Semin Neurol 2009; 29(4): 320-339
DOI: 10.1055/s-0029-1237117
© Thieme Medical Publishers

Neurocognitive Consequences of Sleep Deprivation

Namni Goel1 , Hengyi Rao1 , Jeffrey S. Durmer2 , David F. Dinges1
  • 1Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
  • 2Fusion Sleep, Sleep Medicine Program, Suwanee, Georgia
Further Information

Publication History

Publication Date:
09 September 2009 (online)

ABSTRACT

Sleep deprivation is associated with considerable social, financial, and health-related costs, in large measure because it produces impaired cognitive performance due to increasing sleep propensity and instability of waking neurobehavioral functions. Cognitive functions particularly affected by sleep loss include psychomotor and cognitive speed, vigilant and executive attention, working memory, and higher cognitive abilities. Chronic sleep-restriction experiments—which model the kind of sleep loss experienced by many individuals with sleep fragmentation and premature sleep curtailment due to disorders and lifestyle—demonstrate that cognitive deficits accumulate to severe levels over time without full awareness by the affected individual. Functional neuroimaging has revealed that frequent and progressively longer cognitive lapses, which are a hallmark of sleep deprivation, involve distributed changes in brain regions including frontal and parietal control areas, secondary sensory processing areas, and thalamic areas. There are robust differences among individuals in the degree of their cognitive vulnerability to sleep loss that may involve differences in prefrontal and parietal cortices, and that may have a basis in genes regulating sleep homeostasis and circadian rhythms. Thus, cognitive deficits believed to be a function of the severity of clinical sleep disturbance may be a product of genetic alleles associated with differential cognitive vulnerability to sleep loss.

REFERENCES

  • 1 Hublin C, Kaprio J, Partinen M, Koskenvuo M. Insufficient sleep—a population-based study in adults.  Sleep. 2001;  24(4) 392-400
  • 2 Breslau N, Roth T, Rosenthal L, Andreski P. Daytime sleepiness: an epidemiological study of young adults.  Am J Public Health. 1997;  87(10) 1649-1653
  • 3 Roehrs T, Merlotti L, Petrucelli N, Stepanski E, Roth T. Experimental sleep fragmentation.  Sleep. 1994;  17(5) 438-443
  • 4 Roehrs T A, Timms V, Zwyghuizen-Doorenbos A, Roth T. Sleep extension in sleepy and alert normals.  Sleep. 1989;  12(5) 449-457
  • 5 Pack A I, Pack A M, Rodgman E, Cucchiara A, Dinges D F, Schwab C W. Characteristics of crashes attributed to the driver having fallen asleep.  Accid Anal Prev. 1995;  27(6) 769-775
  • 6 Knipling R R, Wang J S. Crashes and fatalities related to driver drowsiness/fatigue. Research note. Washington, DC; National Highway Traffic Safety Administration November 1994
  • 7 Carskadon M A. Adolescent sleepiness: increased risk in a high-risk population.  Alcohol Drugs Driving. 1989–1990;  5–6 317-328
  • 8 Dinges D F. An overview of sleepiness and accidents.  J Sleep Res. 1995;  4(S2) 4-14
  • 9 Leger D. The cost of sleep-related accidents: a report for the National Commission on Sleep Disorders Research.  Sleep. 1994;  17(1) 84-93
  • 10 McCartt A T, Ribner S A, Pack A I, Hammer M C. The scope and nature of the drowsy driving problem in New York State.  Accid Anal Prev. 1996;  28(4) 511-517
  • 11 Horne J A, Reyner L. Vehicle accidents related to sleep: a review.  Occup Environ Med. 1999;  56(5) 289-294
  • 12 Mitler M M, Carskadon M A, Czeisler C A, Dement W C, Dinges D F, Graeber R C. Catastrophes, sleep, and public policy: consensus report.  Sleep. 1988;  11(1) 100-109
  • 13 Stutts J C, Wilkins J W, Scott Osberg J, Vaughn B V. Driver risk factors for sleep-related crashes.  Accid Anal Prev. 2003;  35(3) 321-331
  • 14 Colquhoun W P. Accidents, injuries and shift work. In: Department of Health and Human Services, ed. Shift Work and Health. Washington, DC; Government Printing Office 1976
  • 15 Folkard S, Monk T H. Shiftwork and performance.  Hum Factors. 1979;  21 483-492
  • 16 Richardson G S, Miner J D, Czeisler C A. Impaired driving performance in shiftworkers: the role of the circadian system in a multifactorial model.  Alcohol Drugs Driving. 1989–1990;  5–6 265-273
  • 17 Stoohs R A, Guilleminault C, Itoi A, Dement W C. Traffic accidents in commercial long-haul truck drivers: the influence of sleep-disordered breathing and obesity.  Sleep. 1994;  17(7) 619-623
  • 18 McCartt A T, Rohrbaugh J W, Hammer M C, Fuller S Z. Factors associated with falling asleep at the wheel among long-distance truck drivers.  Accid Anal Prev. 2000;  32(4) 493-504
  • 19 Lyznicki J M, Doege T C, Davis R M, Williams M A. Sleepiness, driving, and motor vehicle crashes. Council on Scientific Affairs, American Medical Association.  JAMA. 1998;  279(23) 1908-1913
  • 20 Marcus C L, Loughlin G M. Effect of sleep deprivation on driving safety in housestaff.  Sleep. 1996;  19(10) 763-766
  • 21 Steele M T, Ma O J, Watson W A, Thomas Jr H A, Muelleman R L. The occupational risk of motor vehicle collisions for emergency medicine residents.  Acad Emerg Med. 1999;  6(10) 1050-1053
  • 22 Geer R T, Jobes D R, Tew J D, Stepsis L H. Incidence of automobile accidents involving anesthesia residents after on-call duty cycles.  Anesthesiology. 1997;  87 A938
