Comprehensive I Childhood Neurocognitive Measures Sensitive to Sleep Deprivation

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Comprehensive IChildhood Neurocognitive Measures
Sensitive to Sleep Deprivation

• Nicolle Vincent
• Clinical Psychology PhD student
• Supervisor Dr. Penny Corkum

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Study Rationale

• CIHR grant Stimulant Medication on Sleep in
  ADHD
• TID dosage
• Subjective Objective measures (actigraphy and
  polysomnography) of sleep
• Periods Baseline, Acute blinded medication
  trial, after an open-label maintenance trial
• Daytime consequences? Particularly cognitive
  ability

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Current Study Objective

• To find for CIHR study
• Cognitive measures (Child)
• (learning, memory, attention, creativity, etc.)
• Good psychometric properties
• Sensitive to modest sleep deprivation

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Summary of Cognitive Performance Effects of Sleep
Deprivation

• Involuntary microsleeps occur
• Attention-intensive performance is unstable with
  increased errors
• Cognitive slowing occurs in subject-paced tasks,
  while time pressure increases cognitive errors
• Response time slows
• Decline in short-term recall and working memory
• Reduced learning (acquisition) of cognitive tasks
• Performance requiring divergent thinking
  deteriorates
• Response suppression errors increase in tasks
  primarily subserved by prefrontal cortex
• Response perseveration on ineffective solutions
  is more likely
• Increased compensatory effort is required to
  remain behaviorally effective
• Tasks may be begun well, but performance
  deteriorates as task duration increases
• There is growing neglect of activities judged to
  be nonessential (loss of situational awareness)

Durmer Dinges, 2005
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Adult Sleep Deprivation

• Meta-analysis 19 articles
• Coding Characteristics

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Pilcher Huffcutt, 1996
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Adult Sleep Deprivation

• Meta-analysis
• Mean level of functioning comparable to 9th
  percentile for non-sleep deprived participants

Pilcher Huffcutt, 1996
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Sleep Sensitive measures

• Considerations
• Length pacing of cognitive task
• Accuracy performance highly dependent on measure
  (e.g. logical reasoning, mental addition, visual
  search task, word memory task)
• Length of sleep deprivation (lt 46 hrs too short ?)

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Adult Sleep Deprivation

• Common Cognitive Measures
• Attention
• (dependent variable being reaction time )
• e.g. The psychomotor vigilance task (PVT),
  Continuous Performance Test (CPT)
• Executive Functioning
• (reliance upon working memory and attention
  systems )
• e.g. Wisconsin card-sorting task, the Tower of
  London task, Torrence tests of creative thinking,
  the Hayling sentence completion task, and
  Thurstones verbal learning task

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Childhood Sleep Deprivation

• PROBLEM
• Very little data addressing inadequate sleep and
  daytime functioning in children
• More research in Childhood OSA and
  neurobehavioral functioning

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Literature Review
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Literature Review Contd
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Literature Review
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Literature Review

• Impaired
• Verbal abilities
• Figural creativity (drawings) was not affected by
  acute sleep loss
• Abstract thinking
• Not impaired
• Rote learning
• Brief periods of focused attention vigilance

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Literature Review

• Suggests that complex tasks requiring executive
  control may be most sensitive to modest sleep
  deprivation
• Decision create a battery of tests (i.e. NES,
  NAB) or use the ANT?

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Attention Network Test (ANT)

• Child Version
• Combination of Cued Reaction Time (Posner, 1980)
  Flanker Task (Eriksen Eriksen, 1974)
• Assesses 3 networks of attention
• Alerting, orienting, executive control
• Based on neuroimaging studies
• (different anatomies of the 3 networks)
• 20 - 30 minutes to complete
• Good psychometric properties
• Used in genetic, psychopathology therapy
  outcome studies

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ANT
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Methodology Plan

• Pilot Study, 5-10 children
• Restrict sleep - 1 night
• Use Actigraphy and pre post cognitive assessment

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Extra Fallone 2001

• Suggests using longer continuous performance
  tests
• Connors Continuous Performance test
• Test of Variables of Attention (Greenberg, 91)

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Extra Sadeh 2003

• 6 day protocol
• Day 1 and 2 regular sleep
• NBF tested
• Day 3 instructed to restrict or extend sleep by 1
  hour (for 3 nights)
• NBF tested Day 6
• Results reveal average restriction (41 minutes)
  and extension (35 min)

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Esther Lau
Neuropsychological Test Battery
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Neurobehavioural Assessment Battery (NAB)

• activation-deactivartion checklist (ADACL),
• probed word memory task
• a 10 minute simple reaction time test (similar to
  the PVT)
• 90-second digit symbol substitution task, and a
  series of brief time estimation trials.
• 20 minutes
• Done on the computer