Sleep loss affects vigilance: effects of chronic insomnia and sleep therapy.

ELLEMARIJE ALTENA, YSBRAND D. VAN DER WERF, ROB L. M. STRIJERS, EUS J. W. VAN SOMEREN
Journal of Sleep Research. 2008-09-01; 17(3): 335-343
DOI: 10.1111/j.1365-2869.2008.00671.x

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1. J Sleep Res. 2008 Sep;17(3):335-43. doi: 10.1111/j.1365-2869.2008.00671.x.

Sleep loss affects vigilance: effects of chronic insomnia and sleep therapy.

Altena E(1), Van Der Werf YD, Strijers RL, Van Someren EJ.

Author information:
(1)Department of Sleep and Cognition, Netherlands Institute for Neuroscience, an
institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The
Netherlands.

Although complaints of impaired daytime functioning are essential to the
diagnosis of primary insomnia, objective evidence for cognitive dysfunction has
been hard to establish. A prerequisite for understanding the neurocognitive
consequences of primary insomnia is to establish task paradigms that robustly
differentiate insomniacs from well-sleeping subjects. We hypothesized that the
decline in performance that typically occurs with an increasing cognitive demand
would provide a more sensitive measure than performance on a single task version.
The hypothesis was tested, first, by assessing the performance on two vigilance
tasks with different cognitive demands in 25 elderly patients with primary
insomnia and 13 healthy well-sleeping age-matched subjects. Secondly, we
investigated the performance response to sleep therapy using a waiting-list
controlled design. Sleep therapy consisted of a multi-component intervention
including sleep restriction, cognitive behavioral therapy, bright-light therapy,
structured physical activity and body temperature manipulations. The results show
that insomniacs differed markedly from controls in their reaction times across
tasks with different cognitive demands: patients responded faster on the ‘simple’
vigilance task, yet slower on the ‘complex’ vigilance task. Sleep therapy
effectively restored normal performance: patients became significantly slower on
the ‘simple’ task and faster on the ‘complex’ task, returning to the performance
levels of control subjects. These findings indicate that the performance decline
associated with increasing cognitive demands is possibly the first sensitive and
robust measure of the neurocognitive sequelae of insomnia. We suggest that future
studies on cognition in primary insomnia should apply a design that varies task
demands.

DOI: 10.1111/j.1365-2869.2008.00671.x
PMID: 18844819 [Indexed for MEDLINE]


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