Reduced visual processing capacity in sleep deprived persons

Psychedelic Art and Implications for Mental Health: Randomized Pilot Study

BACKGROUND

Psychedelic art (PA) emerged in the 1960s during the psychedelic era; then characterized by visuals induced by the ingestion of psychedelic drugs, it is now an art form known for its vibrant colors, distorted forms, and intricate patterns. Building upon the existing research on art viewing as an effective means to improving physiological and psychological well-being, viewing PA is postulated to evoke positive emotions and provide a meditative experience, contributing to improved mental well-being.

OBJECTIVE

This study aims to investigate how digitally rendered PA influences viewers' perceived emotional, mental, and physical states compared to imagery of natural scenery, offering insights into potential applications in mental health care and well-being.

METHODS

Overall, 102 participants age 18 to 35 years were randomly assigned to either the experimental group viewing 300 seconds of PA imagery (50/102, 49%) or the control group viewing 300 seconds of scenic imagery (52/102, 51%), after which every participant completed a survey that gathered qualitative data on the perceived impact of viewing their given imagery on their physical, mental, and emotional states through open-ended questions. Thematic analysis was conducted to identify the patterns of experiences reported by the participants.

RESULTS

Qualitative analysis unveiled a greater intensity and diversity of emotional, mental, and physical impacts induced by PA compared to natural scenery, including the sense of relaxation and peace, anxiety and stress alleviation, joy, thrill and sense of euphoria, sensations of awe and wonder, hypnotizing effect, holistic meditative effect, provocation of creative thoughts, induced hyperawareness of bodily states, and transitions from induced overstimulation or anxious thoughts to feelings of calmness.

CONCLUSIONS

The preliminary findings of this study suggest that PA is a rich and complex form of visual art that has the potential to facilitate healing and promote well-being and mental health. PA presents promising avenues for integration into mental health care, therapeutic practices, digital health, health care environment, and medical research.

Total sleep deprivation effects on the attentional blink

The Attentional Blink (AB) is a phenomenon that reflects difficulty in detecting or identifying the second of two successive targets (T1 and T2) that are presented in rapid succession, between 200-500ms apart. The AB involves indicators of attentional and temporal integration mechanisms related to the early stages of visual processing. The aim of this study was to identify the effects of 24-h of sleep deprivation (total sleep deprivation, TSD) on the attentional and temporal integration mechanisms of the AB. Twenty-two undergraduate students were recorded during five successive days, in these three conditions: baseline (two days), TSD (one day), and recovery (two days). Each day, at around 12:00 h, participants responded to a Rapid Serial Visual Presentation task (RSVP) that presented two targets separated by random intervals from 100 to 1000ms. The attentional mechanisms were assessed by the AB presence, the AB magnitude, and the AB interval, while the temporal integration mechanisms were evaluated by lag-1 sparing and order reversal responses. TSD negatively affected the attentional mechanisms, which is expressed by an overall reduction in performance, an extended AB interval, and a reduced AB magnitude. TSD also negatively affected the temporal integration mechanisms, manifested by an absence of lag-1 sparing and an increase in order reversals. These results suggest that people are still able to respond to two successive stimuli after 24 h without sleep. However, it becomes more difficult to respond to both stimuli because the attentional and temporal integration mechanisms of the AB are impaired.

Does sleep quality affect balance? The perspective from the somatosensory, vestibular, and visual systems

OBJECTIVE

Previous studies have focused on the balance system's involvement in sleep deprivation or disorders. This study investigated how daily routine sleep quality affects the balance system of people without sleep deprivation or diagnosed sleep disorders.

METHODS

The study included 45 participants with a BMI score of <25. The PSQI was used to determine sleep quality. The SOT, HS-SOT, and ADT evaluated the vestibular system's functionality.

RESULTS

In SOT, condition 3, 4, 5, and 6 composite scores, VIS and VEST composite balance scores, and HS-SOT 5 scores were lower in the HPSQI group. At the same time, there is a statistically significant negative correlation between these scores and PSQI scores.

CONCLUSION

Poor sleep quality may be a factor influencing the balance system. Sleep quality affects the visual and vestibular systems rather than the somatosensory system. The population should be made aware of this issue, and clinicians should consider the potential impact of sleep quality when evaluating the balance system.

Impact of sleep disruption on BDD symptoms and treatment response

BACKGROUND

Body dysmorphic disorder (BDD) is severe, undertreated, and relatively common. Although gold-standard cognitive behavioral therapy (CBT) for BDD has strong empirical support, a significant number of patients do not respond. More work is needed to understand BDD's etiology and modifiable barriers to treatment response. Given its high prevalence and impact on the development, maintenance, and treatment of related, frequently comorbid disorders, sleep disruption is a compelling, but not-yet studied factor.

METHODS

Data were drawn from a randomized controlled trial of guided smartphone app-based CBT for BDD. Included participants were offered 12-weeks of treatment, immediately (n = 40) or after a 12-week waitlist (n = 37). Sleep disruption and BDD symptom severity were assessed at baseline, week-6, and week-12.