  • 23 Hastings M H, Reddy A B, Maywood E S. A clockwork web: circadian timing in brain and periphery, in health and disease.  Nat Rev Neurosci. 2003;  4(8) 649-661
  • 24 Neri D F, Oyung R L, Colletti L M, Mallis M M, Tam P Y, Dinges D F. Controlled breaks as a fatigue countermeasure on the flight deck.  Aviat Space Environ Med. 2002;  73(7) 654-664
  • 25 Price W J, Holley D C. Shiftwork and safety in aviation.  Occup Med. 1990;  5(2) 343-377
  • 26 Bourgeois-Bougrine S, Carbon P, Gounelle C, Mollard R, Coblentz A. Perceived fatigue for short- and long-haul flights: a survey of 739 airline pilots.  Aviat Space Environ Med. 2003;  74(10) 1072-1077
  • 27 Dawson D, Reid K. Fatigue, alcohol and performance impairment.  Nature. 1997;  388(6639) 235
  • 28 Fairclough S H, Graham R. Impairment of driving performance caused by sleep deprivation or alcohol: a comparative study.  Hum Factors. 1999;  41(1) 118-128
  • 29 Williamson A M, Feyer A M. Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication.  Occup Environ Med. 2000;  57(10) 649-655
  • 30 Resident duty hours: enhancing sleep, supervision, and safety. In: Ulmer C, Wolman DM, Johns MME Committee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedules to Improve Patient Safety. Institute of Medicine of the National Academies. Washington, DC; The National Academies Press 2008
  • 31 Saper C B, Chou T C, Scammell T E. The sleep switch: hypothalamic control of sleep and wakefulness.  Trends Neurosci. 2001;  24(12) 726-731
  • 32 Mignot E, Taheri S, Nishino S. Sleeping with the hypothalamus: emerging therapeutic targets for sleep disorders.  Nat Neurosci. 2002;  5(Suppl) 1071-1075
  • 33 Hastings M H. Circadian rhythms: a gut feeling for time.  Nature. 2002;  417(6887) 391-392
  • 34 Van Dongen H PA, Dinges D F. Investigating the interaction between the homeostatic and circadian processes of sleep-wake regulation for the prediction of waking neurobehavioural performance.  J Sleep Res. 2003;  12(3) 181-187
  • 35 Goel N, Van Dongen H PA, Dinges D F. Circadian rhythms in sleepiness, alertness, and performance. In: Kryger MH, Dement WC, Roth T Principles and Practice of Sleep Medicine. 5th ed. Elsevier; In press
  • 36 Achermann P, Dijk D J, Brunner D P, Borbély A A. A model of human sleep homeostasis based on EEG slow-wave activity: quantitative comparison of data and simulations.  Brain Res Bull. 1993;  31(1-2) 97-113
  • 37 Borbély A A. A two process model of sleep regulation.  Hum Neurobiol. 1982;  1(3) 195-204
  • 38 Mallis M M, Mejdal S, Nguyen T T, Dinges D F. Summary of the key features of seven biomathematical models of human fatigue and performance.  Aviat Space Environ Med. 2004;  75(3, Suppl) A4-A14
  • 39 Jewett M E, Duffy J F, Czeisler C A. Khalsa SBS . The timing of the human circadian clock is accurately represented by the core body temperature rhythm following phase shifts to a three-cycle light stimulus near the critical zone.  J Biol Rhythms. 2000;  15(6) 524-530
  • 40 Doran S M, Van Dongen H PA, Dinges D F. Sustained attention performance during sleep deprivation: evidence of state instability.  Arch Ital Biol. 2001;  139(3) 253-267
  • 41 Lim J, Dinges D F. Sleep deprivation and vigilant attention.  Ann N Y Acad Sci. 2008;  1129 305-322
  • 42 Carskadon M A, Dement W C. Daytime sleepiness: quantification of a behavioral state.  Neurosci Biobehav Rev. 1987;  11(3) 307-317
  • 43 Dinges D F. Differential effects of prior wakefulness and circadian phase on nap sleep.  Electroencephalogr Clin Neurophysiol. 1986;  64(3) 224-227
  • 44 Richardson G S, Carskadon M A, Flagg W, Van den Hoed J, Dement W C, Mitler M M. Excessive daytime sleepiness in man: multiple sleep latency measurement in narcoleptic and control subjects.  Electroencephalogr Clin Neurophysiol. 1978;  45(5) 621-627
  • 45 Roehrs T A, Carskadon M A. Standardization of method: essential to sleep science.  Sleep. 1998;  21(5) 445
  • 46 Bonnet M H, Arand D L. Sleepiness as measured by modified multiple sleep latency testing varies as a function of preceding activity.  Sleep. 1998;  21(5) 477-483
  • 47 Mitler M M, Gujavarty K S, Browman C P. Maintenance of wakefulness test: a polysomnographic technique for evaluation treatment efficacy in patients with excessive somnolence.  Electroencephalogr Clin Neurophysiol. 1982;  53(6) 658-661
  • 48 Bjerner B. Alpha depression and lowered pulse rate during delayed actions in a serial reaction test: a study of sleep deprivation.  Acta Physiol Scand. 1949;  19(suppl 65) 1-93
  • 49 Akerstedt T. Sleep/wake disturbances in working life.  Electroencephalogr Clin Neurophysiol Suppl. 1987;  39 360-363
  • 50 Torsvall L, Akerstedt T. Sleepiness on the job: continuously measured EEG changes in train drivers.  Electroencephalogr Clin Neurophysiol. 1987;  66(6) 502-511
  • 51 Williams H L, Lubin A. Impaired performance with acute sleep loss.  Psychol Monogr. 1959;  73 1-26
  • 52 Kribbs N B, Dinges D F. Vigilance decrement and sleepiness. In: Harsh JR, Ogilvie RD Sleep Onset Mechanisms. Washington, DC; American Psychological Association 1994: 113-125
  • 53 Dorrian J, Rogers N L, Dinges D F. Psychomotor vigilance performance: a neurocognitive assay sensitive to sleep loss. In: Kushida CA Sleep Deprivation: Clinical Issues, Pharmacology and Sleep Loss Effects. New York, NY; Marcel Dekker Inc 2005: 39-70
