Neurobehavioral performance impairment in insomnia: relationships with self-reported sleep and daytime functioning

Julia Shekleton, Erin E Flynn-Evans, Belinda Miller, Lawrence J Epstein, Douglas Benjamin Kirsch, Lauren A Brogna, Liza M Burke, Erin Bremer, Jade Mary Murray, Philip R Gerhman, Steven W Lockley, Shanthakumar M W Rajaratnam

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Study Objectives: Despite the high prevalence of insomnia, daytime consequences of the disorder are poorly characterized. This study aimed to identify neurobehavioral impairments associated with insomnia, and to investigate relationships between these impairments and subjective ratings of sleep and daytime dysfunction. Design: Cross-sectional, multicenter study. Setting: Three sleep laboratories in the USA and Australia. Patients: Seventy-six individuals who met the Research Diagnostic Criteria (RDC) for Primary Insomnia, Psychophysiological Insomnia, Paradoxical Insomnia, and/or Idiopathic Childhood Insomnia (44F, 35.8 ? 12.0 years [mean ? SD]) and 20 healthy controls (14F, 34.8 ? 12.1 years). Interventions: N/A. Measurements and Results: Participants completed a 7-day sleep-wake diary, questionnaires assessing daytime dysfunction, and a neurobehavioral test battery every 60-180 minutes during an afternoon/evening sleep laboratory visit. Included were tasks assessing sustained /and switching attention, working memory, subjective sleepiness, and effort. Switching attention and working memory were significantly worse in insomnia patients than controls, while no differences were found for simple or complex sustained attention tasks. Poorer sustained attention in the control, but not the insomnia group, was significantly associated with increased subjective sleepiness. In insomnia patients, poorer sustained attention performance was associated with reduced health-related quality of life and increased insomnia severity. Conclusions: We found that insomnia patients exhibit deficits in higher level neurobehavioral functioning, but not in basic attention. The findings indicate that neurobehavioral deficits in insomnia are due to neurobiological alterations, rather than sleepiness resulting from chronic sleep deficiency
Original languageEnglish
Pages (from-to)107 - 116
Number of pages10
JournalSleep
Volume37
Issue number1
DOIs
Publication statusPublished - 2014

Cite this

Shekleton, Julia ; Flynn-Evans, Erin E ; Miller, Belinda ; Epstein, Lawrence J ; Kirsch, Douglas Benjamin ; Brogna, Lauren A ; Burke, Liza M ; Bremer, Erin ; Murray, Jade Mary ; Gerhman, Philip R ; Lockley, Steven W ; Rajaratnam, Shanthakumar M W. / Neurobehavioral performance impairment in insomnia: relationships with self-reported sleep and daytime functioning. In: Sleep. 2014 ; Vol. 37, No. 1. pp. 107 - 116.
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title = "Neurobehavioral performance impairment in insomnia: relationships with self-reported sleep and daytime functioning",
abstract = "Study Objectives: Despite the high prevalence of insomnia, daytime consequences of the disorder are poorly characterized. This study aimed to identify neurobehavioral impairments associated with insomnia, and to investigate relationships between these impairments and subjective ratings of sleep and daytime dysfunction. Design: Cross-sectional, multicenter study. Setting: Three sleep laboratories in the USA and Australia. Patients: Seventy-six individuals who met the Research Diagnostic Criteria (RDC) for Primary Insomnia, Psychophysiological Insomnia, Paradoxical Insomnia, and/or Idiopathic Childhood Insomnia (44F, 35.8 ? 12.0 years [mean ? SD]) and 20 healthy controls (14F, 34.8 ? 12.1 years). Interventions: N/A. Measurements and Results: Participants completed a 7-day sleep-wake diary, questionnaires assessing daytime dysfunction, and a neurobehavioral test battery every 60-180 minutes during an afternoon/evening sleep laboratory visit. Included were tasks assessing sustained /and switching attention, working memory, subjective sleepiness, and effort. Switching attention and working memory were significantly worse in insomnia patients than controls, while no differences were found for simple or complex sustained attention tasks. Poorer sustained attention in the control, but not the insomnia group, was significantly associated with increased subjective sleepiness. In insomnia patients, poorer sustained attention performance was associated with reduced health-related quality of life and increased insomnia severity. Conclusions: We found that insomnia patients exhibit deficits in higher level neurobehavioral functioning, but not in basic attention. The findings indicate that neurobehavioral deficits in insomnia are due to neurobiological alterations, rather than sleepiness resulting from chronic sleep deficiency",
author = "Julia Shekleton and Flynn-Evans, {Erin E} and Belinda Miller and Epstein, {Lawrence J} and Kirsch, {Douglas Benjamin} and Brogna, {Lauren A} and Burke, {Liza M} and Erin Bremer and Murray, {Jade Mary} and Gerhman, {Philip R} and Lockley, {Steven W} and Rajaratnam, {Shanthakumar M W}",
year = "2014",
doi = "10.5665/sleep.3318",
language = "English",
volume = "37",
pages = "107 -- 116",
journal = "Sleep",
issn = "0161-8105",
publisher = "Associated Professional Sleep Societies",
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Shekleton, J, Flynn-Evans, EE, Miller, B, Epstein, LJ, Kirsch, DB, Brogna, LA, Burke, LM, Bremer, E, Murray, JM, Gerhman, PR, Lockley, SW & Rajaratnam, SMW 2014, 'Neurobehavioral performance impairment in insomnia: relationships with self-reported sleep and daytime functioning' Sleep, vol. 37, no. 1, pp. 107 - 116. https://doi.org/10.5665/sleep.3318

