Multiple nights of partial sleep deprivation do not affect prospective remembering at long delays

A systematic and meta-analytic review of the impact of sleep restriction on memory formation

Modern life causes a quarter of adults and half of teenagers to sleep for less than is recommended (Kocevska et al., 2021). Given well-documented benefits of sleep on memory, we must understand the cognitive costs of short sleep. We analysed 125 sleep restriction effect sizes from 39 reports involving 1234 participants. Restricting sleep (3-6.5 hours) compared to normal sleep (7-11 hours) negatively affects memory formation with a small effect size (Hedges' g = 0.29, 95 % CI = [0.13, 0.44]). We detected no evidence for publication bias. When sleep restriction effect sizes were compared with 185 sleep deprivation effect sizes (Newbury et al., 2021) no statistically significant difference was found, suggesting that missing some sleep has similar consequences for memory as not sleeping at all. When the analysis was restricted to post-encoding, rather than pre-encoding, sleep loss, sleep deprivation was associated with larger memory impairment than restriction. Our findings are best accounted for by the sequential hypothesis which emphasises complementary roles of slow-wave sleep and REM sleep for memory.

Activity-Based Prospective Memory in Insomniacs

OBJECTIVE

To investigate the activity-based prospective memory performance in patients with insomnia, divided, on the basis of actigraphic evaluation, into sleep onset, maintenance, mixed and negative misperception insomnia.

METHODS

A total of 153 patients with insomnia (I, 83 females, mean age + SD = 41.37 + 16.19 years) and 121 healthy controls (HC, 78 females, mean age + SD = 36.99 + 14.91 years) wore an actigraph for one week. Insomnia was classified into sleep onset insomnia (SOI), maintenance insomnia (MaI), mixed insomnia (MixI) and negative misperception insomnia (NMI). To study their activity-based prospective memory performance, all the participants were required to push the actigraph event marker button twice, at bedtime (task 1) and at get-up time (task 2).

RESULTS

Only patients with maintenance and mixed insomnia had a significantly lower accuracy in the activity-based prospective memory task at get-up time compared with the healthy controls.

CONCLUSION

The results show that maintenance and mixed insomnia involve an impaired activity-based prospective memory performance, while sleep onset and negative misperception insomnia do not seem to be affected. This pattern of results suggests that the fragmentation of sleep may play a role in activity-based prospective memory efficiency at wake-up in the morning.

A daytime nap restores hippocampal function and improves declarative learning

STUDY OBJECTIVES

Daytime naps can confer benefits on subsequent declarative learning, but the physiological correlates of this improvement are less well studied. We examined learning following a daytime nap compared with an equivalent waking period using fMRI and polysomnography.

METHODS

Forty healthy young adults who slept normally the previous night encoded word pair lists in an MRI scanner at 13:00 and 16:30. Between sessions, participants either stayed awake and watched a documentary (Wake Group; N = 20) or had a 90-minute nap opportunity (Nap Group; N = 20) monitored by polysomnography. Approximately 40 minutes after completing each encoding session, memory for learned words was assessed using cued-recall.

RESULTS

A significant Session × Group interaction effect (p < 0.001) was observed in which memory was significantly improved in the Nap but not in the Wake group (p < 0.001). There was also a Session × Run × Group interaction effect in the left hippocampus (p = 0.001), whereby activation during word pair encoding increased only following the nap. Both performance improvement (rs = 0.46, p = 0.04) and nap-related increase in hippocampal activation (rs = 0.46, p = 0.04) were correlated with nap spindle count (12-15 Hz) but not with slow oscillation power (p's ≥ 0.18).

CONCLUSIONS

After a habitual nocturnal sleep, participants who had a 90-minute afternoon nap encoded word pairs better than a comparable group who stayed awake. Increases in hippocampal activation following the nap suggest restored hippocampal function. Naptime spindles may contribute to improved memory.

Cognitive effects of split and continuous sleep schedules in adolescents differ according to total sleep opportunity

STUDY OBJECTIVES

We compared the basic cognitive functions of adolescents undergoing split (nocturnal sleep + daytime nap) and continuous nocturnal sleep schedules when total sleep opportunity was either below or within the recommended range (i.e. 6.5 or 8 h).