RESULTS

Hypotheses and analysis plan were pre-registered. Two-thirds of patients reported significant insomnia symptoms at baseline. Baseline severity of sleep disruption and BDD symptoms were not related (r = 0.02). Pre-treatment sleep disruption did not predict BDD symptom reduction across treatment, nor did early sleep improvements predict greater BDD symptom improvement. Early BDD symptom improvement also did not predict later improvements in sleep.

LIMITATIONS

Limitations include the small sample, restricted ranges of BDD symptom severity and treatment response, and few metrics of sleep disruption.

CONCLUSIONS

Although insomnia was disproportionately high in this sample and both BDD symptoms and sleep improved in treatment, results suggest sleep and BDD symptoms may function largely independent of one another. More work is encouraged to replicate and better understand findings as well as potential challenges and benefits of addressing sleep in BDD.

Decreased Functional Connectivity of Brain Networks in the Alpha Band after Sleep Deprivation Is Associated with Decreased Inhibitory Control in Young Male Adults

Sleep deprivation leads to reduced inhibitory control in individuals. However, the underlying neural mechanisms are poorly understood. Accordingly, this study aimed to investigate the effects of total sleep deprivation (TSD) on inhibitory control and their neuroelectrophysiological mechanisms from the perspective of the time course of cognitive processing and brain network connectivity, using event-related potential (ERP) and resting-state functional connectivity techniques. Twenty-five healthy male participants underwent 36 h of TSD (36-h TSD), completing Go/NoGo tasks and resting-state data acquisition before and after TSD; their behavioral and electroencephalogram data were recorded. Compared to baseline, participants' false alarms for NoGo stimuli increased significantly (t = -4.187, p < 0.001) after 36-h TSD. ERP results indicated that NoGo-N2 negative amplitude increased and latency was prolonged (t = 4.850, p < 0.001; t = -3.178, p < 0.01), and NoGo-P3 amplitude significantly decreased and latency was prolonged (t = 5.104, p < 0.001; t = -2.382, p < 0.05) after 36-h TSD. Functional connectivity analysis showed that the connectivity of the default mode and visual networks in the high alpha band was significantly reduced after TSD (t = 2.500, p = 0.030). Overall, the results suggest that the negative amplitude increase in N2 after 36-h TSD may reveal that more attention and cognitive resources are invested after TSD; the significant decrease in P3 amplitude may indicate the impairment of advanced cognitive processing. Further functional connectivity analysis indicated impairment of the brain's default mode network and visual information processing after TSD.

Understanding the Need for Sleep to Improve Cognition

The restorative function of sleep is shaped by its duration, timing, continuity, subjective quality, and efficiency. Current sleep recommendations specify only nocturnal duration and have been largely derived from sleep self-reports that can be imprecise and miss relevant details. Sleep duration, preferred timing, and ability to withstand sleep deprivation are heritable traits whose expression may change with age and affect the optimal sleep prescription for an individual. Prevailing societal norms and circumstances related to work and relationships interact to influence sleep opportunity and quality. The value of allocating time for sleep is revealed by the impact of its restriction on behavior, functional brain imaging, sleep macrostructure, and late-life cognition. Augmentation of sleep slow oscillations and spindles have been proposed for enhancing sleep quality, but they inconsistently achieve their goal. Crafting bespoke sleep recommendations could benefit from large-scale, longitudinal collection of objective sleep data integrated with behavioral and self-reported data.

Vigilant Attention, Cerebral Blood Flow and Grey Matter Volume Change after 36 h of Acute Sleep Deprivation in Healthy Male Adults: A Pilot Study

It is commonly believed that alertness and attention decrease after sleep deprivation (SD). However, there are not enough studies on the changes in psychomotor vigilance testing (PVT) during SD and the corresponding changes in brain function and brain structure after SD. Therefore, we recruited 30 healthy adult men to perform a 36 h acute SD experiment, including the measurement of five indicators of PVT every 2 h, and analysis of cerebral blood flow (CBF) and grey matter volume (GMV) changes, before and after SD by magnetic resonance imaging (MRI). The PVT measurement found that the mean reaction time (RT), fastest 10% RT, minor lapses, and false starts all increased progressively within 20 h of SD, except for major lapses. Subsequently, all indexes showed a significant lengthening or increasing trend, and the peak value was in the range of 24 h-32 h and decreased at 36 h, in which the number of major lapses returned to normal. MRI showed that CBF decreased in the left orbital part of the superior frontal gyrus, the left of the rolandic operculum, the left triangular part, and the right opercular part of the inferior frontal gyrus, and CBF increased in the left lingual gyrus and the right superior gyrus after 36 h SD. The left lingual gyrus was negatively correlated with the major lapses, and both the inferior frontal gyrus and the superior frontal gyrus were positively correlated with the false starts. Still, there was no significant change in GMV. Therefore, we believe that 36 h of acute SD causes alterations in brain function and reduces alert attention, whereas short-term acute SD does not cause changes in brain structure.

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.

