Cognitive Performance, Sleepiness, and Mood in Partially Sleep Deprived Adolescents: The Need for Sleep Study - PubMed (original) (raw)

Randomized Controlled Trial

. 2016 Mar 1;39(3):687-98.

doi: 10.5665/sleep.5552.

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Randomized Controlled Trial

Cognitive Performance, Sleepiness, and Mood in Partially Sleep Deprived Adolescents: The Need for Sleep Study

June C Lo et al. Sleep. 2016.

Abstract

Study objectives: To investigate the effects of sleep restriction (7 nights of 5 h time in bed [TIB]) on cognitive performance, subjective sleepiness, and mood in adolescents.

Methods: A parallel-group design was adopted in the Need for Sleep Study. Fifty-six healthy adolescents (25 males, age = 15-19 y) who studied in top high schools and were not habitual short sleepers were randomly assigned to Sleep Restriction (SR) or Control groups. Participants underwent a 2-w protocol consisting of 3 baseline nights (TIB = 9 h), 7 nights of sleep opportunity manipulation (TIB = 5 h for the SR and 9 h for the control groups), and 3 nights of recovery sleep (TIB = 9 h) at a boarding school. A cognitive test battery was administered three times each day.

Results: During the manipulation period, the SR group demonstrated incremental deterioration in sustained attention, working memory and executive function, increase in subjective sleepiness, and decrease in positive mood. Subjective sleepiness and sustained attention did not return to baseline levels even after 2 recovery nights. In contrast, the control group maintained baseline levels of cognitive performance, subjective sleepiness, and mood throughout the study. Incremental improvement in speed of processing, as a result of repeated testing and learning, was observed in the control group but was attenuated in the sleep-restricted participants, who, despite two recovery sleep episodes, continued to perform worse than the control participants.

Conclusions: A week of partial sleep deprivation impairs a wide range of cognitive functions, subjective alertness, and mood even in high-performing high school adolescents. Some measures do not recover fully even after 2 nights of recovery sleep.

Commentary: A commentary on this article appears in this issue on page 497.

Keywords: adolescents; cognitive performance; mood; partial sleep deprivation; sleepiness.

© 2016 Associated Professional Sleep Societies, LLC.

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Figures

Figure 1

Figure 1

(A) Experimental protocol. The 2-w experimental protocol is illustrated in a double raster plot. Both the sleep restriction (SR) and the control groups had three adaptation and baseline nights (B1 to B3; time in bed [TIB] = 9 h), followed by 7 nights of sleep opportunity manipulation (M1 to M7; TIB = 5 h for SR [black bars] and 9 h for control [gray bars]), and 3 nights of recovery sleep (R1 to R3; TIB = 9 h). On most days, a cognitive performance test battery (purple bars) was administered at 10:00, 15:00, and 20:00. (B) Actigraphically and (C) polysomnographically assessed total sleep time (TST) of the SR (red lines) and the control (blue lines) groups from the adaptation and baseline period to the manipulation and recovery periods. Standard errors are illustrated. **P < 0.01; ***P < 0.001 for group contrasts.

Figure 2

Figure 2

Effects of partial sleep deprivation on cognitive performance, subjective sleepiness, and mood. Daily average and standard errors of the sleep restriction (SR) (red lines) and the control (blue lines) groups from the days after the last baseline night (B3), after 1 to 7 nights of sleep manipulation (M1 to M7), and after 2 nights of recovery sleep (R1 and R2) were plotted for (A) sustained attention as indicated by the number of lapses in the Psychomotor Vigilance Task (PVT) and the sensitivity measure (A') in the Sustained Attention to Response Task (SART), (B) working memory and executive functions as indicated by A' in the verbal 1- and 3-back tasks, (C) speed of processing as indicated by the number of correct responses in the Mental Arithmetic Test (MAT) and the Symbol Digit Modalities Test (SDMT), (D) subjective sleepiness level as indicated by score on the Karolinska Sleepiness Scale (KSS), and (E) positive and negative mood as indicated by the score on the Positive and Negative Affect Scale (PANAS). *P < 0.05; **P < 0.01; ***P < 0.001 for group contrasts.

Figure 3

Figure 3

Effect size of partial sleep deprivation on cognitive performance, subjective sleepiness, and mood. Effect size is indicated by the local effect size (Cohen _f_2) of group × day interaction on each cognitive measure (refer to the Methods section for further details). KSS, Karolinska Sleepiness Scale; MAT, Mental Arithmetic Test; PANAS, Positive and Negative Affect Scale (+, score on the positive affect subscale; −, score on the negative affect subscale); PVT, Psychomotor Vigilance Task; SART, Sustained Attention to Response Task; SDMT, Symbol Digit Modalities Test.

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