  • 54 Rogers N L, Dorrian J, Dinges D F. Sleep, waking and neurobehavioural performance.  Front Biosci. 2003;  8 s1056-s1067
  • 55 Horne J A, Pettitt A N. High incentive effects on vigilance performance during 72 hours of total sleep deprivation.  Acta Psychol (Amst). 1985;  58(2) 123-139
  • 56 Patrick G T, Gilbert J A. On the effects of loss of sleep.  Psychol Rev. 1896;  3 469-483
  • 57 Kleitman N. Sleep and Wakefulness. Chicago, IL; The University of Chicago Press 1963
  • 58 Dinges D F. Are you awake? Cognitive performance and reverie during the hypnopompic state. In: Bootzin RR, Kihlstrom JF, Schacter DL Sleep and Cognition. Washington, DC; American Psychological Association 1990: 159-175
  • 59 Nansen F. Farthest North: The Incredible Three-Year Voyage to the Frozen Latitudes for the North. New York, NY; Random House Inc 1999
  • 60 Mallis M M, Maislin G, Powell J W, Staszewski J J, Grace R, Dinges D F. New drowsiness detection technologies testing their validity to track hypovigilance.  Sleep. 1998;  21(suppl 1) 172
  • 61 Price N J, Maislin G, Powell J W et al.. Unobtrusive detection of drowsiness-induced PVT lapses using infrared retinal reflectance of slow eyelid closures.  Sleep. 2003;  26(suppl) A177
  • 62 Morris T L, Miller J C. Electrooculographic and performance indices of fatigue during simulated flight.  Biol Psychol. 1996;  42(3) 343-360
  • 63 Caffier P P, Erdmann U, Ullsperger P. Experimental evaluation of eye-blink parameters as a drowsiness measure.  Eur J Appl Physiol. 2003;  89(3-4) 319-325
  • 64 Russo M, Thomas M, Thorne D et al.. Oculomotor impairment during chronic partial sleep deprivation.  Clin Neurophysiol. 2003;  114(4) 723-736
  • 65 Harrison Y, Horne J A. The impact of sleep deprivation on decision making: a review.  J Exp Psychol Appl. 2000;  6(3) 236-249
  • 66 Pilcher J J, Huffcutt A I. Effects of sleep deprivation on performance: a meta-analysis.  Sleep. 1996;  19(4) 318-326
  • 67 Murray E J. Sleep, Dreams, and Arousal. New York, NY; Appleton-Century-Crofts 1965
  • 68 Van Dongen H PA, Maislin G, Mullington J M, Dinges D F. The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation.  Sleep. 2003;  26(2) 117-126
  • 69 Van Dongen H PA, Rogers N L, Dinges D F. Understanding sleep debt: theoretical and empirical issues.  Sleep Biol Rhythms. 2003;  1 4-12
  • 70 Dinges D F, Rogers N L, Baynard M D. Chronic sleep deprivation. In: Kryger MH, Roth T, Dement WC Principles and Practice of Sleep Medicine. 4th ed. Philadelphia, PA; WB Saunders Company 2005: 67-76
  • 71 Banks S, Dinges D F. Behavioral and physiological consequences of sleep restriction.  J Clin Sleep Med. 2007;  3(5) 519-528
  • 72 Dinges D F, Pack F, Williams K et al.. Cumulative sleepiness, mood disturbance, and psychomotor vigilance performance decrements during a week of sleep restricted to 4-5 hours per night.  Sleep. 1997;  20(4) 267-277
  • 73 Belenky G, Wesensten N J, Thorne D R et al.. Patterns of performance degradation and restoration during sleep restriction and subsequent recovery: a sleep dose-response study.  J Sleep Res. 2003;  12(1) 1-12
  • 74 Drake C L, Roehrs T A, Burduvali E, Bonahoom A, Rosekind M, Roth T. Effects of rapid versus slow accumulation of eight hours of sleep loss.  Psychophysiology. 2001;  38(6) 979-987
  • 75 Wilkinson R T. Sleep deprivation: performance tests for partial and selective sleep deprivation. In: Abt L Progress in Clinical Psychology. New York, NY; Grune and Stratton 1969: 28-43
  • 76 Dinges D F. Probing the limits of functional capability: the effects of sleep loss on short-duration tasks. In: Broughton RJ, Ogilvie RD Sleep, Arousal, and Performance. Boston, MA; Birkhäuser 1992: 177-188
  • 77 Olofsen E, Dinges D F, Van Dongen H P. Nonlinear mixed-effects modeling: individualization and prediction.  Aviat Space Environ Med. 2004;  75(3, Suppl) A134-A140
  • 78 Van Dongen H P, Maislin G, Dinges D F. Dealing with inter-individual differences in the temporal dynamics of fatigue and performance: importance and techniques.  Aviat Space Environ Med. 2004;  75(3, Suppl) A147-A154
  • 79 Dinges D F, Powell J W. Microcomputer analyses of performance on a portable, simple visual RT task during sustained operations.  Behav Res Methods Instrum Comput. 1985;  16 652-655
  • 80 Balkin T J, Bliese P D, Belenky G et al.. Comparative utility of instruments for monitoring sleepiness-related performance decrements in the operational environment.  J Sleep Res. 2004;  13(3) 219-227
  • 81 Kane M J, Engle R W. The role of prefrontal cortex in working-memory capacity, executive attention, and general fluid intelligence: an individual-differences perspective.  Psychon Bull Rev. 2002;  9(4) 637-671
  • 82 Corey-Bloom J, Wiederholt W C, Edelstein S, Salmon D P, Cahn D, Barrett-Connor E. Cognitive and functional status of the oldest old.  J Am Geriatr Soc. 1996;  44(6) 671-674
  • 83 Jones K, Harrison Y. Frontal lobe function, sleep loss and fragmented sleep.  Sleep Med Rev. 2001;  5(6) 463-475
  • 84 Wimmer F, Hoffmann R F, Bonato R A, Moffitt A R. The effects of sleep deprivation on divergent thinking and attention processes.  J Sleep Res. 1992;  1(4) 223-230
  • 85 Horne J A. Sleep loss and “divergent” thinking ability.  Sleep. 1988;  11(6) 528-536
  • 86 Blagrove M, Alexander C, Horne J A. The effects of chronic sleep reduction on the performance of cognitive tasks sensitive to sleep deprivation.  Appl Cogn Psychol. 1995;  9 21-40