METHODS

Adolescent participants (age: 15-19 year) in the 8-h split (n = 24) and continuous (n = 29) sleep groups were compared with 6.5-h split and continuous sleep groups from a previous study (n = 58). These protocols involved two baseline nights (9-h time-in-bed [TIB]), 5 nights of sleep manipulation, 2 recovery nights (9-h TIB), followed by a second cycle of sleep manipulation (3 nights) and recovery (2 nights). Cognitive performance, subjective sleepiness, and mood were evaluated daily; sleep was assessed using polysomnography.

RESULTS

Splitting 6.5 h of sleep with a mid-afternoon nap offered a boost to cognitive function compared to continuous nocturnal sleep. However, when total TIB across 24 h increased to 8 h, the split and continuous sleep groups performed comparably in tests evaluating vigilance, working memory, executive function, processing speed, subjective sleepiness, and mood.

CONCLUSIONS

In adolescents, the effects of split sleep on basic cognitive functions vary by the amount of total sleep obtained. As long as the total sleep opportunity across 24 h is within the recommended range, students may fulfill sleep requirements by adopting a split sleep schedule consisting of a shorter period of nocturnal sleep combined with a mid-afternoon nap, without significant impact on basic cognitive functions.

CLINICAL TRIAL REGISTRATION

NCT04044885.

Evidence Base Update on Assessing Sleep in Youth

BACKGROUND

Sleep is vital to youth well-being and when it becomes disturbed - whether due to environmental or individual factors - mental and physical health suffer. Sleep problems can also be a symptom of underlying mental health disorders. Assessing different components of sleep, including quality and hygiene, can be useful both for identifying mental health problems and for measuring changes in well-being over time. However, there are dozens of sleep-related measures for youth and it can be difficult to determine which to select for a specific research or clinical purpose. The goal of this review was to identify sleep-related measures for clinical and/or research use in youth mental health settings, and to update the evidence base on this topic.

METHOD

We generated a list of candidate measures based on other reviews and searched in PubMed and PsycINFO using the terms "sleep" AND (measure OR assessment OR questionnaire) AND (psychometric OR reliability OR validity). Search results were limited to studies about children and adolescents (aged 2-17) published in English. Additional criteria for inclusion were that there had to be at least three publications reporting on the measure psychometrics in community or mental health populations. Sleep measures meeting these criteria were evaluated using the criteria set by De Los Reyes and Langer (2018).

RESULTS

Twenty-six measures, across four domains of sleep - insomnia, sleep hygiene, sleepiness, sleep quality - met inclusion criteria. Each measure had at least adequate clinical utility. No measure(s) emerged as superior across psychometric domains.

CONCLUSION

Clinicians and researchers must evaluate sleep measures for each use case, as the intended purpose will dictate which measure is best. Future research is necessary to evaluate measure performance in transdiagnostic mental health populations, including youth with serious mental illness.

Are subjective sleepiness and sleep quality related to prospective memory?

Event-based prospective memory (PM) involves carrying out intentions when specific events occur and is ubiquitous in everyday life. It consists of a prospective component (remembering that something must be done) and a retrospective component (remembering what must be done and when). Subjective sleep-related variables may be related to PM performance and an attention-demanding prospective component. In two studies, the relationship of subjective sleepiness and subjective sleep quality with both PM components was investigated with a laboratory PM task and separation of its components via Bayesian multinomial processing tree modeling. In Study 1, neither component of PM was related to naturally occurring subjective sleepiness or sleep quality. In Study 2, sleepiness was experimentally increased by placing some participants in a supine body posture. Testing participants in upright vs. supine posture affected neither PM component. However, body posture moderated the relationship between subjective sleep quality and the prospective component: In supine posture, subjective sleep quality tended to be more positively related to the prospective component. Overall, neither subjective sleepiness nor subjective sleep quality alone was related to PM.

