Sleep deprivation, vigilant attention, and brain function: a review

Hudson, Amanda N.; Dongen, Hans P A Van; Honn, Kimberly

doi:10.1038/s41386-019-0432-6

Cited by 239 publications

(173 citation statements)

References 102 publications

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“…The fact that only the ESS scores correlated with SDs of the intensive attention test, suggests that sleepiness can be related to attention instability, as measured by RT variability. Instability due to sleep loss was already described (e.g., [ 89 ]). Of course, we must still explain why ESS did not correlate with divided attention performance.…”

Section: Discussionmentioning

confidence: 92%

The Neuropsychological Profile of Attention Deficits of Patients with Obstructive Sleep Apnea: An Update on the Daytime Attentional Impairment

et al. 2020

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Introduction: Patients with obstructive sleep apnea (OSA) suffer from several neurocognitive disturbances. One of the neuropsychological processes most investigated in OSA patients is attention, but the results have been controversial. Here, we update the attention profile of OSA patients with the final aim to improve attention assessment, with a possible impact on clinical and medical-legal practices, in terms of which attention subdomains and parameters need consideration and which one is a high-risk OSA phenotype for attention dysfunctions. Method: For this purpose, we assessed 32 previously untreated OSA patients (26 men and 6 women) under 65 years of age (mean age 53.2 ± 7.3; mean education level 10.4 ± 3.4 years) suffering from moderate to severe sleep apnea and hypopnea (mean apnea-hypopnea index (AHI) 45.3 ± 22.9, range 16.1–69.6). A control group of 34 healthy participants matched with OSA patients for age, education level, and general cognitive functioning were also enrolled. The OSA patients and healthy participants were tested through an extensive computerized battery (Test of Attentional Performance, TAP) that evaluated intensive (i.e., alertness and vigilance) and selective (i.e., divided and selective) dimensions of attention and returned different outcome parameters (i.e., reaction time, stability of performance, and various types of errors). Data analysis: The data were analyzed by ANCOVA which compared the speed and accuracy performance of the OSA and control participants (cognitive reserve was treated as a covariate). The possible mechanisms underlying attention deficits in OSA patients were examined through correlation analysis among AHI, oxygenation parameters, sleepiness scores, and TAP outcomes and by comparing the following three phenotypes of patients: severe OSA and severe nocturnal desaturators (AHI++D+), severe OSA nondesaturators (AHI++D−), and moderate OSA nondesaturators (AHI+D−). Results: The results suggest that the OSA patients manifest deficits in both intensive and selective attention processes and that reaction time (RT) alone is ineffective for detecting and characterizing their problems, for which error analysis and stability of performance also have to be considered. Patients with severe OSA and severe hypoxemia underperformed on alertness and vigilance attention subtests. Conclusions: The data suggest the importance of evaluating attention deficits among OSA patients through several parameters (including performance instability). Moreover, the data suggest a multifaceted mechanism underlying attention dysfunction in OSA patients.

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Section: Discussionmentioning

confidence: 92%

The Neuropsychological Profile of Attention Deficits of Patients with Obstructive Sleep Apnea: An Update on the Daytime Attentional Impairment

et al. 2020

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“…We explored the association between objectively measured free-living sleep and working memory and visual attention tasks in healthy adolescents since prior studies conducted in clinical settings have shown that sleep restriction affects these cognitive functions 35 . We found that shorter time in bed the night prior to the cognitive testing was negatively associated with performance on the most challenging short-term memory load, indicating that acute short sleep can affect short-term working memory, even in a healthy population measured in a free-living setting.…”

Section: Discussionmentioning

confidence: 99%

“…Sleep curtailment has been shown to have a deleterious effect on cognitive function both in laboratory studies 9 , 35 and actigraphy-based sleep assessment 15 . For example, adolescents aged 15–19 years randomly assigned to seven nights of sleep restriction, i.e.…”