  • 87 Banderet L E, Stokes J W, Francesconi R, Kowal D M, Naitoh P. Artillery teams in simulated sustained combat: performance and other measures. In: Johnson LC, Tepas DJ, Colquhoun WP, Colligan MJ Biological Rhythms, Sleep and Shiftwork. New York, NY; Spectrum 1981: 459-477
  • 88 Harrison Y, Horne J A. Sleep loss and temporal memory.  Q J Exp Psychol A. 2000;  53(1) 271-279
  • 89 Morris G O, Williams H L, Lubin A. Misperceptions and disorientation during sleep.  Arch Gen Psychiatry. 1960;  2 247-254
  • 90 Norton R. The effects of acute sleep deprivation on selective attention.  Br J Psychol. 1970;  61(2) 157-161
  • 91 Harrison Y, Horne J A. One night of sleep loss impairs innovative thinking and flexible decision making.  Organ Behav Hum Decis Process. 1999;  78(2) 128-145
  • 92 Blagrove M, Alexander C, Horne J A. The effects of chronic sleep reduction on the performance of cognitive tasks sensitive to sleep deprivation.  Appl Cogn Psychol. 1994;  9 21-40
  • 93 Blagrove M. The effects of length of sleep deprivation on interrogative suggestibility.  J Exp Psychol Appl. 1996;  2 48-59
  • 94 May J, Kline P. Measuring the effects upon cognitive abilities of sleep loss during continuous operations.  Br J Psychol. 1987;  78(Pt 4) 443-455
  • 95 Harrison Y, Horne J A. Sleep loss affects risk-taking.  J Sleep Res. 1998;  7(suppl 2) 113
  • 96 Brown I D, Tickner A H, Simmonds D C. Effect of prolonged driving on overtaking criteria.  Ergonomics. 1970;  13(2) 239-242
  • 97 Dinges D F, Kribbs N B. Performing while sleepy: effects of experimentally-induced sleepiness. In: Monk TH Sleep, Sleepiness and Performance. Chichester, UK; John Wiley and Sons 1991: 97-128
  • 98 Kjellberg A. Effects of sleep deprivation on performance of a problem-solving task.  Psychol Rep. 1975;  37(2) 479-485
  • 99 Harrison Y, Horne J A. Sleep deprivation affects speech.  Sleep. 1997;  20(10) 871-877
  • 100 Harrison Y, Horne J A. Sleep loss impairs short and novel language tasks having a prefrontal focus.  J Sleep Res. 1998;  7(2) 95-100
  • 101 Herscovitch J, Stuss D, Broughton R. Changes in cognitive processing following short-term cumulative sleep deprivation and recovery oversleeping.  J Clin Neuropsychol. 1980;  2 301-319
  • 102 Drummond S PA, Brown G G. The effects of total sleep deprivation on cerebral responses to cognitive performance.  Neuropsychopharmacology. 2001;  25(5, Suppl) S68-S73
  • 103 Dang-Vu T T, Desseilles M, Petit D, Mazza S, Montplaisir J, Maquet P. Neuroimaging in sleep medicine.  Sleep Med. 2007;  8(4) 349-372
  • 104 Chee M W, Chuah L Y. Functional neuroimaging insights into how sleep and sleep deprivation affect memory and cognition.  Curr Opin Neurol. 2008;  21(4) 417-423
  • 105 Chuah L Y, Chee M W. Functional neuroimaging of sleep deprived healthy volunteers and persons with sleep disorders: a brief review.  Ann Acad Med Singapore. 2008;  37(8) 689-694
  • 106 Coull J T. Neural correlates of attention and arousal: insights from electrophysiology, functional neuroimaging and psychopharmacology.  Prog Neurobiol. 1998;  55(4) 343-361
  • 107 Kastner S, Ungerleider L G. Mechanisms of visual attention in the human cortex.  Annu Rev Neurosci. 2000;  23 315-341
  • 108 Wager T D, Smith E E. Neuroimaging studies of working memory: a meta-analysis.  Cogn Affect Behav Neurosci. 2003;  3(4) 255-274
  • 109 Shipp S. The brain circuitry of attention.  Trends Cogn Sci. 2004;  8(5) 223-230
  • 110 Naghavi H R, Nyberg L. Common fronto-parietal activity in attention, memory, and consciousness: shared demands on integration?.  Conscious Cogn. 2005;  14(2) 390-425
  • 111 Knudsen E I. Fundamental components of attention.  Annu Rev Neurosci. 2007;  30 57-78
  • 112 McDowd J M. An overview of attention: behavior and brain.  J Neurol Phys Ther. 2007;  31(3) 98-103
  • 113 Drummond S PA, Brown G G, Stricker J L, Buxton R B, Wong E C, Gillin J C. Sleep deprivation-induced reduction in cortical functional response to serial subtraction.  Neuroreport. 1999;  10(18) 3745-3748
  • 114 Thomas M, Sing H, Belenky G et al.. Neural basis of alertness and cognitive performance impairments during sleepiness. I. Effects of 24 h of sleep deprivation on waking human regional brain activity.  J Sleep Res. 2000;  9(4) 335-352
  • 115 Thomas M, Sing H, Belenky G et al.. Neural basis of alertness and cognitive performance impairments during sleepiness II. Effects of 48 and 72 h of sleep deprivation on waking human regional brain activity.  Thalamus Relat Syst. 2003;  2 199-229
  • 116 Drummond S PA, Brown G G, Gillin J C, Stricker J L, Wong E C, Buxton R B. Altered brain response to verbal learning following sleep deprivation.  Nature. 2000;  403(6770) 655-657
  • 117 Drummond S P, Meloy M J, Yanagi M A, Orff H J, Brown G G. Compensatory recruitment after sleep deprivation and the relationship with performance.  Psychiatry Res. 2005;  140 211-223
  • 118 Yoo S S, Hu P T, Gujar N, Jolesz F A, Walker M P. A deficit in the ability to form new human memories without sleep.  Nat Neurosci. 2007;  10(3) 385-392
  • 119 Drummond S P, Brown G G, Salamat J S, Gillin J C. Increasing task difficulty facilitates the cerebral compensatory response to total sleep deprivation.  Sleep. 2004;  27(3) 445-451
