Literature Review

The Negative Effects of Insufficient Sleep on Adults Cognitive Performance

University of Twente

Brigitta Vianney Susanto s1428942

Group 01

November 2017

Lecturer: Silvie Pothof

Words count: 1860

The Negative Effects of Insufficient Sleep on Adults Cognitive Performance

It is known that sleeping is a basic biological need for humans. However, many adults do
not get enough sleep. People stay up late all night due to work responsibilities, study, or poor
time management. There are many health risks associated with lack of sleep, such as metabolic
disorders, cardiovascular diseases and cancer (Luyster, Strollo, Zee, & Walsh, 2012).
Furthermore, sleep deprivation has been investigated that it is closely linked to cognitive
functions, which reduces ones attention and working memory (Durner & Dinges, 2005). The
term cognitive function itself refers to the brain process of acquiring knowledge, understanding
thought, experience and senses. Thus, the importance of getting enough sleep and how dangerous
sleep deprivation has been increasingly recognized.

Sufficient sleep has a crucial role to humans brain in processing new information and
acquiring new skills (Wimmer, Hoffman, Bonato, & Moffitt, 1992). Even though there have
been many researches conducted about the danger of inadequate sleep, the negligence on this
matter in the society is still highly common. This article reviews the negative effects of sleep
deprivation on adults cognition based on scientific researches and reviews.

The aim of this article is to discuss how lack of sleep affects adults cognition. In order to
clearly answer this matter, two main topics will be covered. They are the definition of sufficient
sleep, and the effects of insufficient sleep on the humans cognitive function.
Sufficient Sleep and Insufficient Sleep

Sleep is very crucial for humans, adults and kids, in order to function well in day-to-day
activities. Other than that, sufficient sleep is also helpful in maintaining physical and mental
well-being. In this 24-hour society where people have long working hours, inflexible shift, lack
of physical activity, and high usage of technology, it is very common that sleeping hours is
compromised (Jean-Louis, Youngstedt, & Grandner, 2015). People get less and less sleep due to
work responsibilities. Despite the increasing attention given to the matter of sufficient sleep over
the years, a large portion of the society is still unaware of how many hours of sleep per night is
recommended by scientists and experts for optimal health.

In order to be able to address how many hours of sleep do adults need per day, The
American Academy of Sleep Medicine (AASM) and Sleep Research Society (SRS) created a
panel research. This panel consisted of 15 members who are all experts in sleep medicine and/or
sleep science (Watson et al, 2015). Aside from panel voting, the study also included a large
number of participants with an age ranging from 18 to 60 years old.

After conducting panel discussion, a few rounds of voting, and observations on the
participants, the research team concluded a single recommendation on the amount of sleep
needed to maintain optimal health for adults. Adults who sleep less than seven hours per night
are more likely to report poor general health and weak physical state than those who sleep
between seven and eight hours of sleep (Watson et al, 2015). Those who get less than seven
hours of sleep are more prone to catch disease and health risk. However, Watson et al (2015)
also indicated that poorer general health and health risks increase with those with more than nine
hours of sleep per night. In conclusion, the study that was conducted by AASM and SRS
recommends adults to get sleep between seven and eight hours per night to maintain optimal
health.

Aside from the study by AASM and SRS, the National Sleep Foundation (NSF) also
conducted a similar research in order to increase health and well-being through sleep awareness.
Through a panel research comprised of 6 sleep experts and 12 experts in other areas such as
medicine and physiology, the NSF has come into one conclusion. For adults older than 18 years
old, it is recommended to get seven to nine hours of sleep daily (Hirshkowitz et al, 2015). Thus,
sleep less than six hours or longer than ten hours is considered not appropriate for optimal health.

