Neurocognitive performance in insomnia disorder: The impact of hyperarousal and short sleep duration

Abstract

Given the recent evidence on the association between hyperarousal in insomnia disorder and neurocognitive deficits, we aimed to examine the effect of short sleep duration on neurocognitive reaction time tests in insomnia disorder sufferers. We recruited subjects with insomnia disorder (n = 35, mean age = 40.6 years) who scored ≥29 on a Hyperarousal Scale, and a group of controls (n = 54, mean age = 31.5 years) who had no sleep disorders and scored <26 on the Hyperarousal Scale. Participants completed two in-home polysomnograms and four daytime trials of neurocognitive tests, including simple reaction time, choice reaction time, big circle-little circle, rapid visual information processing, attention switching task, and spatial working memory tests. Total sleep time divided study cohorts into subgroups of short (total sleep time <6 hr) and normal (total sleep time ≥6 hr) sleepers. ANCOVA showed a significant interaction between participant type (insomnia disorder versus controls) and sleep duration (short versus normal) for spatial working memory-latency (p = 0.020) and spatial working memory-errors (p = 0.025). The short-sleeping insomnia disorder group had longer spatial working memory-latencies and more spatial working memory-errors than did normal-sleeping controls. Regardless of sleep duration, those with insomnia disorder had more attentional deficits with longer attention switching task-latency (p = 0.011) and more attention switching task-incorrect trials (p = 0.015) than the control group. Normal-sleepers only had longer attention switching task-latency than short-sleepers (p = 0.004). A phenotype of insomnia disorder with hyperarousal and short sleep duration is associated with daytime cognitive deficits in complex attentional and spatial working memory tasks.

Insomnia, sleep duration and academic performance: a national survey of Norwegian college and university students

“…Short sleep duration was associated with a higher risk of students reporting failed examinations in the present study. This finding was independent of a range of lifestyle factors and psychological distress, and the results are in line with previous field and laboratory studies [13,17,18,37,38]. The relationship between sleep duration and failed examinations was further elucidated in some additional regression analyses that were conducted, where we distinguished between six categories of sleep duration.…”

“…For example, a meta-analysis showed that insomnia was associated with mild to moderate impairments on more complex cognitive functioning, such as working memory and executive control, whereas performance on areas such as alertness, sustained attention and vigilance were not affected compared to normal sleepers [34]. Recent advancements in this field suggest that these impairments might be more pronounced among those who have the subtype of insomnia characterized by short sleep duration [17,18]. Indeed, our findings indicate that those with insomnia and a short sleep duration (<6 h) had the highest risk of reporting more failed exams relative to the other categories when no other variables were controlled for.…”

“…To the best of our knowledge, no previous study has examined a more stringent evaluation of disturbed sleep based on an approximation of the DSM-5 criteria for insomnia among college students, and how this relates to the risk of delayed study progress and having failed examinations. Recent laboratory studies suggest that those who have a subtype of insomnia characterized by short sleep duration (<6 h) may experience more pronounced neurocognitive deficit than insomnia sufferers with normal sleep duration and healthy controls [17,18]. However, no previous studies have researched how an approximation of this subtype of insomnia with short sleep duration relates to scholastic parameters such as delayed study progress and having failed examinations.…”

Cognitive performance in patients with implantable cardioverter defibrillators: Associations with objective sleep duration, age and anxiety

“…Our prediction that TST would be associated with performance on tests measuring higher‐order cognitive functions was generally supported, but the type of cognitive task was important. For the reasoning and working memory tasks, associations between longer sleep duration and better performance agree with the direction of association reported in prior studies examining self‐reported TST in adults without ICDs (Fernandez‐Mendoza et al., ; Khassawneh et al., ). This suggests that patients with ICDs may receive cognitive benefits following increased sleep duration.…”

“…For instance, self‐reported TST (i.e. <6 hr) has been associated with worse performance on tests measuring higher‐order or executive function in younger adults with insomnia (Khassawneh, Bathgate, Tsai, & Edinger, ), processing speed and executive function in middle‐aged adults with insomnia (Fernandez‐Mendoza et al., ), and worse global cognitive performance in older adults (Lo, Loh, Zheng, Sim, & Chee, ). Other research has found that objectively measured (i.e.…”