Neurobehavioral performance impairment in insomnia: relationships with self-reported sleep and daytime functioning. / Shekleton, Julia; Flynn-Evans, Erin E; Miller, Belinda; Epstein, Lawrence J; Kirsch, Douglas Benjamin; Brogna, Lauren A; Burke, Liza M; Bremer, Erin; Murray, Jade Mary; Gerhman, Philip R; Lockley, Steven W; Rajaratnam, Shanthakumar M W.

In: Sleep, Vol. 37, No. 1, 2014, p. 107 - 116.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Neurobehavioral performance impairment in insomnia: relationships with self-reported sleep and daytime functioning

AU - Shekleton, Julia

AU - Flynn-Evans, Erin E

AU - Miller, Belinda

AU - Epstein, Lawrence J

AU - Kirsch, Douglas Benjamin

AU - Brogna, Lauren A

AU - Burke, Liza M

AU - Bremer, Erin

AU - Murray, Jade Mary

AU - Gerhman, Philip R

AU - Lockley, Steven W

AU - Rajaratnam, Shanthakumar M W

PY - 2014

Y1 - 2014

N2 - Study Objectives: Despite the high prevalence of insomnia, daytime consequences of the disorder are poorly characterized. This study aimed to identify neurobehavioral impairments associated with insomnia, and to investigate relationships between these impairments and subjective ratings of sleep and daytime dysfunction. Design: Cross-sectional, multicenter study. Setting: Three sleep laboratories in the USA and Australia. Patients: Seventy-six individuals who met the Research Diagnostic Criteria (RDC) for Primary Insomnia, Psychophysiological Insomnia, Paradoxical Insomnia, and/or Idiopathic Childhood Insomnia (44F, 35.8 ? 12.0 years [mean ? SD]) and 20 healthy controls (14F, 34.8 ? 12.1 years). Interventions: N/A. Measurements and Results: Participants completed a 7-day sleep-wake diary, questionnaires assessing daytime dysfunction, and a neurobehavioral test battery every 60-180 minutes during an afternoon/evening sleep laboratory visit. Included were tasks assessing sustained /and switching attention, working memory, subjective sleepiness, and effort. Switching attention and working memory were significantly worse in insomnia patients than controls, while no differences were found for simple or complex sustained attention tasks. Poorer sustained attention in the control, but not the insomnia group, was significantly associated with increased subjective sleepiness. In insomnia patients, poorer sustained attention performance was associated with reduced health-related quality of life and increased insomnia severity. Conclusions: We found that insomnia patients exhibit deficits in higher level neurobehavioral functioning, but not in basic attention. The findings indicate that neurobehavioral deficits in insomnia are due to neurobiological alterations, rather than sleepiness resulting from chronic sleep deficiency

AB - Study Objectives: Despite the high prevalence of insomnia, daytime consequences of the disorder are poorly characterized. This study aimed to identify neurobehavioral impairments associated with insomnia, and to investigate relationships between these impairments and subjective ratings of sleep and daytime dysfunction. Design: Cross-sectional, multicenter study. Setting: Three sleep laboratories in the USA and Australia. Patients: Seventy-six individuals who met the Research Diagnostic Criteria (RDC) for Primary Insomnia, Psychophysiological Insomnia, Paradoxical Insomnia, and/or Idiopathic Childhood Insomnia (44F, 35.8 ? 12.0 years [mean ? SD]) and 20 healthy controls (14F, 34.8 ? 12.1 years). Interventions: N/A. Measurements and Results: Participants completed a 7-day sleep-wake diary, questionnaires assessing daytime dysfunction, and a neurobehavioral test battery every 60-180 minutes during an afternoon/evening sleep laboratory visit. Included were tasks assessing sustained /and switching attention, working memory, subjective sleepiness, and effort. Switching attention and working memory were significantly worse in insomnia patients than controls, while no differences were found for simple or complex sustained attention tasks. Poorer sustained attention in the control, but not the insomnia group, was significantly associated with increased subjective sleepiness. In insomnia patients, poorer sustained attention performance was associated with reduced health-related quality of life and increased insomnia severity. Conclusions: We found that insomnia patients exhibit deficits in higher level neurobehavioral functioning, but not in basic attention. The findings indicate that neurobehavioral deficits in insomnia are due to neurobiological alterations, rather than sleepiness resulting from chronic sleep deficiency

UR - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3902875/pdf/aasm.37.1.107.pdf

U2 - 10.5665/sleep.3318

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