  • 120 Strangman G, Thompson J H, Strauss M M, Marshburn T H, Sutton J P. Functional brain imaging of a complex navigation task following one night of total sleep deprivation: a preliminary study.  J Sleep Res. 2005;  14(4) 369-375
  • 121 Chuah Y M, Venkatraman V, Dinges D F, Chee M W. The neural basis of interindividual variability in inhibitory efficiency after sleep deprivation.  J Neurosci. 2006;  26(27) 7156-7162
  • 122 Venkatraman V, Chuah Y M, Huettel S A, Chee M W. Sleep deprivation elevates expectation of gains and attenuates response to losses following risky decisions.  Sleep. 2007;  30(5) 603-609
  • 123 Yoo S S, Gujar N, Hu P, Jolesz F A, Walker M P. The human emotional brain without sleep—a prefrontal amygdala disconnect.  Curr Biol. 2007;  17(20) R877-R878
  • 124 Wu J C, Gillin J C, Buchsbaum M S et al.. The effect of sleep deprivation on cerebral glucose metabolic rate in normal humans assessed with positron emission tomography.  Sleep. 1991;  14(2) 155-162
  • 125 Wu J C, Gillin J C, Buchsbaum M S et al.. Frontal lobe metabolic decreases with sleep deprivation not totally reversed by recovery sleep.  Neuropsychopharmacology. 2006;  31(12) 2783-2792
  • 126 Elmenhorst D, Meyer P T, Winz O H et al.. Sleep deprivation increases A1 adenosine receptor binding in the human brain: a positron emission tomography study.  J Neurosci. 2007;  27(9) 2410-2415
  • 127 Volkow N D, Wang G J, Telang F et al.. Sleep deprivation decreases binding of [11C]raclopride to dopamine D2/D3 receptors in the human brain.  J Neurosci. 2008;  28(34) 8454-8461
  • 128 Burock M A, Buckner R L, Woldorff M G, Rosen B R, Dale A M. Randomized event-related experimental designs allow for extremely rapid presentation rates using functional MRI.  Neuroreport. 1998;  9(16) 3735-3739
  • 129 Portas C M, Rees G, Howseman A M, Josephs O, Turner R, Frith C D. A specific role for the thalamus in mediating the interaction of attention and arousal in humans.  J Neurosci. 1998;  18(21) 8979-8989
  • 130 Drummond S P, Bischoff-Grethe A, Dinges D F, Ayalon L, Mednick S C, Meloy M J. The neural basis of the psychomotor vigilance task.  Sleep. 2005;  28(9) 1059-1068
  • 131 Drummond S PA, Gillin J C, Brown G G. Increased cerebral response during a divided attention task following sleep deprivation.  J Sleep Res. 2001;  10(2) 85-92
  • 132 Bell-McGinty S, Habeck C, Hilton H J et al.. Identification and differential vulnerability of a neural network in sleep deprivation.  Cereb Cortex. 2004;  14(5) 496-502
  • 133 Chee M W, Choo W C. Functional imaging of working memory after 24 hr of total sleep deprivation.  J Neurosci. 2004;  24(19) 4560-4567
  • 134 Habeck C, Rakitin B C, Moeller J et al.. An event-related fMRI study of the neurobehavioral impact of sleep deprivation on performance of a delayed-match-to-sample task.  Brain Res Cogn Brain Res. 2004;  18(3) 306-321
  • 135 Caldwell J A, Mu Q, Smith J K et al.. Are individual differences in fatigue vulnerability related to baseline differences in cortical activation?.  Behav Neurosci. 2005;  119(3) 694-707
  • 136 Choo W C, Lee W W, Venkatraman V, Sheu F S, Chee M W. Dissociation of cortical regions modulated by both working memory load and sleep deprivation and by sleep deprivation alone.  Neuroimage. 2005;  25(2) 579-587
  • 137 Mu Q, Nahas Z, Johnson K A et al.. Decreased cortical response to verbal working memory following sleep deprivation.  Sleep. 2005;  28(1) 55-67
  • 138 Mu Q, Mishory A, Johnson K A et al.. Decreased brain activation during a working memory task at rested baseline is associated with vulnerability to sleep deprivation.  Sleep. 2005;  28(4) 433-446
  • 139 Chee M W, Chuah L Y, Venkatraman V, Chan W Y, Philip P, Dinges D F. Functional imaging of working memory following normal sleep and after 24 and 35 h of sleep deprivation: correlations of fronto-parietal activation with performance.  Neuroimage. 2006;  31(1) 419-428
  • 140 Chee M W, Chuah Y M. Functional neuroimaging and behavioral correlates of capacity decline in visual short-term memory after sleep deprivation.  Proc Natl Acad Sci U S A. 2007;  104(22) 9487-9492
  • 141 Chee M W, Tan J C, Zheng H et al.. Lapsing during sleep deprivation is associated with distributed changes in brain activation.  J Neurosci. 2008;  28(21) 5519-5528
  • 142 Lim J, Choo W C, Chee M W. Reproducibility of changes in behaviour and fMRI activation associated with sleep deprivation in a working memory task.  Sleep. 2007;  30(1) 61-70
  • 143 Mander B A, Reid K J, Davuluri V K et al.. Sleep deprivation alters functioning within the neural network underlying the covert orienting of attention.  Brain Res. 2008;  1217 148-156
  • 144 Tomasi D, Wang R L, Telang F et al.. Impairment of attentional networks after 1 night of sleep deprivation.  Cereb Cortex. 2009;  19(1) 233-240
  • 145 Sterpenich V, Albouy G, Boly M et al.. Sleep-related hippocampo-cortical interplay during emotional memory recollection.  PLoS Biol. 2007;  5(11) e282
  • 146 Chuah L Y, Chee M W. Cholinergic augmentation modulates visual task performance in sleep-deprived young adults.  J Neurosci. 2008;  28(44) 11369-11377
  • 147 Luber B, Stanford A D, Bulow P et al.. Remediation of sleep-deprivation-induced working memory impairment with fMRI-guided transcranial magnetic stimulation.  Cereb Cortex. 2008;  18(9) 2077-2085
