Previous research has shown that total sleep deprivation produces impairment in sustained attention and vigilance especially if the deprivation period is greater than 48 hours. However little is known about the effects of sleep deprivation on performance of tasks considered to be measures of higher cortical functioning such as tests of cognitive flexibility and the capacity to shift from one response set to another. One current hypothesis is that sleep deprivation of a shorter duration (34-36 hours) adversely affects higher cortical function while effects on attention and vigilance tasks are relatively mild. Performance on an intelligence test, a test of sustained attention and tests designed to measure higher cortical function were compared in a group of 29 subjects who underwent 34-36 hours of continuous sleep deprivation and 32 normal sleeping control subjects. No significant group performance differences in the hypothesized direction were noted on any measure. One night of total sleep deprivation does not appear to impair performance on tasks that are designed to assess higher cortical functioning.

The sleep of 15 adult subjects who reported heightened generalized anxiety in the absence of other psychiatric syndromes and a 15-adult contrast group were studied by means of nocturnal polysomnography. Analysis of polysomnography variables revealed a significant discriminant function that accounted for 79% of the variance between groups, indicating that high-anxiety/worry subjects took longer to fall asleep, had a smaller percentage of deep (slow-wave) sleep, and more frequent transitions into light sleep [stage 1 nonrapid eye movement (NREM)]. Additional analyses indicated that high-anxiety/worry subjects had a greater percentage of light sleep, more early microarousals, a lower rapid eye movement (REM) density relative to low-anxiety subjects. These subjects also showed more electrodermal storming when slow-wave sleep and REM sleep variables were covaried. Results indicated disrupted sleep depth and continuity similar to that documented in clinical anxiety disorder patients and distinct from that of depressed patients. These results indicate that generalized anxiety and worry in otherwise healthy individuals may act to produce a clinically significant sleep disturbance in the absence of other psychiatric symptoms.

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This investigation compared progressive muscle relaxation plus cognitive distraction (PMR/CD), hypothesized to better improve sleep onset, versus sleep restriction and stimulus control (SR/SC), hypothesized to better improve sleep maintenance, versus a flurazepam (Dalmane) positive contrast condition (MED) and a sleep hygiene education minimal treatment control condition (SHE). Participants with chronic insomnia (N = 53), completed 2 baseline weeks of sleep diaries, and were randomly assigned to a treatment group for 2 more weeks. In the second phase, PMR/CD participants were assigned to 2 weeks of PMR/CD + SR/SC + SHE while SHE participants continued SHE. Results indicated that PMR/CD had greater effect upon sleep onset than SR/SC and SHE, SR/SC had greater effect on sleep maintenance than PMR/CD, and MED was better than the other treatments. In the second phase, the treatment package produced modest additional improvements and SHE performed superior to expectations.

The Dot Counting Test (DCT) offers a technique for malingering detection that is less transparent than the forced-choice testing that has received so much recent attention. The present study defined six dependent variables derived from DCT responses, and examined these variables in the context of differentiating simulators from non-simulators. Four groups of subjects were studied: normal controls, neuropsychological evaluation patients, naive (uncoached) malingering simulators, and sophisticated (coached) malingering simulators. Results demonstrate that the DCT provides several different scores that significantly differ between simulators and non-simulators. The DCT appears to hold promise as an additional tool to neuropsychologists in the detection of malingering.