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❶Because if this, we are back to the fact that students who get enough sleep always do better than those who are lacking in the rest department.

Causes of sleep deprivation

Introduction
The health consequences of no sleep

White blood cells produced decreases, and so does growth hormones. Studies showed that people who received less than four hours of sleep per night were three times more likely to die in the next six years. L This further proves that not getting enough sleep can severely impact your life , and damage some of the most important organs in your body which can lead to death. In the article, "Sleep Deprivation and teens: All of them have at least one hour less sleep than a person should, which completely alters their awareness.

A study in the journal Sleep found that teenagers who go to bed after midnight are twenty-four percent more likely to suffer from depression and twenty percent more likely to consider harming themselves than those who go to bed before ten at night. This source was selected because it is a lot older than all of the other. Even in , sleep deprivation and the effects it had on students was an issue becoming larger and larger.

However, the site also states that adolescents should have right at nine hours of sleep to function properly. Also, teenagers need a healthy amount of sleep because it helps them control their stress and emotions a lot better. Most adults think they get enough sleep, but an adolescent is considered to be anyone from eleven to twenty-two. This article will help the impact of the research paper because it shows that more than ten years ago sleep deprivation was still an issue at large.

Most adolescents are "evening types" which means they stay up late on the week nights and even later on the weekends. This means they are consistently operating on not enough sleep during the week, and "catching up" on the weekends.

This can alter the body's natural sleep cycle, making it even harder to sleep during the weeknights. This can lead to Delayed Sleep Phase Disorder DSPD which is when an individual's internal clock cycle of sleep dies not correspond with their desired sleep and wake times.

Dahnt This information can better the research being done because it yet again proves that sleep deprivation can have major effects, especially in young adults. In the article "The still of Sleep Loss in America", Herche says that over twenty percent of Americans get less than six hours if sleep. Many people and doctors alike blame this on the fact that there is always something to distract people from sleeping.

Things such as television, computers, and cell phones. Sleep disorders are severely under-diagnosed and under-treated. This generation gets more than twenty percent less sleep than the generation before us. Herche, This article can help people better understand not just sleep deprivation in one specific location, but in all of America. Sitting down with my mother seemed logical because our family has many people suffering from forms of sleep deprivation.

I asked how sleep deprivation made her feel. She responded with "it makes me feel like a walking zombie. I've not been able to sleep for up to almost three days. I just feel foggy and fatigued and cant think right. She goes on to say "after staying up so long, you become so tired you can't sleep no matter what". I ask if she's done anything people have told her about that she can't remember doing. She laughingly responded with "I've randomly passed out from being so exhausted and drained with various sorts of food in my mouth.

What is the impact of sleep deprivation in our world today. Sleep deprivation targets North Carolina. Over thirty percent of people in the Charlotte area stated in a survey that they had insufficient sleep over the last fourteen days.

This directly corresponds to the fact that sleep deprivation always targets more people than someone would think. It goes on to show that in North Carolina alone, almost thirty- five percent of all it's residents are in some form sleep deprived.

North Carolina is one of the most affected stars in the entire country, but not as bad as others. It was proven that in North Carolina, more women than men were sleep deprived, by about four percent.

The most common age if people not getting enough sleep was the ages of people between twenty-five and thirty-four. This percentage was about thirty-five point eight.

The race with the lowest percentage was Hispanic, and the race with highest percentage was Native American. Something interesting to me was their employment status results. The highest percentage by far was those people unable to work, which was fifty-one percent. Then the unemployed came next. Most of them were unmarried. Also, more of the people surveyed who had sleep deprivation also had children. People's health had an effect, and most people suffering were underweight in North Carolina.

The World at Large. Sleep deprivation not only effects one particular ace, it effects the entire world. The numbers if sleep deprived people have been steadily increasing over the years.

In just America alone, over thirty percent of people are suffering from some form of sleep deprivation. The database based on Word Net is a lexical database for the English Language. Sleep Disorders In your sleep research paper, discuss sleep disorders such as insomnia, the inability to fall asleep or remain asleep at night; sleep apnea, breathing disruptions during sleep; narcolepsy, uncontrollably falling sleep; and restless leg syndrome, a strange sensation in the legs and the need to move them constantly.

Sleep Deprivation Focus your research paper on sleep deprivation -- when a person doesn't get the amount of sleep he needs. Sleep Stages Sleep happens in four stages -- stages 1 through 3, then a rapid eye movement period known as REM -- which gives you ample material for a research paper. Dreaming No one knows for sure why humans dream while they sleep. Are You Getting Enough Sleep? Stages of Sleep Web MD: The Health Benefits of Dreams. Photo Credits sleep image by DXfoto. Accessed 14 September Research Paper Topics on Sleep.