  • 148 Van Dongen H PA, Baynard M D, Maislin G, Dinges D F. Systematic interindividual differences in neurobehavioral impairment from sleep loss: evidence of trait-like differential vulnerability.  Sleep. 2004;  27(3) 423-433
  • 149 Stern Y. What is cognitive reserve? Theory and research application of the reserve concept.  J Int Neuropsychol Soc. 2002;  8(3) 448-460
  • 150 Zarahn E, Aguirre G K, D'Esposito M. Empirical analyses of BOLD fMRI statistics. I. Spatially unsmoothed data collected under null-hypothesis conditions.  Neuroimage. 1997;  5(3) 179-197
  • 151 Friston K J, Josephs O, Zarahn E, Holmes A P, Rouquette S, Poline J. To smooth or not to smooth? Bias and efficiency in fMRI time-series analysis.  Neuroimage. 2000;  12(2) 196-208
  • 152 Aguirre G K, Zarahn E, D'Esposito M. Empirical analyses of BOLD fMRI statistics. II. Spatially smoothed data collected under null-hypothesis and experimental conditions.  Neuroimage. 1997;  5(3) 199-212
  • 153 Aguirre G K, Detre J A, Zarahn E, Alsop D C. Experimental design and the relative sensitivity of BOLD and perfusion fMRI.  Neuroimage. 2002;  15(3) 488-500
  • 154 Detre J A, Leigh J S, Williams D S, Koretsky A P. Perfusion imaging.  Magn Reson Med. 1992;  23(1) 37-45
  • 155 Detre J A, Alsop D C. Perfusion magnetic resonance imaging with continuous arterial spin labeling: methods and clinical applications in the central nervous system.  Eur J Radiol. 1999;  30(2) 115-124
  • 156 Wang J, Rao H, Wetmore G S et al.. Perfusion functional MRI reveals cerebral blood flow pattern under psychological stress.  Proc Natl Acad Sci U S A. 2005;  102(49) 17804-17809
  • 157 Kim J, Whyte J, Wang J, Rao H, Tang K Z, Detre J A. Continuous ASL perfusion fMRI investigation of higher cognition: quantification of tonic CBF changes during sustained attention and working memory tasks.  Neuroimage. 2006;  31(1) 376-385
  • 158 Olson I R, Rao H, Moore K S, Wang J, Detre J A, Aguirre G K. Using perfusion fMRI to measure continuous changes in neural activity with learning.  Brain Cogn. 2006;  60(3) 262-271
  • 159 Rao H, Wang J, Tang K, Pan W, Detre J A. Imaging brain activity during natural vision using CASL perfusion fMRI.  Hum Brain Mapp. 2007;  28(7) 593-601
  • 160 Rao H, Gillihan S J, Wang J et al.. Genetic variation in serotonin transporter alters resting brain function in healthy individuals.  Biol Psychiatry. 2007;  62(6) 600-606
  • 161 Rao H, Wang J, Giannetta J et al.. Altered resting cerebral blood flow in adolescents with in utero cocaine exposure revealed by perfusion functional MRI.  Pediatrics. 2007;  120(5) e1245-e1254
  • 162 Wang Z, Faith M, Patterson F et al.. Neural substrates of abstinence-induced cigarette cravings in chronic smokers.  J Neurosci. 2007;  27(51) 14035-14040
  • 163 Wang J, Aguirre G K, Kimberg D Y, Roc A C, Li L, Detre J A. Arterial spin labeling perfusion fMRI with very low task frequency.  Magn Reson Med. 2003;  49(5) 796-802
  • 164 Asllani I, Habeck C, Borogovac A et al.. Effects of 48hr sleep deprivation on cerebral blood flow measured with arterial spin labeling MRI. In: Proceedings of the 15th Annual Meeting of the International Society for Magnetic Resonance in Medicine Berkeley, CA; International Society for Magnetic Resonance in Medicine 2007: 0507
  • 165 Rao H, Lim J, Wu W C, Detre J A, Dinges D F. Neural correlates of inter-individual differences in sleep deprivation susceptibility: a pilot perfusion imaging study on the Psychomotor Vigilance Test. Paper presented at: National Sleep Foundation Young Investigators Conference, Basic Research Session March 2, 2008 Washington, DC;
  • 166 Carskadon M A, Dement W C. Cumulative effects of sleep restriction on daytime sleepiness.  Psychophysiology. 1981;  18(2) 107-113
  • 167 Leproult R, Colecchia E F, Berardi A M, Stickgold R, Kosslyn S M, Van Cauter E. Individual differences in subjective and objective alertness during sleep deprivation are stable and unrelated.  Am J Physiol Regul Integr Comp Physiol. 2003;  284(2) R280-R290
  • 168 Van Dongen H PA, Dinges D F. Sleep, circadian rhythms, and psychomotor vigilance.  Clin Sports Med. 2005;  24(2) 237-249
  • 169 Van Dongen H PA, Vitellaro K M, Dinges D F. Individual differences in adult human sleep and wakefulness: leitmotif for a research agenda.  Sleep. 2005;  28(4) 479-496
  • 170 von Schantz M. Phenotypic effects of genetic variability in human clock genes on circadian and sleep parameters.  J Genet. 2008;  87(5) 513-519
  • 171 Landolt H P. Genotype-dependent differences in sleep, vigilance, and response to stimulants.  Curr Pharm Des. 2008;  14(32) 3396-3407
  • 172 Partonen T, Treutlein J, Alpman A et al.. Three circadian clock genes Per2, Arntl, and Npas2 contribute to winter depression.  Ann Med. 2007;  39(3) 229-238
  • 173 Johansson C, Willeit M, Smedh C et al.. Circadian clock-related polymorphisms in seasonal affective disorder and their relevance to diurnal preference.  Neuropsychopharmacology. 2003;  28(4) 734-739
  • 174 Desan P H, Oren D A, Malison R et al.. Genetic polymorphism at the CLOCK gene locus and major depression.  Am J Med Genet. 2000;  96(3) 418-421
  • 175 Benedetti F, Dallaspezia S, Fulgosi M C et al.. Actimetric evidence that CLOCK 3111 T/C SNP influences sleep and activity patterns in patients affected by bipolar depression.  Am J Med Genet B Neuropsychiatr Genet. 2007;  144B 631-635