Rapid eye movement sleep mediates age-related decline in prospective memory consolidation

STUDY OBJECTIVES

Prospective memory, or remembering to execute future intentions, accounts for half of everyday forgetting in older adults. Sleep intervals benefit prospective memory consolidation in young adults, but it is unknown whether age-related changes in slow wave activity, sleep spindles, and/or rapid eye movement (REM) sleep mediate hypothesized effects of aging on prospective memory consolidation.

METHODS

After an adaptation night, 76 adults aged 18-84 completed two experimental nights of in-laboratory polysomnography recording. In the evening, participants encoded and practiced a prospective memory task and were tested the next morning. On a counterbalanced night, they encoded and practiced a control task, and were tested the following morning.

RESULTS

Increasing age predicted worse prospective memory consolidation (r = -.34), even when controlling for encoding, speed, and control-task performance (all ps < .05). Frontal delta power, slow oscillations, and spindle density were not related to prospective memory consolidation. REM sleep duration, however, explained significant variance in prospective memory consolidation when controlling for age (∆R2 = .10). Bootstrapping mediation showed that less REM sleep significantly mediated the aging effect on prospective memory consolidation [b = -.0016, SE = 0.0009 (95% confidence interval [CI] = -0.0042 to -0.0004)]. REM sleep continued to mediate 24.29% of the total effect of age on prospective memory after controlling for numerous demographic, cognitive, mental health, and sleep variables.

CONCLUSION

Age-related variance in REM sleep is informative to how prospective memory consolidation changes with increasing age. Future work should consider how both REM sleep and slow wave activity contribute, perhaps in a sequential or dynamic manner, to preserving cognitive functioning with increasing age.

The impact of sleep deprivation on declarative memory

Sleep plays a crucial role in memory stabilization and integration, yet many people obtain insufficient sleep. This review assesses what is known about the level of sleep deprivation that leads to impairments during encoding, consolidation and retrieval of declarative memories, and what can be determined about the underlying neurophysiological processes. Neuroimaging studies that deprived sleep after learning have provided some of the most compelling evidence for sleep's role in the long-term reorganization of memories in the brain (systems consolidation). However, the behavioral consequences of losing sleep after learning-shown by increased forgetting-appear to recover over time and are unaffected by more common forms of partial sleep restriction across several nights. The capacity to encode new memories is the most vulnerable to sleep loss, since long-term deficits have been observed after total and partial sleep deprivation, while retrieval mechanisms are relatively unaffected. The negative impact of sleep loss on memory has been explored extensively after a night of total sleep deprivation, but further research is needed on the consequences of partial sleep loss over many days so that impairments may be generalized to more common forms of sleep loss.

Sleep improves memory for the content but not execution of intentions in adolescents

OBJECTIVE

Sleep benefits prospective memory in young adults probably in part due to its well-established role in enhancing declarative memory, thereby facilitating retrieval of the intention content. In prior work on adolescents, we did not detect differences in prospective memory comparing five nights of sleep restriction and adequate sleep. Here, we examined whether this might be attributed to a limited role of sleep in benefiting the declarative content in this age group, and whether a sleep benefit on prospective memory would be uncovered with a shorter retention interval.

METHODS

A total of 59 adolescents (mean ± standard deviation: 16.55 ± 0.94 years) were instructed to remember to press a special key in response to two target words embedded in a semantic categorization task. Memory was tested after a 12-h retention interval, which included either overnight sleep (21:00-09:00, n = 29) or daytime wakefulness (09:00-21:00, n = 30).

RESULTS

We found no significant group difference in the percentage of target words correctly responded to (mean ± standard error of the mean for the sleep group: 32.76 ± 6.69%; wake group: 41.67 ± 7.61%, t = 0.88, p = 0.38). However, participants who slept recalled more target words compared to those who stayed awake (98.28 ± 1.72% vs. 86.67 ± 5.32%, t = 2.05, p < 0.05). In addition, a significantly greater proportion of sleep participants (n = 28 of 29) compared to wake participants (n = 24 of 30) recalled both target words correctly (χ² = 3.76, p < 0.05).

CONCLUSION

These findings suggest that during adolescence, sleep plays a more prominent role in improving memory for the content as compared to the execution of intentions.