In addition, Drummond et al used a within-subject design, whereas Forest and Godbout had a between-subject design. In visual memory, recognition was similar in the experimental and control groups when the measurement was taken once after 36 h SD Harrison and Horne , whereas the practice effect in visual recall was postponed by SD in a study with three measurements baseline, 25 h SD, recovery; Alhola et al Performance was impaired in probed forced memory recall Wright and Badia , and memory search McCarthy and Waters , but no effect was found in episodic memory Nilsson et al , implicit memory, prose recall, crystallized semantic memory, procedural memory, or face memory Quigley et al In the studies failing to find an effect, however, the subjects spent only the SD night under controlled conditions Quigley et al ; Nilsson et al Free recall and recognition are both episodic memory functions which seem to be affected differently by SD.

Temporal memory for faces recall deteriorated during 36 h of SD, although in the same study, face recognition remained intact Harrison and Horne In verbal memory, the same pattern was observed Drummond et al One explanation may be different neural bases, which supports the prefrontal vulnerability hypothesis.

Episodic memory is strongly associated with the functioning of the medial temporal lobes Scoville and Milner , but during free recall in a rested state, even stronger brain activation is found in the prefrontal cortex Hwang and Golby It is unclear whether this prefrontal activation reflects episodic memory function, the organization of information in working memory, or the executive control of attention and memory.

Recognition, instead, presumably relies on the thalamus in addition to medial temporal lobes Hwang and Golby Since SD especially disturbs the functioning of frontal brain areas Drummond et al ; Thomas et al , it is not surprising that free recall is more affected than recognition.

Although the prefrontal cortex vulnerability hypothesis has received wide support in the field of SD research, other brain areas are also involved. For instance, the exact role of the thalamus remains unknown. Some studies measuring attention or working memory have noted an increase in thalamic activation during SD eg, Portas et al ; Chee and Choo ; Habeck et al ; Choo et al This may reflect an increase in phasic arousal or an attempt to compensate attentional performance during a demanding condition of low arousal caused by SD Coull et al In other cognitive tasks such as verbal memory Drummond and Brown or logical reasoning Drummond et al , no increase in thalamic activation was found despite the fact that behavioral deterioration occurred.

However, it is possible that the brain activation patterns during SD reflect something more than merely different cognitive domains. Harrison and Horne stated that their results may also reflect the difficulty of the task assigned to subjects.

Sleep deprivation impairs visuomotor performance, which is measured with tasks of digit symbol substitution, letter cancellation, trail-making or maze tracing Table 1. It is believed that visual tasks would be especially vulnerable to sleep loss because iconic memory has short duration and limited capacity Raidy and Scharff Another suggestion is that SD impedes engagement of spatial attention, which can be observed as impairments in saccadic eye movements Bocca and Denise Decreased oculomotor functioning is associated with impaired visual performance De Gennaro et al and sleepiness eg, De Gennaro et al ; Zils et al However, further research is needed to confirm this explanation, since not all studies have found oculomotor impairment with cognitive performance decrements Quigley et al Again the results are inconsistent deteriorated performance was reported by Blagrove et al ; McCarthy and Waters ; Monk and Carrier , and Harrison and Horne ; no effects were noted by Linde and Bergstrom ; Quigley et al , or Drummond et al The studies reporting no effect have mainly used SD of ca.

Thus reasoning ability seems to be maintained during short-term SD. However, choosing divergent study designs may result in different outcomes. Monk and Carrier repeated the cognitive test every 2 h and found deterioration after as little as 16 h of SD.

In the studies with longer SD, the tests have been conducted either in the late afternoon McCarthy and Waters ; Harrison and Horne or have been repeated several times Blagrove et al ; Monk and Carrier Therefore, the different results may reflect the effect of circadian rhythm on alertness and cognitive performance.

In the morning or before noon, the circadian process reaches its peak, inducing greater alertness, whereas the timing of the circadian nadir coincides with the late afternoon testing see Achermann In addition to the cognitive domains already introduced, total SD affects several other cognitive processes as well. It increases rigid thinking, perseveration errors, and difficulties in utilizing new information in complex tasks requiring innovative decision-making Harrison and Horne Deterioration in decision-making also appears as more variable performance and applied strategies Linde et al , as well as more risky behavior Killgore et al Several other tasks have been used in the sleep deprivation studies Table 1.

