Vulnerability in Executive Functions to Sleep Deprivation Is Predicted by Subclinical Attention-Deficit/Hyperactivity Disorder Symptoms

The Selective Impairments of Total Sleep Deprivation on Alerting, Orienting, and Executive Control: Evidence from Event-Related Potentials

BACKGROUND

Many studies have shown that total sleep deprivation (TSD) impairs the attention network, which includes three subcomponents as follows: alerting, orienting, and executive control. However, the specific attention network(s) damaged by TSD remains unclear.

METHODS

Twenty two participants were enrolled to complete the attention network test (ANT) before and after 36 h of TSD with simultaneous electroencephalography recordings.

RESULTS

The repeated-measures analysis of variance of the response time (RT) suggested that the interaction effect between sleep conditions (before versus after TSD) and target congruence (incongruent versus congruent target) was significant; that is, the RT of the incongruent target was longer than that of the congruent target, whereas this difference disappeared after TSD. Furthermore, the interaction effect of sustained potential (SP) amplitude between the sleep conditions and target congruence was significant; that is, the incongruent target invoked a less positive sustained potential amplitude after than before TSD; whereas that invoked by the congruent target was not.

CONCLUSION

TSD selectively impairs attention networks. TSD affects the executive control network the most, which is followed by the alerting network rather than the orienting network. This provides a new perspective for understanding how shortened sleep affects attention.

CLINICAL TRIAL REGISTRATION

No: ChiCTR2400088448. Registered 19 August 2024, https://www.chictr.org.cn.

Locus coeruleus microstructural integrity is associated with vigilance vulnerability to sleep deprivation

Insufficient sleep compromises cognitive performance, diminishes vigilance, and disrupts daily functioning in hundreds of millions of people worldwide. Despite extensive research revealing significant variability in vigilance vulnerability to sleep deprivation, the underlying mechanisms of these individual differences remain elusive. Locus coeruleus (LC) plays a crucial role in the regulation of sleep-wake cycles and has emerged as a potential marker for vigilance vulnerability to sleep deprivation. In this study, we investigate whether LC microstructural integrity, assessed by fractional anisotropy (FA) through diffusion tensor imaging (DTI) at baseline before sleep deprivation, can predict impaired psychomotor vigilance test (PVT) performance during sleep deprivation in a cohort of 60 healthy individuals subjected to a rigorously controlled in-laboratory sleep study. The findings indicate that individuals with high LC FA experience less vigilance impairment from sleep deprivation compared with those with low LC FA. LC FA accounts for 10.8% of the variance in sleep-deprived PVT lapses. Importantly, the relationship between LC FA and impaired PVT performance during sleep deprivation is anatomically specific, suggesting that LC microstructural integrity may serve as a biomarker for vigilance vulnerability to sleep loss.

Correlation research on physical activity and executive function in female college students with subclinical depression

Researchers have found that there may be a correlation between physical activity, executive function, and depression for college students with depression. However, there is limited information available regarding the relationship and interaction between subclinical depression, physical activity, and executive function among college students with subclinical depression. The purpose of this study is to assess the correlation and interaction between subclinical depression, physical activity, and executive function in female college students with subclinical depression. The ActiGraph GT3X was utilized to measure physical activity time, and the colour-word Stroop task was employed to evaluate the executive function of the participants. The findings revealed that female college students with subclinical depression had a significantly lower time for moderate-intensity physical activity compared to healthy female college students. Additionally, the subclinical depression group took significantly longer to complete the colour-word Stroop task compared to the healthy group of female college students. The results of correlation and mediation analyses suggest a negative correlation between BDI-II scores and physical activity time and executive function in female college students with subclinical depression. Moreover, executive function appears to play a partial mediating role in the relationship between physical activity and subclinical depression.

Assessing Resilience to Sleep Loss Among the Italian Population: A 13-Item Model of the Iowa Resistance to Sleeplessness Test (iREST)

Purpose

The present study aimed to validate the Italian version of the Iowa Resistance to Sleeplessness Test (iREST), a 16-item self-report assessing resilience to sleep debt in the affective, cognitive, and somatic domains.

Participants and Methods

We examined its factor structure, assessed internal consistency and criterion validity, and established test-retest reliability on 768 Italian native speakers (65.8% of women) with a mean age of 25.98 years old.

Results

Confirmatory factor analysis (CFA) revealed a new 13-item structure for the Italian iREST (iREST-13), demonstrating more satisfactory goodness-of-fit values, and exhibiting good internal consistency (Cronbach's α ranging from 0.73 to 0.89), relative to the 16-item original version. Results supported the iREST convergent validity, showing significant independence from established measures of sleep; low correlations with conceptually unrelated measures supported divergent validity, indicating that the iREST effectively measures resistance to sleeplessness without confounding with other constructs. Lastly, test-retest reliability was evaluated by administering the iREST to the same sample with a 2-week interval: the significant correlations supported its temporal stability.

