performance has
been published recently (Van Dongen et al 2005), measure the effect of "real-world sleep on
we will focus here on the studies with group performance."
comparisons and just briefly address the
trait-like vulnerability To measure cognitive performance,
researchers examined the subjects’
https://www.ncbi.nlm.nih.gov/pmc/articles/
keystroke speed on a computer and their
PMC2656292/ click interactions on a web search engine.
Those results were correlated with sleep
data collected from wearable fitness
Sleep deprived suffer performance loss, devices.
according to new study
AuthorTracie WhitePublished onJanuary 26, As Zeitzer explains in a blog post about the
2017 study by Microsoft’s research group:

More bad news for insomniacs and those of Searching the web requires your brain to do
us who struggle to get enough sleep at a few complex tasks: Figure out what terms
night. Lack of sleep definitely affects your to search on, type the query and then
performance the next day, and probably for process the results to decide which one to
a longer period of time than you might click. Even small differences in the amount
expect, according to a new study. of time it would take you to click on the
result are indicative of how rapidly you are
Among the findings: Two consecutive nights processing that information. The idea is
of less than six hours could leave you people have slower processing speeds as
they get more tired.
sluggish for the following six days. (Surprised?
You aren't alone: This stat sparked a gasp of
dismay at my office staff Results showed that over the first 24 hours,
meeting.) Researchers also found that having one insufficient night of sleep is
staying up an extra hour, even if followed by associated with 1.2 percent slower
a full night’s sleep, is correlated with slower performance on average keystroke timing.
performance the next day. But going to bed Two insufficient nights of sleep are 4.8
an hour earlier than normal has a negligible percent slower compared to two nights with
effect. longer than six hours of sleep each (2.7
percent and 7.3 percent increases for click
The study appeared today on arXiv.org — times respectively.) The study adds: "These
an online repository for scientific papers in effect estimates took into account any real-
the fields of math and science. world behavioral compensation such as
increased caffeine intake that would help
improve performance after sleep loss."
"The data set is pretty amazing," says Jamie
Zeitzer, PhD, a co-author of the study and a
Stanford assistant professor of psychiatry The research is another example of the use
and behavioral sciences. "We looked at of mobile technology allowing researchers
more than 30,000 people over 18 months, to collect much larger data sets in real-
which came out to more than 3 million world time than through traditional studies.
nights of sleep analyzed." More from Zeitzer:

The study — led by Tim Althoff, a Stanford The web-scale study provides insight into the
PhD student in computer science, during a impact of sleep deprivation in the real
summer 2016 internship with Microsoft world, where people compensate for lost
Research in Redmond, Washington — is sleep with extra coffee and naps, and
thought to be the largest to date to otherwise adapt to life circumstances that
limit pillow time. The findings largely overlap
with results from small and controlled lab-
scale studies, where participants are
systematically sleep deprived and assessed
on standardized tests.

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