  • 176 Ebisawa T. Circadian rhythms in the CNS and peripheral clock disorders: human sleep disorders and clock genes.  J Pharmacol Sci. 2007;  103(2) 150-154
  • 177 Lamont E W, James F O, Boivin D B, Cermakian N. From circadian clock gene expression to pathologies.  Sleep Med. 2007;  8(6) 547-556
  • 178 Kimura M, Winkelmann J. Genetics of sleep and sleep disorders.  Cell Mol Life Sci. 2007;  64(10) 1216-1226
  • 179 Tafti M, Maret S, Dauvilliers Y. Genes for normal sleep and sleep disorders.  Ann Med. 2005;  37(8) 580-589
  • 180 Dauvilliers Y, Maret S, Tafti M. Genetics of normal and pathological sleep in humans.  Sleep Med Rev. 2005;  9(2) 91-100
  • 181 Bodenmann S, Xu S, Luhmann U F et al.. Pharmacogenetics of modafinil after sleep loss: catechol-O-methyltransferase genotype modulates waking functions but not recovery sleep.  Clin Pharmacol Ther. 2009;  85(3) 296-304
  • 182 Rétey J V, Adam M, Khatami R et al.. A genetic variation in the adenosine A2A receptor gene (ADORA2A) contributes to individual sensitivity to caffeine effects on sleep.  Clin Pharmacol Ther. 2007;  81(5) 692-698
  • 183 Nadkarni N A, Weale M E, von Schantz M, Thomas M G. Evolution of a length polymorphism in the human PER3 gene, a component of the circadian system.  J Biol Rhythms. 2005;  20(6) 490-499
  • 184 Ciarleglio C M, Ryckman K K, Servick S V et al.. Genetic differences in human circadian clock genes among worldwide populations.  J Biol Rhythms. 2008;  23(4) 330-340
  • 185 Viola A U, Archer S N, James L M et al.. PER3 polymorphism predicts sleep structure and waking performance.  Curr Biol. 2007;  17(7) 613-618
  • 186 Groeger J A, Viola A U, Lo J C, von Schantz M, Archer S N, Dijk D J. Early morning executive functioning during sleep deprivation is compromised by a PERIOD3 polymorphism.  Sleep. 2008;  31(8) 1159-1167
  • 187 Viola A U, James L M, Archer S N, Dijk D J. PER3 polymorphism and cardiac autonomic control: effects of sleep debt and circadian phase.  Am J Physiol Heart Circ Physiol. 2008;  295(5) H2156-H2163
  • 188 Archer S N, Viola A U, Kyriakopoulou V, von Schantz M, Dijk D J. Inter-individual differences in habitual sleep timing and entrained phase of endogenous circadian rhythms of BMAL1, PER2 and PER3 mRNA in human leukocytes.  Sleep. 2008;  31(5) 608-617
  • 189 Archer S N, Robilliard D L, Skene D J et al.. A length polymorphism in the circadian clock gene Per3 is linked to delayed sleep phase syndrome and extreme diurnal preference.  Sleep. 2003;  26(4) 413-415
  • 190 Pereira D S, Tufik S, Louzada F M et al.. Association of the length polymorphism in the human Per3 gene with the delayed sleep-phase syndrome: does latitude have an influence upon it?.  Sleep. 2005;  28(1) 29-32
  • 191 Jones K H, Ellis J, von Schantz M, Skene D J, Dijk D J, Archer S N. Age-related change in the association between a polymorphism in the PER3 gene and preferred timing of sleep and waking activities.  J Sleep Res. 2007;  16(1) 12-16
  • 192 Ebisawa T, Uchiyama M, Kajimura N et al.. Association of structural polymorphisms in the human period3 gene with delayed sleep phase syndrome.  EMBO Rep. 2001;  2(4) 342-346
  • 193 Goel N, Banks S, Mignot E, Dinges D F. PER3 polymorphism predicts cumulative sleep homeostatic but not neurobehavioral changes to chronic partial sleep deprivation.  PLoS One. 2009;  4(6) e5874
  • 194 EEG arousals: scoring rules and examples: a preliminary report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association.  Sleep. 1992;  15 173-184
  • 195 Bonnet M H. Performance and sleepiness as a function of frequency and placement of sleep disruption.  Psychophysiology. 1986;  23(3) 263-271
  • 196 Levine B, Roehrs T, Stepanski E, Zorick F, Roth T. Fragmenting sleep diminishes its recuperative value.  Sleep. 1987;  10(6) 590-599
  • 197 Martin S E, Brander P E, Deary I J, Douglas N J. The effect of clustered versus regular sleep fragmentation on daytime function.  J Sleep Res. 1999;  8(4) 305-311
  • 198 Martin S E, Engleman H M, Deary I J, Douglas N J. The effect of sleep fragmentation on daytime function.  Am J Respir Crit Care Med. 1996;  153(4 Pt 1) 1328-1332
  • 199 Roehrs T, Shore E, Papineau K, Rosenthal L, Roth T. A two-week sleep extension in sleepy normals.  Sleep. 1996;  19 576-582
  • 200 Stepanski E, Lamphere J, Badia P, Zorick F, Roth T. Sleep fragmentation and daytime sleepiness.  Sleep. 1984;  7(1) 18-26
  • 201 Stepanski E, Lamphere J, Roehrs T, Zorick F, Roth T. Experimental sleep fragmentation in normal subjects.  Int J Neurosci. 1987;  33(3-4) 207-214
  • 202 Bonnet M H. Performance and sleepiness following moderate sleep disruption and slow wave sleep deprivation.  Physiol Behav. 1986;  37(6) 915-918
  • 203 Bonnet M H. Sleep restoration as a function of periodic awakening, movement, or electroencephalographic change.  Sleep. 1987;  10(4) 364-373
  • 204 Bonnet M H. Infrequent periodic sleep disruption: effects on sleep, performance and mood.  Physiol Behav. 1989;  45(5) 1049-1055
  • 205 Bonnet M H. The effect of sleep fragmentation on sleep and performance in younger and older subjects.  Neurobiol Aging. 1989;  10(1) 21-25
  • 206 Bonnet M H, Berry R B, Arand D L. Metabolism during normal, fragmented, and recovery sleep.  J Appl Physiol. 1991;  71(3) 1112-1118
  • 207 Kingshott R N, Cosway R J, Deary I J, Douglas N J. The effect of sleep fragmentation on cognitive processing using computerized topographic brain mapping.  J Sleep Res. 2000;  9(4) 353-357