Semantic Expectation Effects on Object Detection: Using Figure Assignment to Elucidate Mechanisms

Recent evidence suggesting that object detection is improved following valid rather than invalid labels implies that semantics influence object detection. It is not clear, however, whether the results index object detection or feature detection. Further, because control conditions were absent and labels and objects were repeated multiple times, the mechanisms are unknown. We assessed object detection via figure assignment, whereby objects are segmented from backgrounds. Masked bipartite displays depicting a portion of a mono-oriented object (a familiar configuration) on one side of a central border were shown once only for 90 or 100 ms. Familiar configuration is a figural prior. Accurate detection was indexed by reports of an object on the familiar configuration side of the border. Compared to control experiments without labels, valid labels improved accuracy and reduced response times (RTs) more for upright than inverted objects (Studies 1 and 2). Invalid labels denoting different superordinate-level objects (DSC; Study 1) or same superordinate-level objects (SSC; Study 2) reduced accuracy for upright displays only. Orientation dependency indicates that effects are mediated by activated object representations rather than features which are invariant over orientation. Following invalid SSC labels (Study 2), accurate detection RTs were longer than control for both orientations, implicating conflict between semantic representations that had to be resolved before object detection. These results demonstrate that object detection is not just affected by semantics, it entails semantics.

Evaluation of the postural balance and visual perception in young adults with acute sleep deprivation

BACKGROUND/OBJECTIVE

Few studies have suggested a relationship between vestibular system and sleep deprivation. The aim of the present study is to investigate the effects of acute sleep deprivation lasting 24 hours or more on the postural balance and the visual abilities related to the vestibular system in healthy young adults.

METHODS

Thirty-one healthy young adults (8 males, 23 female; ages 18- 36 years) who had experienced at least 24 hours of sleep deprivation were included in the study. Subjects made two visits to the test laboratory. One visit was scheduled during a sleep deprivation (SD) condition, and the other was scheduled during a daily life (DL) condition. Five tests- the Sensory Organization Test (SOT), Static Visual Acuity Test (SVA), Minimum Perception Time Test (mPT), Dynamic Visual Acuity Test (DVA), and Gaze Stabilization Test (GST)- were performed using a Computerized Dynamic Posturography System.

RESULTS

A statistically significant difference was found between SD and DL measurements in somatosensorial (p = 0.003), visual (p = 0.037), vestibular (p = 0.008) ratios, and composite scores (p = 0.001) in SOT. The mPT results showed a statistically significant difference between SD and DL conditions (p = 0.001). No significant difference was found between SD and DL conditions in the comparison of the mean SVA (p = 0.466), DVA (p = 0.192), and GST head velocity values (p = 0.160).

CONCLUSIONS

Sleep deprivation has a considerable impact on the vestibular system and visual perception time in young adults. Increased risk of accidents and performance loss after SD were thought to be due to the postural control and visual processing parameters rather than dynamic visual parameters of the vestibular system.

The relationship between sleep efficiency and clinical symptoms is mediated by brain function in major depressive disorder

BACKGROUND

Sleep disturbance is a common and key symptom that affects most of patients with major depressive disorder (MDD). However, neural substrates underlying sleep disturbance and their clinical relevance in depression remain unclear.

METHODS

Ninety-six MDD patients underwent resting-state functional MRI. Fractional amplitude of low-frequency fluctuation (fALFF) and resting-state functional connectivity (rsFC) were used to measure brain function. Overnight polysomnography was performed to objectively measure sleep efficiency (SE), which was used to classify patients into normal sleep efficiency (NSE) and low sleep efficiency (LSE) groups. Between-group differences in fALFF and rsFC were examined using two-sample t-tests. Moreover, correlation and mediation analyses were conducted to test for potential associations between SE, brain functional changes, and clinical variables.

RESULTS

LSE group showed decreased fALFF in right cuneus, thalamus, and middle temporal gyrus compared to NSE group. MDD patients with low SE also exhibited lower rsFC of right cuneus to right lateral temporal cortex, which was associated with more severe depression and anxiety symptoms. More importantly, mediation analyses revealed that the relationships between SE and severity of depression and anxiety symptoms were significantly mediated by the altered rsFC. In addition, these low SE-related brain functional alterations were not affected by antidepressant medication and were independent of structural changes.

LIMITATIONS

The lack of healthy controls because of "first-night effect".

CONCLUSION

These findings not only may expand existing knowledge about neuropathology of sleep disturbance in depression, but also may inform real-world clinical practice by improving depression and anxiety symptoms through sleep regulation.

The Instant Spontaneous Neuronal Activity Modulation of Transcutaneous Auricular Vagus Nerve Stimulation on Patients With Primary Insomnia

Primary insomnia (PI) is associated with increased spontaneous neuronal activity. Transcutaneous auricular vagus nerve stimulation (taVNS) modulates brain function, and it is an effective treatment for primary insomnia. However, whether taVNS alleviates insomnia through modulating spontaneous neuronal activity is not fully clarified. This study aims to investigate the instant effect of taVNS in modulating spontaneous neuronal activity in PI patients using resting-state functional magnetic resonance imaging (rs-fMRI). Twenty-two PI subjects underwent rs-fMRI scanning prior and immediately after 30 min treatment of taVNS controlled by twenty healthy adults. Amplitude of low frequency fluctuations (ALFF) analysis was employed to assess the difference in spontaneous neuronal activity between PI patients and healthy adults, as well as between pre-treatment and post-treatment of taVNS. The taVNS-induced altered ALFF brain areas were then selected as regions of interest to perform the resting state functional connectivity (RSFC) analysis in PI patients. The right precuneus showed significantly increased ALFF in PI patients. After immediate taVNS treatment, the ALFF was significantly decreased in the right precuneus and increased in the left middle occipital gyrus. The RSFC in right precuneus with right angular, right superior frontal gyrus, and right middle frontal gyrus was significantly decreased. This study provides insights into the instant brain effects of taVNS on PI patients.