For example, motor function, rhythm, receptive and expressive speech, and memory measured with the Luria-Nebraska Neuropsychological Battery deteriorated after one night of SD, whereas tactile function, reading, writing, arithmetic and intellectual processes remain intact Kim et al The adverse effects of total SD shown in experimental designs have also been confirmed in real-life settings, mainly among health care workers, professional drivers and military personnel Samkoff and Jacques ; Otmani et al ; Philibert ; Russo et al Performance of residents in routine practice and repetitive tasks requiring vigilance becomes more error-prone when wakefulness is prolonged for a review, see Samkoff and Jacques However, in new situations or emergencies, the residents seem to be able to mobilize additional energy sources to compensate for the effects of tiredness.

More recent meta-analysis shows that SD of less than 30 h causes a significant decrease in both the clinical and overall performance of both residents and non-physicians Philibert What role does motivation play in cognitive performance? Can high motivation reverse the adverse effect of SD?

Does poor motivation further deteriorate performance? According to a commonly held opinion, high motivation compensates for a decrease in performance, but only a few attempts have been made to confirm this theory. Estimating the compensatory effect of motivation in performance during SD is generally difficult, because persons participating in research protocols, especially in SD studies, usually have high initial motivation.

Harrison and Horne , suggest that the deterioration of cognitive performance during SD could be due to boredom and lack of motivation caused by repeated tasks, especially if the tests are simple and monotonous.

They used short, novel, and interesting tasks to abolish this motivational gap, yet still noted that SD impaired performance. In contrast, other researchers suggest that sleep-deprived subjects could maintain performance in short tasks by being able to temporarily increase their attentional effort.

When a task is longer, performance deteriorates as a function of time. A meta-analysis by Pilcher and Huffcutt provides support for that: Based on this, it is probably necessary to make a distinction between mere attentional effort and more general motivation. Although attentional effort reflects motivational aspects in performance, motivation in a broader sense can be considered a long-term process such as achieving a previously set goal, eg, completing a study protocol.

If one has already invested a great deal of time and effort in the participation, motivation to follow through may be increased. Different aspects of motivation were investigated in a study with 72 h SD, where the subjects evaluated both motivation to perform the tasks and motivation to carry out leisure activities Mikulincer et al Cognitive tasks were repeated every two hours. Performance motivation decreased only during the second night of SD, whereas leisure motivation decreased from the second day until the end of the study on the third day.

The authors concluded that the subjects were more motivated to complete experimental testing than to enjoy leisure activities because by performing the tasks, they could advance the completion of the study. Providing the subjects with feedback on their performance or rewarding them for effort or good performance is shown to help maintain performance both in normal, non-deprived conditions Tomporowski and Tinsley and during SD Horne and Pettitt ; Steyvers ; Steyvers and Gaillard As result, no deteriorating effect on cognitive performance was found.

Unfortunately, a non-motivated control group was not included and thus the effect of motivation remained uncertain. In general, since this issue has not been addressed sufficiently, it is difficult to specify the role of motivation in performance.

It seems that motivation affects performance, but it also appears that SD can lead to a loss of motivation. It has been suggested that the self-evaluation of cognitive performance is impaired by SD.

During 36 h SD, the subjects became more confident that their answers were correct as the wakefulness continued Harrison and Horne Confidence was even stronger when the answer was actually wrong.

In another study, performance was similar between sleep-deprived and control groups in several attentional assessments, but the deprived subjects evaluated their performance as moderately impaired Binks et al The controls considered that their performance was high. Young people seem to underestimate the effect of SD, whereas older people seem to overestimate it.

In a simple reaction time task, both young aged 20—25 years and aging aged 52—63 years subjects considered that their performance had deteriorated after 24 h SD, although performance was actually impaired only in young subjects Philip et al When it comes to the study design and methodology, the way in which the self-evaluation is done may affect the outcome.

The answers possibly reflect presuppositions of the subjects or their desire to please the researcher. The repetition of tasks is also essential. Evaluation ability is poor in studies with one measurement only Binks et al ; Harrison and Horne ; Philip et al , whereas in repeated measures, the subjects are shown to be able to assess their performance quite reliably during 60—64 h SD and recovery Baranski et al ; Baranski and Pigeau Thus, self-evaluation is likely to be more accurate when subjects can compare their performance with baseline.