  • 208 Martin S E, Wraith P K, Deary I J, Douglas N J. The effect of nonvisible sleep fragmentation on daytime function.  Am J Respir Crit Care Med. 1997;  155(5) 1596-1601
  • 209 Downey R, Bonnet M H. Performance during frequent sleep disruption.  Sleep. 1987;  10(4) 354-363
  • 210 Bresnitz E A, Goldberg R, Kosinski R M. Epidemiology of obstructive sleep apnea.  Epidemiol Rev. 1994;  16(2) 210-227
  • 211 Kripke D F, Ancoli-Israel S, Klauber M R, Wingard D L, Mason W J, Mullaney D J. Prevalence of sleep-disordered breathing in ages 40-64 years: a population-based survey.  Sleep. 1997;  20(1) 65-76
  • 212 Olson L G, King M T, Hensley M J, Saunders N A. A community study of snoring and sleep-disordered breathing. Health outcomes.  Am J Respir Crit Care Med. 1995;  152(2) 717-720
  • 213 Redline S, Young T. Epidemiology and natural history of obstructive sleep apnea.  Ear Nose Throat J. 1993;  72(1) 20-21, 24–26
  • 214 Davies R J, Vardi-Visy K, Clarke M, Stradling J R. Identification of sleep disruption and sleep disordered breathing from the systolic blood pressure profile.  Thorax. 1993;  48(12) 1242-1247
  • 215 Ringler J, Basner R C, Shannon R et al.. Hypoxemia alone does not explain blood pressure elevations after obstructive apneas.  J Appl Physiol. 1990;  69(6) 2143-2148
  • 216 Martin S E, Engleman H M, Kingshott R N, Douglas N J. Microarousals in patients with sleep apnoea/hypopnoea syndrome.  J Sleep Res. 1997;  6(4) 276-280
  • 217 Naëgelé B, Thouvard V, Pépin J L et al.. Deficits of cognitive executive functions in patients with sleep apnea syndrome.  Sleep. 1995;  18(1) 43-52
  • 218 Engleman H M, Kingshott R N, Martin S E, Douglas N J. Cognitive function in the sleep apnea/hypopnea syndrome (SAHS).  Sleep. 2000;  23(Suppl 4) S102-S108
  • 219 Miyamoto T, Miyamoto M, Takekawa H, Kubo J, Hirata K, Katayama S. A comparison of middle latency auditory-evoked response in obstructive sleep apnea syndrome before and after treatment.  Psychiatry Clin Neurosci. 2001;  55(3) 251-252
  • 220 Paquereau J, Meurice J C, Neau J P, Ingrand P, Patte F. Auditory brain-stem responses (ABRs) in sleep respiratory disorders.  Eur J Clin Invest. 1994;  24(3) 156-160
  • 221 Sangal R B, Sangal J M. Obstructive sleep apnea and abnormal P300 latency topography.  Clin Electroencephalogr. 1997;  28(1) 16-25
  • 222 Rumbach L, Krieger J, Kurtz D. Auditory event-related potentials in obstructive sleep apnea: effects of treatment with nasal continuous positive airway pressure.  Electroencephalogr Clin Neurophysiol. 1991;  80(5) 454-457
  • 223 Vgontzas A N, Bixler E O, Chrousos G P. Sleep apnea is a manifestation of the metabolic syndrome.  Sleep Med Rev. 2005;  9(3) 211-224
  • 224 Waters K A, Mast B T, Vella S et al.. Structural equation modeling of sleep apnea, inflammation, and metabolic dysfunction in children.  J Sleep Res. 2007;  16(4) 388-395
  • 225 Gozal D, Serpero L D, Sans Capdevila O, Kheirandish-Gozal L. Systemic inflammation in non-obese children with obstructive sleep apnea.  Sleep Med. 2008;  9(3) 254-259
  • 226 Haensel A, Bardwell W A, Mills P J et al.. Relationship between inflammation and cognitive function in obstructive sleep apnea.  Sleep Breath. 2009;  13(1) 35-41
  • 227 Gozal D, Sans Capdevila O, McLaughlin Crabtree V, Serpero L D, Witcher L A, Kheirandish-Gozal L. Plasma IGF-1 levels and cognitive dysfunction in children with obstructive sleep apnea.  Sleep Med. 2009;  10(2) 167-173
  • 228 Fulda S, Schulz H. Cognitive dysfunction in sleep-related breathing disorders: a meta-analysis.  Sleep Res Online. 2003;  5 19-51
  • 229 Chervin R D, Archbold K H, Dillon J E et al.. Associations between symptoms of inattention, hyperactivity, restless legs, and periodic leg movements.  Sleep. 2002;  25(2) 213-218
  • 230 Chervin R D, Archbold K H, Dillon J E et al.. Inattention, hyperactivity, and symptoms of sleep-disordered breathing.  Pediatrics. 2002;  109(3) 449-456
  • 231 Chervin R D, Archbold K H. Hyperactivity and polysomnographic findings in children evaluated for sleep-disordered breathing.  Sleep. 2001;  24(3) 313-320
  • 232 Picchietti D L, England S J, Walters A S, Willis K, Verrico T. Periodic limb movement disorder and restless legs syndrome in children with attention-deficit hyperactivity disorder.  J Child Neurol. 1998;  13(12) 588-594
  • 233 Picchietti D L, Underwood D J, Farris W A et al.. Further studies on periodic limb movement disorder and restless legs syndrome in children with attention-deficit hyperactivity disorder.  Mov Disord. 1999;  14(6) 1000-1007
  • 234 Walters A S, Picchietti D L, Ehrenberg B L, Wagner M L. Restless legs syndrome in childhood and adolescence.  Pediatr Neurol. 1994;  11(3) 241-245
  • 235 Pearson V E, Allen R P, Dean T, Gamaldo C E, Lesage S R, Earley C J. Cognitive deficits associated with restless legs syndrome (RLS).  Sleep Med. 2006;  7(1) 25-30
  • 236 Gamaldo C E, Benbrook A R, Allen R P, Oguntimein O, Earley C J. A further evaluation of the cognitive deficits associated with restless legs syndrome (RLS).  Sleep Med. 2008;  9(5) 500-505

David F DingesPh.D. 

Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania School of Medicine

1013 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021

Email: dinges@mail.med.upenn.edu

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