Conclusion

Further studies are needed to evaluate the applicability of the iREST in diverse populations and explore its relationship with objective sleep measures. Nevertheless, the Italian iREST provides a valuable tool for assessing resistance to sleep loss, offering insights into individual differences in resilience. Additionally, the iREST can assist in identifying individuals who require interventions to enhance resilience to sleep debt, as well as help clinicians evaluate the impact of chronic sleep disruption and deliver targeted interventions.

Cognitive control, bedtime patterns, and testing time in female adolescent students: behavioral and neuro-electrophysiological correlates

Introduction

Shorter and/or disrupted sleep during adolescence is associated with cognitive and mental health risks, particularly in females. We explored the relationship between bedtime behavior patterns co-varying with Social Jet Lag (SJL) and School Start Times (SST) and neurocognitive performance in adolescent female students.

Methods

To investigate whether time of day (morning vs. afternoon), early SSTs and days of the school week can be correlated with neurocognitive correlates of sleep insufficiency, we recruited 24 female students aged 16-18 to report sleep logs, and undergo event-related electroencephalographic recordings on Monday, Wednesday, mornings, and afternoons. Using a Stroop task paradigm, we analyzed correlations between reaction times (RTs), accuracy, time of day, day of week, electroencephalographic data, and sleep log data to understand what relationships may exist.

Results

Participants reported a 2-h sleep phase delay and SJL. Stroop interference influenced accuracy on Monday and Wednesday similarly, with better performance in the afternoon. For RTs, the afternoon advantage was much larger on Monday than Wednesday. Midline Event-Related Potentials (ERPs) yielded higher amplitudes and shorter latencies on Wednesday morning and Monday afternoon, in time windows related to attention or response execution. A notable exception were delayed ERP latencies on Wednesday afternoon. The latter could be explained by the fact that delta EEG waves tended to be the most prominent, suggesting heightened error monitoring due to accumulating mental fatigue.

Discussion

These findings provide insights into the interaction between SJL and SST and suggest evidence-based criteria for planning when female adolescents should engage in cognitive-heavy school activities such as tests or exams.

Distance learning during the COVID-19 pandemic for children with ADHD and/or ASD: a European multi-center study examining the role of executive function deficits and age

BACKGROUND

One of the COVID-19 pandemic consequences that has affected families the most is school lockdowns. Some studies have shown that distance learning has been especially challenging for families with a child with neurodevelopmental disorders such as ADHD or ASD. However, previous studies have not taken the heterogeneity of these disorders into account. The aim of the present study was therefore to investigate differences between families with a child with ADHD, ASD, or both conditions, and to examine the role of underlying deficits in executive functioning (EF) in both children and parents in relation to negative and positive effects of distance learning.

METHODS

Survey data assessing both negative and positive experiences of distance learning were collected from parents with a child aged 5-19 years in seven Western European countries: the UK, Germany, Spain, Sweden, the Netherlands, Italy, and Belgium. Altogether, the study included 1010 families with a child with ADHD and/or ASD and an equally large comparison group of families with a child without mental health problems. We included measures of three different types of negative effects (i.e., effects on the child, effects on the parent, and lack of support from school) and positive effects on the family.

RESULTS

Results confirmed that families with a child with ADHD, ASD or a combination of ADHD and ASD showed higher levels of both negative and positive effects of distance learning than the comparison group. However, few differences were found between the clinical groups. Group differences were more pronounced for older compared to younger children. Regarding the role of both ADHD/ASD diagnosis and EF deficits, primarily children's EF deficits contributed to high levels of negative effects. Parent EF deficits did not contribute significantly beyond the influence of child EF deficits. Families of children with ADHD/ASD without EF deficits experienced the highest levels of positive effects.

CONCLUSIONS

School closings during COVID-19 have a major impact on children with EF problems, including children with neurodevelopmental disorders. The present study emphasizes that schools should not focus primarily on whether a student has a neurodevelopmental disorder, but rather provide support based on the student's individual profile of underlying neuropsychological deficits.

Experimental Sleep Deprivation Results in Diminished Perceptual Stability Independently of Psychosis Proneness

Psychotic disorders as well as psychosis proneness in the general population have been associated with perceptual instability, suggesting weakened predictive processing. Sleep disturbances play a prominent role in psychosis and schizophrenia, but it is unclear whether perceptual stability diminishes with sleep deprivation, and whether the effects of sleep deprivation differ as a function of psychosis proneness. In the current study, we aimed to clarify this matter. In this preregistered study, 146 participants successfully completed an intermittent version of the random dot kinematogram (RDK) task and the 21-item Peters Delusion Inventory (PDI-21) to assess perceptual stability and psychosis proneness, respectively. Participants were randomized to sleep either as normal (8 to 9 h in bed) (n = 72; Mage = 24.7, SD = 6.2, 41 women) or to stay awake through the night (n = 74; Mage = 24.8, SD = 5.1, 44 women). Sleep deprivation resulted in diminished perceptual stability, as well as in decreases in perceptual stability over the course of the task. However, we did not observe any association between perceptual stability and PDI-21 scores, nor a tendency for individuals with higher PDI-21 scores to be more vulnerable to sleep-deprivation-induced decreases in perceptual stability. The present study suggests a compromised predictive processing system in the brain after sleep deprivation, but variation in psychosis trait is not related to greater vulnerability to sleep deprivation in our dataset. Further studies in risk groups and patients with psychosis are needed to evaluate whether sleep loss plays a role in the occurrence of objectively measured perceptual-related clinical symptoms.