Although chronic partial sleep restriction is common in everyday life and even more prevalent than total SD, surprisingly few studies have evaluated its effects on cognitive performance. Even fewer studies have compared the effects of acute total sleep deprivation and chronic partial sleep restriction. Belenky and co-workers evaluated the effect of partial sleep restriction in a laboratory setting in groups which were allowed to spend 3, 5 or 7 h in bed daily for seven consecutive days.

The control group spent 9 h in bed. In the 3 h group, both speed and accuracy in the PVT deteriorated almost linearly as the sleep restriction continued. In this group, performance was clearly the worst.

In the 5- and 7 h groups, performance speed deteriorated after the first two restriction nights, but then remained stable though impaired during the rest of the sleep restriction from the third night onwards.

Impairment was greater in the 5- than 7 h group. Accuracy followed the same pattern in the 7 h group, but further declined in the 5 h group as the study went on. Both speed and accuracy were impaired at the beginning of the sleep restriction period followed by a plateau and finally, another drop after the seventh night of deprivation.

However, no change was found in probed recall memory or serial addition tests, probably because of the practice effect and short duration of the tests serial addition test: It is difficult to compare the effects of total and partial SD based on existing literature due to large variation in methodologies, including the length of SD or the type of cognitive measures.

The only study that has compared total and partial SD found that after controlling learning effects, cognitive performance declined almost linearly in the course of the study in all four experimental groups Van Dongen et al a: The control group was allowed 8 h in bed for 14 days. Impairment in psychomotor vigilance test and digit symbol substitution task for the 4 h group after 14 days was equal to that of the total SD group after 2 nights.

The effect of 6 h restricted sleep corresponded to 1 night of total SD in psychomotor vigilance and digit symbol. Performance remained unaffected in the control group. According to the well-controlled studies Dinges et al ; Belenky et al ; Van Dongen et al a , the less sleep obtained due to sleep restriction, the more cognitive performance is impaired. Otherwise, it is difficult to draw conclusions about the effects of chronic sleep restriction because of methodological problems in the previous studies.

Blagrove et al compared subjects that slept at home either 5 h or 8 h per night for 4 weeks and found no effect in a short task of logical reasoning duration 5 min. The statistical analyses were compromised by the small sample size 6 subjects in the experimental group and only 4 subjects in the control group.

In another protocol, they also carried out auditory vigilance test, two column addition, finding embedded figures, and logical reasoning 10 min tasks, and again no effect was observed with groups of 6—8 subjects having 4, 5 or 8 h sleep per night for 7, 19 or 40 weeks respectively Blagrove et al Casement et al reported no change in working memory and motor speed in the group whose sleep was restricted to 4 h per night for 9 nights.

In the control group, performance improved. The study was carried out in a controlled clinical environment, but only one short test session per day was included, which means that subjects may have been able to temporarily increase their effort and thus maintain their performance.

Furthermore, the results were confounded by the practice effect. In other sleep restriction studies, SD cannot be considered chronic, since the length of the restriction has been 1—3 nights Stenuit and Kerkhofs ; Swann et al ; Versace et al Since chronic partial SD mimics every day life situations more than acute total SD, additional studies on how it affects cognitive performance are warranted.

In addition, the tasks used in previous studies have been quite short and simple, and trials with more demanding cognitive tasks are required. The effects of sleep restriction have also been addressed by drive simulation studies, which are interesting and practical designs.

Just one night of restricted sleep 4 h increased right edge-line crossings in a motorway drive simulation of 90 minutes Otmani et al One sleep-restricted night did not increase the probability of a crash, but after five nights of partial SD, the quantity of accidents increased Thorne et al The recovery processes of cognitive performance after sleep loss are still obscure.

In many SD studies, the recovery period has either not been included in the protocol or was not reported. Recovery sleep is distinct from normal sleep. Sleep latency is shorter, sleep efficiency is higher, the amounts of SWS and REM-sleep are increased and percentages of stage 1 sleep and awake are decreased Armitage et al ; Kilduff et al The characteristics of recovery sleep may also depend on circumstances and some differences seem to come with eg, aging Kalleinen et al Evidence suggests that one sleep period at least eight hours can reverse the adverse effects of total SD on cognition Brendel et al ; Corsi-Cabrera et al ; Adam et al ; Drummond et al ; Kendall et al The tasks have been mainly simple attentional tasks; for example, the PVT used by Adam et al has been proven to have practically no learning curve and little if any correlation with aptitude Durmer and Dinges Thus, it is likely that the improvement was mostly caused by the recovery process and not just the practice effect.