Insufficient sleep comes with many health risks, which includes physiological and
psychological aspects. Cohen et al (2009) claimed that insufficient sleep causes poor immune
function, which means that the body produces weaker antibody and thus is unable to resist virus
and disease such as hepatitis and influenza. Similarly, metabolism is also deemed threatened
with insufficient sleep (Sharma & Kavuru, 2010). Metabolism is the whole biochemical
processes in living organism that includes energy (calories) that body burns to maintain itself. In
addition, Meier-Ewert et al (2004) proved that sleep loss may cause poor cardiovascular health
by increasing C-reactive protein, which refers to a substance that is produced by the liver in
response to inflammation. Furthermore, insufficient sleep also affects neurocognitive
performance, which includes sleepiness, attention deficit, executive function, emotional
reactivity (McCoy et al, 2011), and visual and prospective memory (Kyle et al, 2017).

Effects of Insufficient Sleep on Adults Cognitive Performance

Sufficient sleep is very crucial for brains cognitive performance. Cognitive performance
refers to the brains ability to process and utilize information and knowledge acquired from the
surroundings (Kamphuis, 2014). Humans well-functioning brain controls a set of voluntary and
involuntary actions. These actions include memory, attention, emotions, mood, response, and
perception. If one does not get the minimum recommended amount of sleep, the brains ability to
perform these actions deteriorates. This is caused by the area within the human brain that is
affected by sleep deprivation, which impairs cognitive performance (Alhola & Polo-Kantola,
2007). Since brain is the organ that controls humans body and activities, getting sufficient sleep
is essential to perform daily activities.

The relation between insufficient sleep and cognitive performance has caught attention to
researchers and scientists. One research conducted by Van Dongen (as cited in Watson et al,
2015) found two essential points between insufficient sleep and cognitive performance. First, the
shorter the sleep duration per night, the greater the cognitive impairment is. Second, the longer
one is exposed to sleep restriction, the greater the cognitive deficits. In other words, the less
sleep one gets per night, and the longer it endures, the more visible the cognitive impairment is.

The first domain that is greatly affected by sleep loss is attention. According to Balkin et
al (as cited in McCoy & Strecker, 2011), attention is the basic and the essential part of all other
cognitive processes. Sleep loss has been closely linked to impaired performance on attentional
tasks that require speed and accuracy (Frenda & Fenn, 2016). Basically, sleep loss affects
performance by restricting the brains ability to sustain attention and alertness, especially for
tasks that do not require high level of concentration (Durmer & Dinges, 2015). One type of
attention recognized by McCoy & Strecker (2011) is called sustained attention, or vigilance.
Vigilance refers to the brains ability to sustain attention to complete tasks for a certain period of
time (Oken, Salinsky, & Elsas, 2006). Because sleep loss leads to attention deficits, it increases
basic reaction time, which means slower response to a stimulant. Since one of the main activities
that adults do in daily basis is driving, insufficient sleep is dangerous and may lead to motor
vehicles accidents. This is proven by a cross-sectional conducted by Thompson and Li (as cited
in Watson et al, 2015) that there is an association between sleep duration below seven hours and
drowsy driving with at least one incident of falling asleep while driving. In other words, drowsy
driving is sensitive to sleep duration below seven hours, which means motor crash risk increases
when insufficient sleep is obtained (Watson et al, 2015).