Effect of Angle of View and Partial Sleep Deprivation on Distance Perception

The present study aimed to investigate the effects of intensive effort on egocentric distance perception according to different angles of view after sleep deprivation at the beginning (SDB) or at the end (SDE) of the night and after a normal sleep night (NNS). Ten male students soccer players (age 22.8 ± 1.3 years; body mass 72.0 ± 10.4 kg; body height 180.0 ± 3.0 cm) performed a repeated cycling (RS) exercise (10 × 6 s maximal cycling with 24 s in between) after SDB, SDE, and NNS. They were asked to estimate three distances (i.e. 15, 25, and 35 m) before and after RS from different angles of view [i.e. in front (0°) and in side (45° left and 45° right)]. For 35 m, distance estimation was better during NNS compared to SDB and SDE for the front and the two side angles either before or after RS (p < 0.05). Concerning 25 m, distance estimation was better after compared to before RS for the front angle during the NNS session (p < 0.05). For 15 m, distance estimation was better during NNS than SDB and SDE for the front and both side angles after RS (p < 0.05). We concluded that partial sleep deprivation negatively affected the estimation of the egocentric distance for the three angles of view either at rest or after RS exercise.

Effect of cognitive load and emotional valence of distractors on performance during sleep extension and subsequent sleep deprivation

Study Objectives

The purpose of the present study was to assess the extent to which sleep extension followed by sleep deprivation impacts performance on an attentional task with varying cognitive and attentional demands that influence decisions.

Methods

Task performance was assessed at baseline, after 1 week of sleep extension, and after 40 h of total sleep deprivation.

Results

One week of sleep extension resulted in improved performance, particularly for high cognitive load decisions regardless of the emotional salience of attentional distractors. Those who extended sleep the most relative to their habitual sleep duration showed the greatest improvement in general performance during sleep extension. However, a higher percentage of time spent in slow-wave sleep (SWS) on the last night of the sleep extension phase was negatively correlated with performance on more difficult high cognitive load items, possibly reflecting a relatively higher level of residual sleep need. Sleep deprivation generally resulted in impaired performance, with a nonsignificant trend toward greater performance decrements in the presence of emotionally salient distractors. Performance overall, but specifically for high cognitive load decisions, during total sleep deprivation was negatively correlated with longer sleep and higher SWS percentage during subsequent recovery sleep.

Conclusions

The present findings suggest two possibilities: those who performed relatively poorly during sleep deprivation were more vulnerable because (1) they utilized mental resources (i.e. accrued sleep debt) at a relatively faster rate during wakefulness, and/or (2) they failed to “pay down” pre-study sleep debt to the same extent as better-performing participants during the preceding sleep extension phase.

Neural recruitment related to threat perception differs as a function of adolescent sleep

Detecting threat cues in the environment is an important aspect of social functioning. This is particularly true for adolescents as social threats become more salient and they navigate increasingly complex relationships outside of the family. Sleep relates to socioemotional processing throughout development, but the neurobiological relevance of sleep for threat perceptions in adolescence remains unknown. In the present study, 46 human adolescents (aged 14-18 years; 26 female) made judgments while undergoing a brain scan about whether unfamiliar, affectively neutral, computer-generated faces were threatening. Prior to the scan, several indices of sleep were assessed nightly for two-weeks using actigraphy. Sleep duration and poor sleep quality (defined as less efficiency, more awakenings, longer awakenings), factors influenced by biological and psychosocial changes during adolescence, elicited distinct neural activation patterns. Sleep duration was positively associated with activation in visual and face processing regions (occipital cortex, occipital fusiform gyrus), and this activation was linked to increased threat detection during the threat perception task. Sleep quality was negatively related to dorsolateral prefrontal cortex activation, which moderated the relation between reaction time (RT) and exposure to faces. Findings suggest reduced threat perception for adolescents with shorter sleep durations and more impulsive responding (as evinced by less consistent RT) for adolescents experiencing worse quality sleep. This study identifies an association between sleep and neural functioning relevant for socioemotional decision making during adolescence, a time when these systems undergo significant development.

Functional brain alterations in acute sleep deprivation: An activation likelihood estimation meta-analysis

Sleep deprivation (SD) is a common problem in modern societies, which leads to cognitive dysfunctions including attention lapses, impaired working memory, hindering decision making, impaired emotional processing, and motor vehicle accidents. Numerous neuroimaging studies have investigated the neural correlates of SD, but these studies have reported inconsistent results. Thus, we aimed to identify convergent patterns of abnormal brain functions due to acute SD. Based on the preferred reporting for systematic reviews and meta-analyses statement, we searched the PubMed database and performed reference tracking and finally retrieved 31 eligible functional neuroimaging studies. Then, we applied activation estimation likelihood meta-analysis and found reduced activity mainly in the right intraparietal sulcus and superior parietal lobule. The functional decoding analysis using the BrainMap database indicated that this region is mostly related to visuospatial perception, memory and reasoning. The significant co-activation of this region using the BrainMap database were found in the left superior parietal lobule, intraparietal sulcus, bilateral occipital cortex, left fusiform gyrus and thalamus. This region also connected with the superior parietal lobule, intraparietal sulcus, insula, inferior frontal gyrus, precentral, occipital and cerebellum through resting-state functional connectivity in healthy subjects. Taken together, our findings highlight the role of superior parietal cortex in SD.