After chronic partial sleep restriction, the recovery process of cognitive functioning seems to take longer than after acute total SD. The group that spent 3 h in bed showed the greatest decline as well as the greatest recovery, although it did not reach baseline level again. In the 5 h group, a similar deterioration-recovery curve was observed, although it was not as steep.

Those authors concluded that during mild and moderate chronic partial SD, the brain adapted to a stressful condition to maintain performance, yet at a reduced level. This adaptation process was obviously so demanding that it postponed the restoration of normal functioning. According to their results, it could be further interpreted that when sleep restriction was severe, no such adaptation occurred, which in turn allowed for greater recovery.

However, these results may be biased because of poor statistical sensitivity in multiple comparisons. They have also been criticized by eg, Van Dongen et al , who pointed out that another confounding factor may have been considerable interindividual differences in recovery rates.

Since interindividual differences have been observed in response to SD, it is likely — although not yet adequately verified — that those individual traits also affect the recuperation. Sleep structure changes with aging. Slow wave sleep and sleep efficiency decrease, and alterations in the circadian rhythm occur for reviews, see Dzaja et al ; Gaudreau et al Sleep complaints also become more frequent Leger et al Yet, during prolonged wakefulness, cognitive performance seems to be maintained better in aging people than in younger ones Bonnet and Rosa ; Smulders et al ; Philip et al ; Stenuit and Kerkhofs Total SD of 24 h deteriorated vigilance in young subjects 20—25 years , whereas performance in aging subjects 52—63 years remained unaffected Philip et al Similarly, during three consecutive nights of partial SD 4 h in bed performance in psychomotor vigilance task declined more in young subjects 20—30 years than in aging ones 55—65 years, Stenuit and Kerkhofs In visual episodic memory, visuomotor performance and divided attention, aging subjects 58—72 years were able to maintain their performance after 25 h of SD and showed improvement only after a recovery night Alhola et al However, no comparison with young subjects was made in that study.

Sleep deprivation deteriorates accuracy of performance, especially in young subjects Brendel et al ; Smulders et al ; Adam et al ; Karakorpi et al Regarding performance speed, however, results have been inconsistent and the performance of aging subjects has declined more, less, or equally compared to that of younger people. In simple and two-choice reaction time tasks as well as in a vigilance task, reaction speed was impaired in aging subjects 59—72 years during 40 h SD, whereas young subjects 20—26 years kept up their speed Karakorpi et al In contrast, two other studies found that young subjects were slower than aging subjects Brendel et al ; Adam et al During 24 h wakefulness, performance speed in a vigilance task was impaired in both and year-olds, but more so in the young subjects Brendel et al This was confirmed in another study with 40 h SD Adam et al When measuring reaction speed in three different choice-reaction time tasks, performance deteriorated similarly in young 18—24 years and aging 62—73 years subjects after 28 h total SD Smulders et al Even though there is some evidence that older subjects tolerate SD better than young subjects, it is difficult to determine the age effect during SD with precision.

However, because of age-related changes in many aspects of sleep and wakefulness, it is plausible that aging influences reactions to SD. As suggested previously, the weaker SD effect in aging may be due to attenuation of the circadian amplitude, which is reflected in the performance curve in vigilance tasks Blatter et al Also, changes in the homeostatic process may play a role. During wakefulness, the accumulation of sleep pressure seems to be reduced in aging Murillo-Rodriguez et al , which could leave older subjects more alert.

There is also evidence that aging subjects recover faster from SD than young subjects in terms of physiological sleep Bonnet and Rosa ; Brendel et al This faster recovery in sleep state may also mean better restoration of cognitive performance Bonnet and Rosa ; Brendel et al However, more research is necessary to confirm these hypotheses. The age effect found in previous studies could also be explained by methodological factors, such as inadequate control of the baseline conditions.

Younger subjects are usually more chronically sleep deprived National Sleep Foundation due to several reasons, such as studying, career building or raising children. Chronic sleep restriction may cause long-term changes in brain functions that are not reversible during short adaptation and baseline periods in sleep laboratory studies.

Furthermore, in the long run, people tend to get used to experiencing sleepiness Van Dongen et al a and thus may not even recognize being chronically sleep deprived.

Perhaps aging people also have more experience that helps them to cope with the challenges posed by SD. Nevertheless, based on the available studies, it is impossible to distinguish the factors behind the age effect.