The second notable negative effects of insufficient sleep is the decrease of working
memory performance. Baddeley (as cited in McCoy & Strecker, 2011) refers working memory
as the brains ability to store and manipulate information. In fact, attention and working memory
are interrelated. The executive ability of working memory helps the brain process tasks that
requires attentional functions, such as sustained attention or vigilance. Attention and working
memory are both linked to the frontal lobes of the brain, which is a vulnerable area to sleep
deprivation (Ahola & Polo-Kantola, 2007). In a study conducted by Van Dongen (as cited in
Frenda & Fenn, 2016), the association between sleep loss and working memory impairment is
proven to exist, attention and working memory are impaired by extended wakefulness on adults.
Kyle et al (2017) administered a study that asked the participants to complete a set of tasks,
which three of them were numeric short-term memory, visual memory, and prospective memory.
In numeric short-term memory task, participants were shown a string of numbers which then
disappeared. After that, they were asked to repeat the sequence in reversed order. In visual
memory task, six pairs of cards with symbols were presented in a random pattern to the
participants. Later, the cards were turned face down and the participants were asked to locate
pairs of symbols as many as possible in as few attempts as possible. In prospective memory, in
the beginning of the test the participants were asked to remember to perform a set of pre-planned
instructions after they have completed the test. By the end of the research, Kyle et al (2017)
concluded that the association between sleep loss and working memory is statistically
significant, especially on numeric short-term memory and visual memory, but less significant on
prospective memory. Additionally, in another study conducted by Kahol et al (2007), the
behaviors between sleep deprived and non-sleep deprived participants are compared and
assessed. Participants were shown a sequence of three or four colored lights and then asked to
memorize and repeat the sequence. As a result, those who were sleep deprived performed the
task much faster, which initially was thought a positive effect. However, there was a significant
difference between the sleep deprived and non-sleep deprived participants in the numbers of
errors made, with the sleep deprived group performing much worse (Kahol et al, 2007). In other
words, the two studies have proven that sleep loss does affect the brain by impairing working
memory performance.

Conclusion

Sleeping is an essential for living organism, especially for human. However, insufficient
sleep is still common in the society where people are busy with responsibilities and works.
Studies have shown that the recommended minimum amount of sleep per night for adults to
maintain an optimal health is between seven and eight hours of sleep. If less than seven hours of
sleep is obtained, this affects the brains cognitive function, which refers to the ability to process,
utilize and store knowledge and information. This association has been proved by researches and
studies which confirmed that insufficient sleep does impair the cognitive performance. There are
two main interrelated cognitive functions that are affected by insufficient sleep, they are attention
and working memory. Sleep loss affects the brains ability to produce alertness and quick
response time, which reduces ones attention. This is dangerous in daily life due to increased
risks of drowsy driving and falling asleep behind the wheel. Furthermore, insufficient sleep also
affects the brains working memory function negatively by especially impairing its ability to
perform numeric short-term memory, visual memory, and prospective memory.
Literature Matrix

Subquestions Source 1 Source 2 Source 3 Source 4 Source 5 Synthesis

(Joint (Sleep and (The effect (The (Sleep
consensus cognitive of sleep cognitive deprivation:
statement of performance: deprivation cost of impact on
AASM) cross- on working sleep lost) cognitive
(Watson et sectional memory) (McCoy & performance)
al, 2015) associations) (Frenda & Strecker, (Alhola &
(Kyle et al, Fenn, 2011) Polo-
2016) 2016) Kantola,
2007)
What is Less than 6 - Adults - The average A
sufficient hours of should get sleep length recommended
sleep? sleep is at least 7 is between 7 amount of
inappropriate hours of and 8.5 sleep for
for optimal sleep per hours per adults is at
health in night to get day least 7 hours
adults. 7 9 optimal of sleep per
hours of health night in order
sleep is results. to maintain
appropriate optimal
for optimal health.
health.
What are the Daytime Reasoning, Subjective Attention Decreased Cognitive
negative sleep basic evaluation deficits, alertness, aspects that
effects of propensity reaction of executive slow are impaired
insufficient and drowsy time, sleepiness function, responses. by sleep loss
sleep on driving. The numeric and mood, non- Attention, is mainly
cognitive shorter the short-term attention declarative working attention and
aspects of the sleep memory, and and memory working
brain? duration, the visual vigilance, declarative memory.
greater the memory, and general memory, Attention
cognitive prospective cognitive emotional includes
deficits. memory processing reactivity vigilance and
Some and basic reaction
cognitive sensory time.
aspects that perception. Working
are affected memory
are the includes
stability of numeric
vigilant short-term
attention, memory,
cognitive visual
processing memory and
speed, and prospective
working memory.
memory.
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