Neurobehavioral dynamics following chronic sleep restriction: dose-response effects of one night for recovery.
OBJECTIVE
Establish the dose-response relationship between increasing sleep durations in a single night and recovery of neurobehavioral functions following chronic sleep restriction.


METHODS
Intent-to-treat design in which subjects were randomized to 1 of 6 recovery sleep doses (0, 2, 4, 6, 8, or 10 h TIB) for 1 night following 5 nights of sleep restriction to 4 h TIB.


METHODS
Twelve consecutive days in a controlled laboratory environment.


METHODS
N = 159 healthy adults (aged 22-45 y), median = 29 y).


METHODS
Following a week of home monitoring with actigraphy and 2 baseline nights of 10 h TIB, subjects were randomized to either sleep restriction to 4 h TIB per night for 5 nights followed by randomization to 1 of 6 nocturnal acute recovery sleep conditions (N = 142), or to a control condition involving 10 h TIB on all nights (N = 17).


RESULTS
Primary neurobehavioral outcomes included lapses on the Psychomotor Vigilance Test (PVT), subjective sleepiness from the Karolinska Sleepiness Scale (KSS), and physiological sleepiness from a modified Maintenance of Wakefulness Test (MWT). Secondary outcomes included psychomotor and cognitive speed as measured by PVT fastest RTs and number correct on the Digit Symbol Substitution Task (DSST), respectively, and subjective fatigue from the Profile of Mood States (POMS). The dynamics of neurobehavioral outcomes following acute recovery sleep were statistically modeled across the 0 h-10 h recovery sleep doses. While TST, stage 2, REM sleep and NREM slow wave energy (SWE) increased linearly across recovery sleep doses, best-fitting neurobehavioral recovery functions were exponential across recovery sleep doses for PVT and KSS outcomes, and linear for the MWT. Analyses based on return to baseline and on estimated intersection with control condition means revealed recovery was incomplete at the 10 h TIB (8.96 h TST) for PVT performance, KSS sleepiness, and POMS fatigue. Both TST and SWE were elevated above baseline at the maximum recovery dose of 10 h TIB.


CONCLUSIONS
Neurobehavioral deficits induced by 5 nights of sleep restricted to 4 h improved monotonically as acute recovery sleep dose increased, but some deficits remained after 10 h TIB for recovery. Complete recovery from such sleep restriction may require a longer sleep period during 1 night, and/or multiple nights of recovery sleep. It appears that acute recovery from chronic sleep restriction occurs as a result of elevated sleep pressure evident in both increased SWE and TST.
Banks
Siobhan
S
Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6021, USA.
Van Dongen
Hans P A
HP
Maislin
Greg
G
Dinges
David F
DF
D000328:Adult; D001143:Arousal / Q000502:physiology; D001288:Attention / Q000502:physiology; D002908:Chronic Disease; D003072:Cognition Disorders / Q000503:physiopathology* / Q000523:psychology*; D005221:Fatigue / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D017286:Polysomnography; D011597:Psychomotor Performance / Q000502:physiology; D011930:Reaction Time / Q000502:physiology; D012890:Sleep / Q000502:physiology*; D012892:Sleep Deprivation / Q000503:physiopathology* / Q000523:psychology*; D012894:Sleep Stages / Q000502:physiology; D013997:Time Factors; D014851:Wakefulness / Q000502:physiology; D055815:Young Adult
J Sleep Res. 2007 Mar;16(1):33-41
17309761
Am J Physiol. 1991 Jul;261(1 Pt 2):R198-208
1858947
BMC Neurosci. 2007 Feb 22;8:15
17316437
Chronobiol Int. 2008 Apr;25(2):309-19
18484366
Sleep. 2005 Nov;28(11):1446-54
16335485
Chronobiol Int. 2008 Apr;25(2):297-308
18533328
Int J Neurosci. 1990 May;52(1-2):29-37
2265922
Biol Cybern. 1994;71(2):115-21
8068773
J Sleep Res. 2007 Jun;16(2):170-80
17542947
Ann N Y Acad Sci. 2008;1129:305-22
18591490
Sleep. 1996 Sep;19(7):576-82
8899937
Electroencephalogr Clin Neurophysiol. 1982 Jun;53(6):658-61
6177511
J Sleep Res. 2003 Mar;12(1):1-12
12603781
Hum Neurobiol. 1982;1(3):195-204
7185792
Sleep. 2009 Mar;32(3):311-21
19294951
Electroencephalogr Clin Neurophysiol. 1981 May;51(5):483-95
6165548
J Clin Sleep Med. 2007 Aug 15;3(5):519-28
17803017
J Neurophysiol. 2005 Dec;94(6):4224-33
16014798
J Theor Biol. 2009 Jan 21;256(2):227-39
18938181
J Sleep Res. 2009 Sep;18(3):291-303
19552702
Sleep. 2003 Mar 15;26(2):117-26
12683469
Sci Transl Med. 2010 Jan 13;2(14):14ra3
20371466
Am J Physiol Regul Integr Comp Physiol. 2005 Jul;289(1):R209-16
15790749
J Neurosci. 2010 Feb 17;30(7):2686-93
20164352
J Appl Psychol. 1989 Oct;74(5):728-38
2793773
Sleep. 1993 Feb;16(2):100-13
8446828
Science. 2009 Aug 14;325(5942):825-6
19679803
J Sleep Res. 1992 Jun;1(2):63-79
10607028
Sleep. 2004 Sep 15;27(6):1050-2
15532196
J Biol Rhythms. 2003 Feb;18(1):80-90
12568247
Arch Ital Biol. 2001 Apr;139(3):253-67
11330205
Sleep. 2004 Jun 15;27(4):799-802
15283017
Sleep. 1999 Feb 1;22(1):11-31
9989363
Sleep. 2007 Sep;30(9):1085-95
17910380
Psychophysiology. 1981 Mar;18(2):107-13
6111825
Arch Gen Psychiatry. 1966 Jul;15(1):29-35
5939071
Sleep. 2009 Feb;32(2):217-22
19238809
Brain Res. 1993 Oct 29;626(1-2):190-9
8281430
Am J Physiol. 1984 Feb;246(2 Pt 2):R161-83
6696142
Aviat Space Environ Med. 2010 Aug;81(8):735-44
20681233
Electroencephalogr Clin Neurophysiol. 1997 Nov;103(5):554-62
9402886
Proc Natl Acad Sci U S A. 2007 Jun 19;104(25):10697-702
17548824
Sleep. 1997 Apr;20(4):267-77
9231952