There are dissimilarities between genders in sleep structure measured with polysomnography for a review, see Manber and Armitage Furthermore, women of all ages report more sleeping problems than men Leger et al Sex hormones affect sleep through several mechanisms, both genomic and nongenomic, including neurochemical and vascular mechanisms for a review, see Dzaja et al This ensures instant and short-term effects as well as long-term ones. It is possible that physiological responses to SD are not equal among men and women.

During SD of 38 h, EEG showed more sleep activity in men than in women during waking rest and cognitive performance Corsi-Cabrera et al Presumably, therefore, one recovery night of nine hours would be enough to restore waking EEG activity in men, but not in women.

Only a few studies have examined gender differences in cognitive performance during SD. In a vigilance task, performance was more impaired in men but returned to the baseline level in both men and women after recovery sleep Corsi-Cabrera et al In another study, women performed better than men in verbal and in visuo-constructive tasks during 35 h SD Binks et al No gender differences were observed in word fluency, maintenance or suppression of attention, auditory attention or cognitive flexibility.

In that study, however, only one point of measurement was included, and so the difference in performance could be caused by SD or initial distinctions between the gender groups.

Few attempts have been made to evaluate the effect of sex hormones on coping with SD. It has been suggested that hormone therapy, which is widely used for women during their menopausal transition to help alleviate climacteric symptoms, attenuates physiological stress response Lindheim et al However, after 25 h of total SD, no difference was observed between hormone therapy users and nonusers in visual episodic memory, visuomotor performance, verbal attention and shared attention Alhola et al In addition, during 40 h of SD, hormone therapy did not produce any advantage in reaction time or vigilance tasks Karakorpi et al The previous studies suggest that women cope with continuous wakefulness better than men.

According to evolution, the demands of child nurturing and rearing in women would support this hypothesis Corsi-Cabrera et al , but that certainly does not constitute a comprehensive explanation today. Gender differences during SD could be due to either physiological or social factors. There are differences in the brain structure and functioning of men and women Ragland et al ; Cowell et al These can be seen in cognitive performance in normal, non-deprived conditions: Men and women also exhibit behavioral and lifestyle differences, which are mainly due to socialization and gender roles Eagly and Wood Current literature, however, provides only minimal evidence of differential effects during SD, and does not resolve the issue of sexual dimorphism in coping with SD.

Several studies provide evidence that during total SD, performance becomes more variable as assessed from the within-subject point of view eg, Smith et al ; Habeck et al ; Choo et al This is considered to reflect the wake-state instability caused by prolonged wakefulness. However, Doran et al were probably the first to also examine between-subjects variability, which they found to increase in PVT as wakefulness was extended to 88 hours.

They suggested that some people are more vulnerable to the effects of sleep loss than others, which could probably explain the lack of significant results in some group comparisons. These differences between subjects could have arguably been caused by differences in sleep history, but the sleep patterns for the preceding week were controlled with sleep diaries, actigraph, and calls to the time-stamped voice recorder.

The interindividual variability has been further examined with a thorough protocol where a three night study baseline, 36 h SD and recovery was carried out three times Van Dongen et al Sleep history was manipulated by instructing subjects to stay in bed for either 6 or 12 h per night for one week before the study. The 12 h procedure was repeated and the order of the conditions was counterbalanced. The authors concluded that interindividual differences were systematic and independent from sleep history.

The trait-like differential vulnerability to sleep loss has received support from an fMRI study attempting to reveal the neural basis for the interindividual differences Chuah et al The results indicated that the subjects less vulnerable to SD had lower prefrontal cortex activation at the rested wakefulness than the more vulnerable subjects.

During SD, activation increased temporarily in the prefrontal cortex and in some other areas only in the less vulnerable subjects. Since interindividual differences have also been found in other sleep-related variables, such as duration, timing, and quality of sleep, sleepiness, and circadian phase Van Dongen ; Van Dongen et al , it is plausible that the tolerance to SD may also vary.

Nevertheless, more studies are needed for further support. Although the adverse effects of SD on cognitive performance are quite well established, some studies have failed to detect any deterioration.

Inadequate descriptions of study protocols or subject characteristics in some studies make it difficult to interpret the neutral results. However, it is likely that such results are due to methodological shortcomings, such as insensitive cognitive measures, failure to control the practice effect or other confounding factors, like individual sleep history or napping during the study. Also, if the task is carried out only once during the SD period, the results may be influenced by circadian rhythm.

Sleep deprivation studies are laborious and expensive to carry out, which may lead to compromises in the study design:


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