Tired and lack focus? Insomnia increases distractibility

Chronic insomnia is associated with subjective daytime cognitive dysfunction, but objective corroborative data are often lacking. In this study, we use Perceptual Load Theory to objectively assess distractibility in participants with insomnia ( N = 23) compared with age- and sex-matched controls ( N = 23). Following overnight supervised sleep observation, all participants completed a selective attention task which varied in the level of perceptual load and distractor congruency. The insomnia group was found to be more distracted than controls, whereas their selective attention mechanism appeared to be intact, with reduced distractor processing under high load for both groups. Insomnia symptom severity was positively correlated with participant distractibility. These findings suggest that there are insomnia-related daytime cognitive impairments that are likely to arise from compromised cognitive control rather than an ineffective selective attention mechanism. This task may be clinically useful in assessing daytime impairments, and potentially treatment response, in those with insomnia.

Sleep regulates visual selective attention in Drosophila

Although sleep deprivation is known to impair attention in humans and other mammals, the underlying reasons are not well understood, and whether similar effects are present in non-mammalian species is not known. We therefore sought to investigate whether sleep is important for optimizing attention in an invertebrate species, the genetic model Drosophila melanogaster We developed a high-throughput paradigm to measure visual attention in freely walking Drosophila, using competing foreground/background visual stimuli. We found that whereas sleep-deprived flies could respond normally to either stimulus alone, they were more distracted by background cues in a visual competition task. Other stressful manipulations such as starvation, heat exposure and mechanical stress had no effects on visual attention in this paradigm. In contrast to sleep deprivation, providing additional sleep using the GABA-A agonist 4,5,6,7-tetrahydroisoxazolo-[5,4-c]pyridine-3-ol (THIP) did not affect attention in wild-type flies, but specifically improved attention in the learning mutant dunce Our results reveal a key function of sleep in optimizing attention processes in Drosophila, and establish a behavioral paradigm that can be used to explore the molecular mechanisms involved.

Sleep and mindfulness meditation as they relate to false memory

By a systematic analysis of the current literature, we compare two states of sleep and meditation in terms of their role in the formation or suppression of Deese-Roediger-McDermott (DRM) false memory. We aim to suggest that the occurrence of false memory under these two states is a result of reinforcing some abilities and changes in cognitive systems which can ultimately improve some aspects of cognitive functions. In our analogy, we propose that: (1) both sleep and meditation may improve source monitoring ability whose failure is one of the most important mechanisms in producing false memories, and (2) despite improvement in source monitoring ability, adaptive cognitive processes, as mechanisms which are common in sleep and meditation, can still produce false memories. In conclusion, we propose that in spite of their contribution to false memory through adaptive processes, the beneficial role of sleep and meditation in cognition may be more prominent than their harmful role.

Sleep Deprivation Promotes Habitual Control over Goal-Directed Control: Behavioral and Neuroimaging Evidence

Sleep is one of the most fundamental processes of life, playing an important role in the regulation of brain function. The long-term lack of sleep can cause memory impairments, declines in learning ability, and executive dysfunction. In the present study, we evaluated the effects of sleep deprivation on instrumental learning behavior, particularly goal-directed and habitual actions in humans, and investigated the underlying neural mechanisms. Healthy college students of either gender were enrolled and randomly divided into sleep deprivation group and sleep control group. fMRI data were collected. We found that one night of sleep deprivation led to greater responsiveness to stimuli that were associated with devalued outcomes in the slips-of-action test, indicating a deficit in the formation of goal-directed control and an overreliance on habits. Furthermore, sleep deprivation had no effect on the expression of acquired goal-directed action. The level of goal-directed action after sleep deprivation was positively correlated with baseline working memory capacity. The neuroimaging data indicated that goal-directed learning mainly recruited the ventromedial PFC (vmPFC), the activation of which was less pronounced during goal-directed learning after sleep deprivation. Activation of the vmPFC during goal-directed learning during training was positively correlated with the level of goal-directed action performance. The present study suggests that people rely predominantly on habits at the expense of goal-directed control after sleep deprivation, and this process involves the vmPFC. These results contribute to a better understanding of the effects of sleep loss on decision-making.SIGNIFICANCE STATEMENT Understanding the cognitive consequences of sleep deprivation has become extremely important over the past half century, given the continued decline in sleep duration in industrialized societies. Our results provide novel evidence that goal-directed action may be particularly vulnerable to sleep loss, and the brain mechanism underlying this effect was explored. Elucidation of the effects of sleep deprivation on decision-making will deepen our understanding of the function of sleep, emphasizing the role of sleep in cognitive impairments and mental health.

