Elsevier

Physiology & Behavior

Volume 91, Issue 5, 15 August 2007, Pages 579-587
Physiology & Behavior

Effects of sleep deprivation on impulsive behaviors in men and women

https://doi.org/10.1016/j.physbeh.2007.03.020Get rights and content

Abstract

The purpose of this study was to examine the effects of sleep deprivation on impulsive behavior. Patients with impulse control disorders often report sleep problems, and sleep deprivation even in healthy individuals impairs cognition, decision-making, and perhaps impulse control. To characterize the effects of sleep loss on specific forms of impulsive behavior, we tested the effects of overnight, monitored sleep deprivation on measures of impulsivity and cognition in healthy volunteers. Ten men and ten women completed two 24 h sessions in random order, in which they were either allowed to sleep normally or remained awake all night. At 8:30 am and 6:15 pm on the day after sleep or no sleep, participants were tested on the Balloon Analogue Risk Task (BART), the Experiential Discounting Task, the Adjusting Amount Delay and Probability Discounting Task, and the Stop Task. Participants also completed mood questionnaires and the Automated Neuropsychological Assessment Matrix (ANAM) throughout the course of the day. Sleep deprivation did not affect most of the measures of impulsive behavior. However, on the BART, sleep deprivation decreased risk taking in women, but not men. Sleep deprivation produced expected increases in subjective fatigue, and impaired performance on measures of attention and cognitive efficiency on the ANAM. The results indicate that sleep deprivation does not specifically increase impulsive behaviors but may differentially affect risk taking in men and women.

Introduction

Since the invention of the light bulb, adults in the United States have gone from sleeping over 9 to under 7 h a night [1], [2]. The serious adverse health consequences of chronic sleep restriction are beginning to be recognized [3], and emerging evidence suggests sleep loss impairs both attention and higher cognitive functions [4]. Some of these impairments in cognitive functioning may affect decision-making, and may increase the likelihood of making impulsive or risky decisions. The purpose of the present study was to assess the effects of sleep deprivation on standardized-measures of impulsive behavior.

Sleep loss is associated with deficits in cognition, attention and increases in some forms of impulsive behavior. Sleep disturbances are common among psychiatric patients with disorders characterized by impulsive behavior, such as Attention Deficit Hyperactivity Disorder (AD/HD), Borderline Personality Disorder, and Antisocial Personality Disorder with a history of violent aggression [5], [6], [7]. Children with sleep-disordered breathing have a nearly 3-fold increase in cognitive and behavioral abnormalities, including hyperactivity and inattention [8]. Controlled studies involving sleep deprivation in healthy volunteers demonstrate that loss of sleep impairs vigilance, increases risky decision-making, and affects performance on strategic cognitive tasks related to impulsive behavior [4], [9], [10], [11], [12], [13], [14], [15]. Several studies have demonstrated that fatigue and sleep deprivation impairs vigilance and reaction time on monotonous tasks [9], [10], [11], [12]. In one study of impulsive or risky decision-making, Brown et al. [13] showed that fatigue due to extended driving increased ‘risky decisions’ without affecting other driving skills. ‘Risky decisions’ were defined by participants’ willingness to engage in specific hazardous overtaking maneuvers (e.g., passing in low visibility, forcing other drivers to adjust speed to permit them to pass). In another study, Sicard et al. [14] reported that pilots submitted to 24 h of strenuous flights became more risk-prone as they became more drowsy. Finally, Killgore et al. [15] recently reported that sleep deprivation impaired performance on the Iowa Gambling Task, a complex strategic task that requires integration of payoff-to-penalty ratios and may be related to risk taking. Thus both clinical and laboratory data indicate that fatigue and sleep loss is associated with inattention and increased risk taking.

The effects of sleep deprivation can also be assessed using tasks specifically designed to measure impulsive behavior. Impulsive behavior has been defined operationally in several contexts, and tasks have been developed to measure these different forms of impulsive behavior. For example, delay discounting tasks provide an index of preference for immediate versus delayed rewards [16], stop signal and go no/go tasks provide measures of behavioral inhibition, or the ability to withhold a prepotent response [17], [18], and procedures such as the Balloon Analogue Risk Task have been designed to directly access risk taking [19]. These measures have been used to detect individual differences in impulsive tendencies (e.g., in children with AD/HD), and to assess impairments after acute pharmacological interventions [20], [21], [22], [23]. Two recent studies have examined the effects of sleep deprivation on measures of impulsive behavior. In one study [24] it was reported that young adults discounted more on a delay discounting task after remaining awake until 4 am than when they completed the task in the afternoon. In another study, Chuah et al. [25] reported that 24 h of sleep deprivation impaired performance on a Go/No Go Task, although it increased errors of both omission and commission which suggests a non-specific cognitive impairment. Thus, we currently have only limited knowledge of the effects of sleep deprivation on behavioral measures designed to measure specific forms of impulsivity. This information may be valuable to help better understand the adverse consequences of sleep loss.

The present study was designed to characterize the effects of sleep deprivation on impulsive behavior in men and women using three distinct measures of impulsivity: risk taking, delay discounting and behavioral inhibition [26]. We included both men and women because there is some evidence for sex differences in the effects of sleep deprivation [27], [28], and there is some suggestion of baseline sex differences in certain measures of impulsivity [29]. To assess interactions between sleep deprivation and circadian factors, we measured impulsivity both in the morning and the evening after a night with or without sleep. In addition, we utilized a neuropsychological test battery to assess non-specific, general attention and cognitive impairments, obtained subjective ratings of mood and fatigue, and measured, heart rate, blood pressure, salivary cortisol and urinary catecholamine levels.

Thus, we hypothesized that overnight sleep deprivation would increase risk taking and delay discounting, and impair behavioral inhibition. We hypothesized that the effects of sleep deprivation on risk taking would be more pronounced in men due to previously reported gender differences in risk perception following sleep deprivation [28]. Sleep deprivation was also expected to induce a general impairment in cognitive functioning on the neuropsychological test battery, increase subjective ratings of fatigue, and produce physiological changes.

Section snippets

Participants

Healthy men and women (n = 10,10) aged 18 to 45 years participated. Participants were recruited by means of posters, advertisements in newspapers, and word-of-mouth referrals. After a brief telephone interview, candidates attended an in-person clinical assessment, including a psychiatric interview and physical examination with an electrocardiogram. Volunteers were excluded if they met criteria for major Axis I DSM-IV diagnoses [30], had less than high school education, medical problems or current

Participants

The demographic characteristics of the participants and their current and lifetime recreational drug use histories are summarized in Table 2. Most participants were in their early 20s, most were currently fulltime college students and most had light or no histories of illicit drug use. Most were non-smokers and their average weekly alcohol consumption was less than 5 drinks per week. Eight participants (4 men and 4 women) were regular caffeine users who consumed on average less then 2 cups of

Discussion

In the present study, we investigated the effects of overnight sleep deprivation in men and women on several measures of impulsivity in addition to measures of general cognitive performance, subjective states, and physiological measures. Sleep deprivation did not increase impulsivity on the specific measures of behavioral inhibition, discounting, or risk taking. Indeed, women (but not men) made fewer, rather than more, risk taking responses on the BART after 24–36 h of sleep deprivation. As

Acknowledgements

This work was supported by DA09133, T32DA07255 and M01RR00055. Sarah Kamhawi, Jasmine Lew, Karen Kuckuck, Anita Marton, Brian D’Anza, Lisa Vicini, and Maliha Darugar provided excellent technical assistance.

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