Section: Discussionmentioning

confidence: 99%

Association between free-living sleep and memory and attention in healthy adolescents

Stefansdottir

Gundersen

Rögnvaldsdóttir

et al. 2020

Sci Rep

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In laboratory studies, imposed sleep restriction consistently reduces cognitive performance. However, the association between objectively measured, free-living sleep and cognitive function has not been studied in older adolescents. To address this gap, we measured one week of sleep with a wrist-worn GT3X+ actigraph in 160 adolescents (96 girls, 17.7 ± 0.3 years) followed by assessment of working memory with an n-back task and visual attention with a Posner cue-target task. Over the week, participants spent 7.1 ± 0.8 h/night in bed and slept 6.2 ± 0.8 h/night with 88.5 ± 4.8% efficiency and considerable intra-participant night-to-night variation, with a standard deviation in sleep duration of 1.2 ± 0.7 h. Sleep measures the night before cognitive testing were similar to weekly averages. Time in bed the night before cognitive testing was negatively associated with response times during the most challenging memory task (3-back; p = 0.005). However, sleep measures the night before did not correlate with performance on the attention task and weekly sleep parameters were not associated with either cognitive task. Our data suggests shorter acute free-living sleep may negatively impact difficult memory tasks, however the relationship between free-living sleep and cognitive task performance in healthy adolescents is less clear than that of laboratory findings, perhaps due to high night-to-night sleep variation.

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“…If time in bed is considerably less than perceived sleep need, this represents a measure of partial sleep deprivation. Chronic partial sleep deprivation has been shown to lead to modifications in executive function [41], to increase impulsive actions [42] and to reduce sustained [43] and vigilant attention [44] which could increase ANMAS even in the absence of sleepiness. Insomniacs can be divided into two groups, those with and those without reduced sleep time and our finding that sleep debt contributes to ANMAS implies an increased risk in those with reduced sleep time.…”

Section: Anmas and Sleep Habitsmentioning

confidence: 99%

Do hypnotics increase the risk of driving accidents or near miss accidents due to hypovigilance? The effects of sex, chronic sleepiness, sleep habits and sleep pathology

Royant-Parola¹,

Kovess

Brion³

et al. 2020

PLoS ONE

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Driving accidents due to hypovigilance are common but the role of hypnotics is unclear in patients suffering from sleep disorders. Our study examined factors influencing accidents and near miss accidents attributed to sleepiness at the wheel (ANMAS). Using data from an online questionnaire aimed at patients with sleep disorders, we analysed the associations between ANMAS, sociodemographic data, symptoms of sleep disorders, severity of insomnia (Insomnia Severity Index (ISI)) symptoms of anxiety and depression (Hospital Anxiety and Depression scale with depression (HADD) and anxiety (HADA) subscales), chronic sleepiness (Epworth sleepiness scale ESS), hypnotic use and information about sleep habits. Hypnotics were hierarchically grouped into Z-drugs, sedative medication, melatonin and over the counter (OTC) alternative treatments. Of 10802 participants; 9.1% reported ANMAS (Men 11.1% women 8.3%) and 24.4% took hypnotics (Z-drugs 8.5%, sedative medication 8%, melatonin 5.6% and alternative treatments 2.5%). Logistic regression analysis identified the following risk factors for ANMAS: moderate (

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Sleep deprivation, vigilant attention, and brain function: a review

Cited by 239 publications

References 102 publications

The Neuropsychological Profile of Attention Deficits of Patients with Obstructive Sleep Apnea: An Update on the Daytime Attentional Impairment

The Neuropsychological Profile of Attention Deficits of Patients with Obstructive Sleep Apnea: An Update on the Daytime Attentional Impairment

Association between free-living sleep and memory and attention in healthy adolescents

Do hypnotics increase the risk of driving accidents or near miss accidents due to hypovigilance? The effects of sex, chronic sleepiness, sleep habits and sleep pathology

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