Neurocognitive Consequences of Sleep Deprivation

Jeffrey S. Durmer, MD, PhD; David F. Dinges, PhD

Disclosures

Semin Neurol. 2005;25(1):117-129. 

In This Article

Conclusions

Sleep deprivation, whether from disorder or lifestyle, whether acute or chronic, poses significant cognitive risks in the performance of many ordinary tasks such as driving and operating machinery. Theories and hypotheses of how sleep deprivation affects neurocognitive abilities are evolving rapidly as both the range of cognitive effects from sleep loss and the neurobiology of sleep-wake regulation are better understood. For example, recent experiments reveal that following days of chronic sleep restriction, significant daytime cognitive dysfunction accumulates to levels comparable to that found after severe acute total sleep deprivation. Executive performance functions subserved by the prefrontal cortex in concert with the anterior cingulate and posterior parietal systems seem particularly vulnerable to sleep loss. Following wakefulness in excess of 16 hours, deficits in attention and executive function tasks are demonstrable through well-validated testing protocols. The destabilization of neurocognitive function following prolonged wakefulness may be due to alterations in both cortical and subcortical neural processing as demonstrated by neuroimaging and electrophysiological measures. Although neurophysiological processes show similar changes across human brains following sleep deprivation, individual performance of cognitive measures vary greatly in response to sleep deprivation, suggesting a traitlike (possibly genetic) differential vulnerability or compensatory changes in the neurological systems involved in cognition. Sleep-disordered breathing and nocturnal movement disorders show similar waking neurocognitive deficits to those seen in experimental sleep fragmentation protocols. Further studies of neurocognitive deficits in human disorders are needed as they impact large segments of the population.

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