Degradation of cortical representations during encoding following sleep deprivation

A night of total sleep deprivation (TSD) reduces task-related activation of fronto-parietal and higher visual cortical areas. As this reduction in activation corresponds to impaired attention and perceptual processing, it might also be associated with poorer memory encoding. Related animal work has established that cortical columns stochastically enter a 'down' state in sleep deprivation, leading to predictions that neural representations are less stable and distinctive following TSD. To test these predictions participants incidentally encoded scene images while undergoing fMRI, either during rested wakefulness (RW) or after TSD. In scene-selective PPA, TSD reduced stability of neural representations across repetition. This was accompanied by poorer subsequent memory. Greater representational stability benefitted subsequent memory in RW but not TSD. Even for items subsequently recognized, representational distinctiveness was lower in TSD, suggesting that quality of encoding is degraded. Reduced representational stability and distinctiveness are two novel mechanisms by which TSD can contribute to poorer memory formation.

Influence of night duty on endoscopic therapy for bile duct stones

AIM

To examine the influence of night duty (ND) on endoscopic therapy for biliary duct stones.

METHODS

The subjects consisted of 133 patients who received initial endoscopic therapy for biliary duct stones performed by eight endoscopists after they had been on (ND group, n = 34 patients) or not [day duty (DD) group, n = 99 patients]. Patient characteristics (age, gender, history of abdominal surgery, transverse diameter of the largest stone, number of stones), years of experience of the endoscopists, endoscopic procedures [sphincterotomy, papillary balloon dilation (EPBD), papillary large balloon dilation (EPLBD)], and outcomes of initial endoscopy (procedure time; rate of stone removal by the first endoscopist; procedure success rate by the first endoscopist: removal of stones or endoscopic retrograde biliary drainage; rate of final stone removal; final procedure success rate; complications; hospitalization after the procedure) were compared retrospectively between the two groups. History of abdominal surgery and treatment outcomes were also compared between the groups for each of the four endoscopists who performed most of the procedures in the ND group.

RESULTS

There were no significant differences regarding the number of treatments performed by each endoscopist or the years of experience between the ND and DD groups. The frequency of endoscopic retrograde cholangiopancreatography procedures did not differ significantly between the groups. There were also no significant differences regarding patient characteristics: age, gender, history of abdominal surgery (ND 7: Billroth II 4, R-Y 3; DD 18: double tract reconstruction 1, Billroth I 3, Billroth II 6, R-Y 7, duodenoduodenostomy for annular pancreas 1), transverse diameter of largest stone, and number of stones between the two groups. Among the treatment procedures, the endoscopic sphincterotomy and EPBD rates did not differ significantly between the groups. However, EPLBD was performed more frequently in the ND group [47.1% (16/34) vs 19.2% (19/99)]. Regarding outcomes, there were no significant differences in the rate of stone removal, procedure success rate, complications (ND: pancreatitis 1; DD: pancreatitis 6, duodenal bleeding 1, decreased blood pressure 1, hypoxia 2), or hospitalization after the procedure. However, the procedure time was significantly longer in the ND group (71.5 ± 44.7 vs 54.2 ± 28.8). Among the four endoscopists, there were no significant differences in patient history of abdominal surgery, removal of stones, or procedure success rate. However, the procedure time for one endoscopist was significantly longer in the ND group.

CONCLUSION

The time required for endoscopic therapy for bile duct stones might be influenced by ND.

The Yin and Yang of Sleep and Attention

Sleep is not a single state, but a complex set of brain processes that supports several physiological needs. Sleep deprivation is known to affect attention in many animals, suggesting that a key function of sleep is to regulate attention. Conversely, tasks that require more attention drive sleep need and sleep intensity. Attention involves the ability to filter incoming stimuli based on their relative salience, and this is likely to require coordinated synaptic activity across the brain. This capacity may have only become possible with the evolution of related neural mechanisms that support two key sleep functions: stimulus suppression and synaptic plasticity. We argue here that sleep and attention may have coevolved as brain states that regulate each other.

Increased Automaticity and Altered Temporal Preparation Following Sleep Deprivation

STUDY OBJECTIVES

Temporal expectation enables us to focus limited processing resources, thereby optimizing perceptual and motor processing for critical upcoming events. We investigated the effects of total sleep deprivation (TSD) on temporal expectation by evaluating the foreperiod and sequential effects during a psychomotor vigilance task (PVT). We also examined how these two measures were modulated by vulnerability to TSD.

DESIGN

Three 10-min visual PVT sessions using uniformly distributed foreperiods were conducted in the wake-maintenance zone the evening before sleep deprivation (ESD) and three more in the morning following approximately 22 h of TSD. TSD vulnerable and nonvulnerable groups were determined by a tertile split of participants based on the change in the number of behavioral lapses recorded during ESD and TSD. A subset of participants performed six additional 10-min modified auditory PVTs with exponentially distributed foreperiods during rested wakefulness (RW) and TSD to test the effect of temporal distribution on foreperiod and sequential effects.

SETTING

Sleep laboratory.

PARTICIPANTS

There were 172 young healthy participants (90 males) with regular sleep patterns. Nineteen of these participants performed the modified auditory PVT.

