Concordance of multiple methods to define resiliency and vulnerability to sleep loss depends on Psychomotor Vigilance Test metric

Abstract

Study Objectives Sleep restriction (SR) and total sleep deprivation (TSD) reveal well-established individual differences in Psychomotor Vigilance Test (PVT) performance. While prior studies have used different methods to categorize such resiliency/vulnerability, none have systematically investigated whether these methods categorize individuals similarly. Methods 41 adults participated in a 13-day laboratory study consisting of 2 baseline, 5 SR, 4 recovery, and one 36h TSD night. The PVT was administered every 2h during wakefulness. Three approaches (Raw Score [average SR performance], Change from Baseline [average SR minus average baseline performance], and Variance [intraindividual variance of SR performance]), and within each approach, six thresholds (±1 standard deviation and the best/worst performing 12.5%, 20%, 25%, 33%, and 50%) classified Resilient/Vulnerable groups. Kendall’s tau-b correlations examined the concordance of group categorizations of approaches within and between PVT lapses and 1/reaction time (RT). Bias-corrected and accelerated bootstrapped t-tests compared group performance. Results Correlations comparing the approaches ranged from moderate to perfect for lapses and zero to moderate for 1/RT. Defined by all approaches, the Resilient groups had significantly fewer lapses on nearly all study days. Defined by the Raw Score approach only, the Resilient groups had significantly faster 1/RT on all study days. Between-measures comparisons revealed significant correlations between the Raw Score approach for 1/RT and all approaches for lapses. Conclusion The three approaches defining vigilant attention resiliency/vulnerability to sleep loss resulted in groups comprised of similar individuals for PVT lapses but not for 1/RT. Thus, both method and metric selection for defining vigilant attention resiliency/vulnerability to sleep loss is critical.

Cortisol and C-Reactive Protein Vary During Sleep Loss and Recovery but Are Not Markers of Neurobehavioral Resilience

“…During sleep deprivation and psychological stress, the range of the Spearman relative rank correlations between the two objective performance measures (3-min PVT and DSST) was ρ = −0.579, p = 0.001, and the range between the objective performance measures and the KSS was ρ = −0.142–0.371, p = 0.036–0.439. The profiles of change in NTB performance and self-report scores with sleep loss and psychological stress are comparable to results obtained in laboratory studies ( Dennis et al, 2017 ; Yamazaki and Goel, 2020 ; Brieva et al, 2021 ; Casale et al, 2021b ; Yamazaki et al, 2021a , b ).…”

“…As such, resilient and vulnerable individuals were determined by a median split on average values from the three NTB sessions during TSD ( Patanaik et al, 2015 ; Moreno-Villanueva et al, 2018 ; Caldwell et al, 2020 ) for 3-min PVT total lapses and errors, DSST performance, and KSS scores. We dichotomized participants as such given that, for initial examination and categorization of novel biomarkers, it is more suitable and applicable to create resilient and vulnerable groups in healthy adult samples, as per convention in the field ( Chuah et al, 2009 ; Rocklage et al, 2009 ; Chee and Tan, 2010 ; Diekelmann et al, 2010 ; Patanaik et al, 2015 ; Yeo et al, 2015 ; Xu et al, 2016 ; Moreno-Villanueva et al, 2018 ; Caldwell et al, 2020 ; Salfi et al, 2020 ; Brieva et al, 2021 ; Casale et al, 2021b ; Yamazaki et al, 2021b ), especially given our sample size. Importantly, systematic examination of multiple approaches and thresholds for evaluating differential neurobehavioral vulnerability to sleep loss has demonstrated that median splits on averaged performance scores, rather than change from baseline or variance in scores, are consistent indicators of resilience and vulnerability during sleep deprived and well-rested periods ( Brieva et al, 2021 ; Casale et al, 2021b ; Yamazaki et al, 2021b ), thus further justifying our methods.…”

“…Chronic sleep deprivation is an important public health concern associated with many adverse health outcomes and clinical disorders such as anxiety, depression, immune dysfunction, Alzheimer’s disease, cardiovascular disease, obesity, cancer, and overall morbidity and mortality ( Ferrie et al, 2007 ; Gallicchio and Kalesan, 2009 ; Mullington et al, 2009 ; Phan and Malkani, 2019 ; Al-Rashed et al, 2021 ). Sleep deprivation is a potent stressor generally resulting in marked increases in physiological sleepiness (e.g., the Maintenance of Wakefulness Test and the Multiple Sleep Latency Test) and subjective sleepiness [e.g., the Karolinska Sleepiness Scale (KSS)] and significant deficits in cognitive performance ( Banks and Dinges, 2007 ; Goel et al, 2009 ; Casale et al, 2021a , b ; Yamazaki et al, 2021a , b ). However, a number of studies show there are robust and highly replicable phenotypic individual differences in response to repeated exposure to sleep deprivation: some individuals are resilient, and others are vulnerable to total sleep deprivation (TSD) and chronic sleep restriction (SR), both commonly experienced types of sleep loss ( Van Dongen et al, 2004 ; Goel et al, 2009 ; Dennis et al, 2017 ; Yamazaki and Goel, 2020 ).…”

Left Ventricular Ejection Time Measured by Echocardiography Differentiates Neurobehavioral Resilience and Vulnerability to Sleep Loss and Stress

“…Chronic sleep deprivation is a significant public health issue and is associated with multiple adverse health risks such as cardiovascular disease, obesity, diabetes, cancer, and overall morbidity and mortality ( Ferrie et al, 2007 ; Gallicchio and Kalesan, 2009 ; Mullington et al, 2009 ). For many individuals, sleep loss increases self-rated sleepiness and deficits in sustained attention ( Banks and Dinges, 2007 ; Goel et al, 2009 ; Brieva et al, 2021 ; Casale et al, 2021 ; Yamazaki et al, 2021a , b ). However, large, highly replicable, phenotypic individual differences occur in response to sleep deprivation, whereby some individuals are vulnerable, and others are resilient to sleep loss ( Van Dongen et al, 2004 ; Goel, 2017 ; Yamazaki and Goel, 2020 ; Brieva et al, 2021 ; Casale et al, 2021 ; Yamazaki et al, 2021a , b ).…”

“…For many individuals, sleep loss increases self-rated sleepiness and deficits in sustained attention ( Banks and Dinges, 2007 ; Goel et al, 2009 ; Brieva et al, 2021 ; Casale et al, 2021 ; Yamazaki et al, 2021a , b ). However, large, highly replicable, phenotypic individual differences occur in response to sleep deprivation, whereby some individuals are vulnerable, and others are resilient to sleep loss ( Van Dongen et al, 2004 ; Goel, 2017 ; Yamazaki and Goel, 2020 ; Brieva et al, 2021 ; Casale et al, 2021 ; Yamazaki et al, 2021a , b ). These inter-individual differences are robust for common types of sleep loss, such as total sleep deprivation (TSD) and chronic sleep restriction (SR) ( Dennis et al, 2017 ; Yamazaki and Goel, 2020 ), persisting across months and years ( Dennis et al, 2017 ), but do not differ between various subgroups, such as age, sex, race, and body mass index ( Yamazaki and Goel, 2020 ).…”