@article{da269b573dd5415097fb3b014fed4d05,
title = "Chronic sleep restriction greatly magnifies performance decrements immediately after awakening",
abstract = "Study Objectives: Sleep inertia, subjectively experienced as grogginess felt upon awakening, causes cognitive performance impairments that can require up to 1.5 hr to dissipate. It is unknown, however, how chronic sleep restriction (CSR) influences the magnitude and duration of sleep inertia-related performance deficits. Methods: Twenty-six healthy participants were enrolled in one of two in-laboratory sleep restriction protocols (one 32 day randomized control and one 38 day protocol) that separated the influence of sleep and circadian effects on performance using different “day”-lengths (20 and 42.85 hr day-lengths, respectively). The sleep opportunity per 24 hr day was the equivalent of 5.6 hr for each CSR condition and 8 hr for the Control condition. Participant's performance and subjective sleepiness were assessed within ~2 min after electroencephalogram-verified awakening and every 10 min thereafter for 70 min to evaluate performance and subjective sleepiness during sleep inertia. Results: Performance within 2 min of awakening was ~10% worse in CSR conditions compared with Control and remained impaired across the dissipation of sleep inertia in the CSR conditions when compared with Control. These impairments in performance during sleep inertia occurred after only chronic exposure to sleep restriction and were even worse after awakenings during the biological nighttime. Interestingly, despite differences in objective performance, there were no significant differences between groups in subjective levels of sleepiness during sleep inertia. Conclusions: CSR worsens sleep inertia, especially for awakenings during the biological night. These findings are important for individuals needing to perform tasks quickly upon awakening, particularly those who obtain less than 6 hr of sleep on a nightly basis.",
keywords = "Circadian, Forced desynchrony, Insufficient sleep, Sleep inertia, Subjective sleepiness",
author = "McHill, {Andrew W.} and Hull, {Joseph T.} and Cohen, {Daniel A.} and Wei Wang and Czeisler, {Charles A.} and Klerman, {Elizabeth B.}",
note = "Funding Information: This work was supported by National Institutes of Health (NIH) (F32DK107146, T32HL007901, KL2TR002370, K24HL105664, R01HL114088, R01GM105018, R01HL128538, P01AG009975, R21HD086392), Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Center for Advancing Translational Sciences, National Institutes of Health Award UL 1TR002541), and financial contributions from Harvard University and its affiliated academic healthcare centers and National Space Biomedical Research Institute (HFP02802, HFP04201, HDP0006). The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, The Brigham and Women{\textquoteright}s Hospital, Harvard University and its affiliated academic health care centers, or the NIH. Conflict of interest statement. A.W.M. and W.W. have nothing to disclose; J.T.H. is currently employed by Supernus Pharmaceuticals Inc.; D.A.C. has served on the Merck Speaker{\textquoteright}s bureau from 2015– 2017; and C.A.C. has received consulting fees from or served as a paid member of scientific advisory boards for Columbia River Bar Pilots, Gan{\'e}sco Inc., Institute of Digital Media and Child Development, Klarman Family Foundation, Samsung Electronics, Vanda Pharmaceuticals, Washington State Board of Pilotage Commissioners, and Zurich Insurance Company, Ltd. C.A.C. has also received education/research support from Optum, Philips Respironics, Inc., San Francisco Bar Pilots, Schneider Inc., Sysco, and Vanda Pharmaceuticals. The Sleep and Health Education Program of the Harvard Medical School Division of Sleep Medicine, and the Sleep Matters Initiative (which C.A.C. directs) have received funding for educational activities from Cephalon, Inc., Jazz Pharmaceuticals, ResMed, Takeda Pharmaceuticals, Teva Pharmaceuticals Industries Ltd., Sanofi-Aventis, Inc., Sepracor, Inc., Wake Up Narcolepsy, and Mary Ann & Stanley Snider via Combined Jewish Philanthropies. C.A.C. is the incumbent of Publisher Copyright: {\textcopyright} Sleep Research Society 2019. Published by Oxford University Press on behalf of the Sleep Research Society.",
year = "2019",
month = may,
day = "1",
doi = "10.1093/sleep/zsz032",
language = "English (US)",
volume = "42",
journal = "Sleep",
issn = "0161-8105",
publisher = "American Academy of Sleep Medicine",
number = "5",
}