MEASUREMENTS AND RESULTS

Despite behavioral lapses and slower response times, sleep deprived participants could still perceive the conditional probability of temporal events and modify their level of preparation accordingly. Both foreperiod and sequential effects were magnified following sleep deprivation in vulnerable individuals. Only the foreperiod effect increased in nonvulnerable individuals.

CONCLUSIONS

The preservation of foreperiod and sequential effects suggests that implicit time perception and temporal preparedness are intact during total sleep deprivation. Individuals appear to reallocate their depleted preparatory resources to more probable event timings in ongoing trials, whereas vulnerable participants also rely more on automatic processes.

How acute total sleep loss affects the attending brain: a meta-analysis of neuroimaging studies

STUDY OBJECTIVES

Attention is a cognitive domain that can be severely affected by sleep deprivation. Previous neuroimaging studies have used different attention paradigms and reported both increased and reduced brain activation after sleep deprivation. However, due to large variability in sleep deprivation protocols, task paradigms, experimental designs, characteristics of subject populations, and imaging techniques, there is no consensus regarding the effects of sleep loss on the attending brain. The aim of this meta-analysis was to identify brain activations that are commonly altered by acute total sleep deprivation across different attention tasks.

DESIGN

Coordinate-based meta-analysis of neuroimaging studies of performance on attention tasks during experimental sleep deprivation.

METHODS

The current version of the activation likelihood estimation (ALE) approach was used for meta-analysis. The authors searched published articles and identified 11 sleep deprivation neuroimaging studies using different attention tasks with a total of 185 participants, equaling 81 foci for ALE analysis.

RESULTS

The meta-analysis revealed significantly reduced brain activation in multiple regions following sleep deprivation compared to rested wakefulness, including bilateral intraparietal sulcus, bilateral insula, right prefrontal cortex, medial frontal cortex, and right parahippocampal gyrus. Increased activation was found only in bilateral thalamus after sleep deprivation compared to rested wakefulness.

CONCLUSION

Acute total sleep deprivation decreases brain activation in the fronto-parietal attention network (prefrontal cortex and intraparietal sulcus) and in the salience network (insula and medial frontal cortex). Increased thalamic activation after sleep deprivation may reflect a complex interaction between the de-arousing effects of sleep loss and the arousing effects of task performance on thalamic activity.

The association of sleep deprivation on the occurrence of errors by nurses who work the night shift

Purpose: To determine the influence of sleep deprivation on the occurrence of errors by registered nurses working in night shift in intensive care departments. Methods: The study utilized a multi-part questionnaire which included items about demographic characteristics, reported medical errors, and Pittsburgh Sleep Quality Index (PSQI) 300 questionnaires were distributed to registered nurses working in intensive care departments. 138 of the 153 (51% response rate) collected questionnaires were analyzed using correlation and stepwise logistic multiple regression. Results: Registered nurses who were sleep deprived had worse sleep quality in terms of high PSQI than those who were not. None of the demographic variables was statistically significant, not providing evidence that these variables may explain odds for being sleep deprived in the population. Conclusions: Work schedule changes, offering shorter periods of time on night shift and less working hours in the week may lead to better sleep quality and less sleep deprivation.

Time-on-task and sleep deprivation effects are evidenced in overlapping brain areas

Both sleep deprivation and extended task engagement (time-on-task) have been shown to degrade performance in tasks evaluating sustained attention. Here we used pulsed arterial spin labeling (pASL) to study participants engaged in a demanding selective attention task. The participants were imaged twice, once after a normal night of sleep and once after approximately 24h of total sleep deprivation. We compared task-related changes in BOLD signal alongside ASL-based cerebral blood flow (CBF) changes. We also collected resting baseline CBF data prior to and following task performance. Both BOLD fMRI and ASL identified spatially congruent task activation in ventral visual cortex and fronto-parietal regions. Sleep deprivation and time-on-task caused a decline of both measures in ventral visual cortex. BOLD fMRI also revealed such declines in fronto-parietal cortex. Only early visual cortex showed a significant upward shift in resting baseline CBF following sleep deprivation, suggesting that the neural consequences of both SD and ToT are primarily evident in task-evoked signals. We conclude that BOLD fMRI is preferable to pASL in studies evaluating sleep deprivation given its better signal to noise characteristics and the relative paucity of state differences in baseline CBF.

Sleep deprivation accelerates delay-related loss of visual short-term memories without affecting precision

STUDY OBJECTIVES

Visual short-term memory (VSTM) is an important measure of information processing capacity and supports many higher-order cognitive processes. We examined how sleep deprivation (SD) and maintenance duration interact to influence the number and precision of items in VSTM using an experimental design that limits the contribution of lapses at encoding.

DESIGN

For each trial, participants attempted to maintain the location and color of three stimuli over a delay. After a retention interval of either 1 or 10 seconds, participants reported the color of the item at the cued location by selecting it on a color wheel. The probability of reporting the probed item, the precision of report, and the probability of reporting a nonprobed item were determined using a mixture-modeling analysis. Participants were studied twice in counterbalanced order, once after a night of normal sleep and once following a night of sleep deprivation.

SETTING

Sleep laboratory.

PARTICIPANTS

Nineteen healthy college age volunteers (seven females) with regular sleep patterns.

INTERVENTIONS

Approximately 24 hours of total SD.