Trait Anxiety Does Not Predict the Anxiogenic Response to Sleep Deprivation

Sleep deprivation has in several studies been found to increase anxiety. However, the extent to which this anxiogenic effect depends on one’s underlying trait anxiety has not previously been determined. Using two separate sleep-loss experiments, the current research investigated whether trait anxiety (STAI-T) moderates the increase in state anxiety (STAI-S) following one night of total sleep loss (study 1, N = 182, age 25.3 ± 6.5, 103 women) and two nights of partial sleep restriction (study 2, N = 67, age 26.5 ± 7.4, 38 women). Both studies showed the expected anxiogenic effect of sleep loss, and a clear relationship between trait anxiety and state anxiety. However, the anxiogenic effect of sleep loss was not moderated by trait anxiety, as there was an equal impact regardless of trait anxiety level. These findings indicate that, although sleep loss is related to general anxiety as well as anxiety disorders, for a non-clinical sample the anxiogenic effect of short-term sleep loss is not affected by baseline levels of anxiety.

The Impact of Preterm Birth on Sleep through Infancy, Childhood and Adolescence and Its Implications

There is emergent literature on the relationship between the development of sleep-wake cycles, sleep architecture, and sleep duration during the neonatal period on neurodevelopmental outcomes among children born preterm. There is also a growing literature on techniques to assess sleep staging in preterm neonates using either EEG methods or heart and respiration rate. Upon discharge from hospital, sleep in children born preterm has been assessed using parent report, actigraphy, and polysomnography. This review describes the ontogeny and measurement of sleep in the neonatal period, the current evidence on the impact of preterm birth on sleep both in the NICU and in childhood and adolescence, and the interaction between sleep, cognition, and social-emotional outcomes in this population.

Awareness of sleepiness: Temporal dynamics of subjective and objective sleepiness

We systematically examined the temporal relationships between subjective sleepiness and both physiological drowsiness and performance impairment in a controlled laboratory setting. Eighteen healthy young adults (8 women; M_AGE  = 21.44 ± 3.24 years) underwent 40 hr of extended wakefulness, completing a bihourly Karolinska Sleepiness Scale (KSS) and 10-min Psychomotor Vigilance Task (PVT). Microsleeps and slow eye movements (SEMs) were scored during the PVT. KSS scores increased 3 hr prior to performance impairment (p < .001) and 4-6 hr prior to physiological sleepiness (p < .001). There were strong within-subject correlations between KSS and PVT lapses (r = 0.75, p < .001) and physiological drowsiness (r > 0.60, p < .001). Between-subjects product-moment correlations were more modest but showed a significant positive increase across time awake, suggesting that subjective sleepiness and objective outcomes were more tightly correlated after sleep loss. Cross-correlations showed significant positive correlations at 0-lag (p < .034); however, a high proportion of participants showed maximal correlations at positive lags, suggesting KSS was associated with future objective impairment. Within individuals, subjective sleepiness was highly correlated with objective impairment, between-subject correlations were more modest, possibly due to interindividual vulnerability to sleep loss. These results suggest that subjective sleepiness represents an inbuilt early warning system for subsequent drowsiness and performance impairment.

Quantifying Cognitive Impairment After Sleep Deprivation at Different Times of Day: A Proof of Concept Using Ultra-Short Smartphone-Based Tests

Cognitive functioning is known to be impaired following sleep deprivation and to fluctuate depending on the time of day. However, most methods of assessing cognitive performance remain impractical for environments outside of the lab. This study investigated whether 2-min smartphone-based versions of commonly used cognitive tests could be used to assess the effects of sleep deprivation and time of day on diverse cognitive functions. After three nights of normal sleep, participants (N = 182) were randomised to either one night of sleep deprivation or a fourth night of normal sleep. Using the Karolinska WakeApp (KWA), participants completed a battery of 2-min cognitive tests, including measures of attention, arithmetic ability, episodic memory, working memory, and a Stroop test for cognitive conflict and behavioural adjustment. A baseline measurement was completed at 22:30 h, followed by three measurements the following day at approximately 08:00 h, 12:30 h, and 16:30 h. Sleep deprivation led to performance impairments in attention, arithmetic ability, episodic memory, and working memory. No effect of sleep deprivation was observed in the Stroop test. There were variations in attention and arithmetic test performance across different times of day. The effect of sleep deprivation on all cognitive tests was also found to vary at different times of day. In conclusion, this study shows that the KWA's 2-min cognitive tests can be used to detect cognitive impairments following sleep deprivation, and fluctuations in cognitive performance relating to time of day. The results demonstrate the potential of using brief smartphone-based tasks to measure a variety of cognitive abilities within sleep and fatigue research.