MEASUREMENTS AND RESULTS

SD selectively reduced the number of integrated representations that can be retrieved after a delay, while leaving the precision of object information in the stored representations intact. Delay interacted with SD to lower the rate of successful recall.

CONCLUSIONS

Visual short-term memory is compromised during sleep deprivation, an effect compounded by delay. However, when memories are retrieved, they tend to be intact.

Disrupted directed connectivity along the cingulate cortex determines vigilance after sleep deprivation

The cingulate cortex is regarded as the backbone of structural and functional connectivity of the brain. While its functional connectivity has been intensively studied, little is known about its effective connectivity, its modulation by behavioral states, and its involvement in cognitive performance. Given the previously reported effects on cingulate functional connectivity, we investigated how eye-closure and sleep deprivation changed cingulate effective connectivity, estimated from resting-state high-density electroencephalography (EEG) using a novel method to calculate Granger Causality directly in source space. Effective connectivity along the cingulate cortex was dominant in the forward direction. Eyes-open connectivity in the forward direction was greater compared to eyes-closed, in well-rested participants. The difference between eyes-open and eyes-closed connectivity was attenuated and no longer significant after sleep deprivation. Individual variability in the forward connectivity after sleep deprivation predicted subsequent task performance, such that those subjects who showed a greater increase in forward connectivity between the eyes-open and the eyes-closed periods also performed better on a sustained attention task. Effective connectivity in the opposite, backward, direction was not affected by whether the eyes were open or closed or by sleep deprivation. These findings indicate that the effective connectivity from posterior to anterior cingulate regions is enhanced when a well-rested subject has his eyes open compared to when they are closed. Sleep deprivation impairs this directed information flow, proportional to its deleterious effect on vigilance. Therefore, sleep may play a role in the maintenance of waking effective connectivity.

Circadian rhythms, sleep deprivation, and human performance

Much of the current science on, and mathematical modeling of, dynamic changes in human performance within and between days is dominated by the two-process model of sleep-wake regulation, which posits a neurobiological drive for sleep that varies homeostatically (increasing as a saturating exponential during wakefulness and decreasing in a like manner during sleep), and a circadian process that neurobiologically modulates both the homeostatic drive for sleep and waking alertness and performance. Endogenous circadian rhythms in neurobehavioral functions, including physiological alertness and cognitive performance, have been demonstrated using special laboratory protocols that reveal the interaction of the biological clock with the sleep homeostatic drive. Individual differences in circadian rhythms and genetic and other components underlying such differences also influence waking neurobehavioral functions. Both acute total sleep deprivation and chronic sleep restriction increase homeostatic sleep drive and degrade waking neurobehavioral functions as reflected in sleepiness, attention, cognitive speed, and memory. Recent evidence indicating a high degree of stability in neurobehavioral responses to sleep loss suggests that these trait-like individual differences are phenotypic and likely involve genetic components, including circadian genes. Recent experiments have revealed both sleep homeostatic and circadian effects on brain metabolism and neural activation. Investigation of the neural and genetic mechanisms underlying the dynamically complex interaction between sleep homeostasis and circadian systems is beginning. A key goal of this work is to identify biomarkers that accurately predict human performance in situations in which the circadian and sleep homeostatic systems are perturbed.

Deconstructing and reconstructing cognitive performance in sleep deprivation

Mitigation of cognitive impairment due to sleep deprivation in operational settings is critical for safety and productivity. Achievements in this area are hampered by limited knowledge about the effects of sleep loss on actual job tasks. Sleep deprivation has different effects on different cognitive performance tasks, but the mechanisms behind this task-specificity are poorly understood. In this context it is important to recognize that cognitive performance is not a unitary process, but involves a number of component processes. There is emerging evidence that these component processes are differentially affected by sleep loss. Experiments have been conducted to decompose sleep-deprived performance into underlying cognitive processes using cognitive-behavioral, neuroimaging and cognitive modeling techniques. Furthermore, computational modeling in cognitive architectures has been employed to simulate sleep-deprived cognitive performance on the basis of the constituent cognitive processes. These efforts are beginning to enable quantitative prediction of the effects of sleep deprivation across different task contexts. This paper reviews a rapidly evolving area of research, and outlines a theoretical framework in which the effects of sleep loss on cognition may be understood from the deficits in the underlying neurobiology to the applied consequences in real-world job tasks.

Functional imaging correlates of impaired distractor suppression following sleep deprivation

Sleep deprivation (SD) has been shown to affect selective attention but it is not known how two of its component processes: target enhancement and distractor suppression, are affected. To investigate, young volunteers either attended to houses or were obliged to ignore them (when attending to faces) while viewing superimposed face-house pictures. MR signal enhancement and suppression in the parahippocampal place area (PPA) were determined relative to a passive viewing control condition. Sleep deprivation was associated with lower PPA activation across conditions. Critically SD specifically impaired distractor suppression in selective attention, leaving target enhancement relatively preserved. These findings parallel some observations in cognitive aging. Additionally, following SD, attended houses were not significantly better recognized than ignored houses in a post-experiment test of recognition memory contrasting with the finding of superior recognition of attended houses in the well-rested state. These results provide evidence for co-encoding of distracting information with targets into memory when one is sleep deprived.