The Cognitive and Metabolic Effects of Sleep Restriction in Adolescents

NCT03333512 | Completed

• 1 other identifier: NFS4
• Study Type: interventional
• Target: 59
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to examine the neurobehavioural and glucose metabolic responses to two successive cycles of sleep restriction and recovery in adolescents, and to determine the benefits of napping on cognitive performance, alertness, mood and glucose metabolism. Using a split-sleep design, 60 participants, aged 15 to 19 years old, are divided into a nap and a no-nap group. Both groups undergo two cycles of sleep restriction and recovery over a period of 15 days. The no-nap group receives a 6.5-hour sleep opportunity on sleep restriction nights, with no daytime nap opportunity. The nap group receives a 5-hour sleep opportunity on sleep restriction nights, and has a 1.5-hour nap opportunity the following afternoon.

Conditions

Sleep; Sleep Restriction

Keywords

Nap; Recovery Sleep; Cognitive Functions; Glucose Metabolism; Neurobehavioral Functions; Mood; Subjective Sleepiness

Outcome Measures

Primary Outcomes (23)

• Change in sustained attention assessed with the Psychomotor Vigilance Task from morning to afternoon and then evening from baseline days to the first and second cycles of sleep restriction and recovery

  Number of attention lapses (\>500ms)

  3 times daily (10:00, 16:15, and 20:00) for 15 days

• Change in working memory assessed with the 1-back task from morning to afternoon and then evening from baseline days to the first and second cycles of sleep restriction and recovery

  Number of correct responses in the 1-back task

  3 times daily (10:00, 16:15, and 20:00) for 15 days

• Change in executive functions assessed with the 3-back task from morning to afternoon and then evening from baseline days to the first and second cycles of sleep restriction and recovery

  Number of correct responses in the 3-back task

  3 times daily (10:00, 16:15, and 20:00) for 15 days

• Change in the level of subjective sleepiness assessed with the Karolinska Sleepiness Scale from morning to afternoon and then evening from baseline days to the first and second cycles of sleep restriction and recovery

  Score on the Karolinska Sleepiness Scale (1-9 points)

  3 times daily (10:00, 16:15, and 20:00) for 15 days

• Change in positive mood assessed with the Positive and Negative Affect Scale (PANAS) from morning to afternoon and then evening from baseline days to the first and second cycles of sleep restriction and recovery

  Total score on the positive subscale of the PANAS

  3 times daily (10:00, 16:15, and 20:00) for 15 days

• Change in negative mood assessed with the Positive and Negative Affect Scale (PANAS) from morning to afternoon and then evening from baseline days to the first and second cycles of sleep restriction and recovery

  Total score on the negative subscale of the PANAS

  3 times daily (10:00, 16:15, and 20:00) for 15 days

• Change in speed of processing assessed with the Mental Arithmetic Task from morning to afternoon and then evening from baseline days to the first and second cycles of sleep restriction and recovery

  Number of correct responses in the task

  3 times daily (10:00, 16:15, and 20:00) for 15 days

• Change in speed of processing assessed with the Symbol Digit Modalities Task from morning to afternoon and then evening from baseline days to the first and second cycles of sleep restriction and recovery

  Number of correct responses in the task

  3 times daily (10:00, 16:15, and 20:00) for 15 days

• Change in blood glucose level, measured using a blood glucose meter, from baseline following the first period sleep restriction, first period of recovery sleep, and second period of sleep restriction

  Score on blood glucose meter

  Four mornings (after baseline night 2, after sleep restriction night 3 (first sleep restriction period), after recovery night 2 (first recovery period), after sleep restriction night 3 (second sleep restriction period))

• Change in meal and snack consumption from baseline following the first period sleep restriction, first period of recovery sleep, and second period of sleep restriction

  Amount of meals and snacks consumed, measured on an ad libitum basis

  Throughout the 15-day protocol

• Change in memory performance in picture-word association task over sleep restriction nights and recovery night

  Score on picture-word association task

  12 times (morning and evening): after sleep restriction night 1, 2, 3, 4 and 5 (sleep restriction period 1) and after recovery night 2 (recovery period 1)

• Mind-wandering, assessed using a breath-counting task

  Error rate of button presses and percentage of errors that are self-caught

  Single session, during baseline

• Effect of sleep versus wake during delay on the implementation of an intention in the future, where the intention will be encoded either before a 12-hr interval including a night of sleep or a day of wakefulness

  Memory score of correctly remembering to perform the intention following the wake or sleep interval

  Single session during the 15-day protocol, after baseline night 1 or before sleep restriction night 1 (first sleep restriction period)

• Effect of sleep versus wake during delay on memory for rewarded pictures, where the pictures will be encoded either before a 12-hr interval including a night of sleep or a day of wakefulness

  Memory score of correctly remembered encoded pictures following the wake or sleep interval

  Single session during the 15-day protocol, after baseline night 1 or before sleep restriction night 1 (first sleep restriction period)

• Effect of sleep restriction on learning of novel material (about different animal species) across separate sessions

  Memory score on test of learned material

  Single session during the 15-day protocol, after recovery night 2 (first recovery period)

• Effect of sleep restriction on memory of spatial locations

  Performance in four mountains task

  Single session during the 15-day protocol, after sleep restriction night 3 (first sleep restriction period)

• Effect of sleep restriction on problem-solving

  Number of correctly solved equations in matchstick arithmetic task

  Single session during the 15-day protocol, after sleep restriction night 5 (first sleep restriction period)

• Effect of sleep restriction on picture encoding

  Memory score of correctly remembered encoded pictures of non-famous people, landscapes, scenes and objects

  Single session during the 15-day protocol, after recovery night 2 (second recovery period)

• Effect of sleep restriction on effort/temporal discounting

  Choice preference (perform a longer duration task for a higher reward, or to take a break for a lower/no reward) in effort/temporal discounting task is measured

  Three sessions during the 15-day protocol (after baseline night 1, after sleep restriction night 5 (first sleep restriction period) and after recovery night 2 (first recovery period))

• Effect of prior knowledge about the position of items in a previously learned hierarchy on learning of the position of novel items in a new hierarchy

  Percentage of correct responses on the test

  Single session, during baseline

• Effect of sleep restriction on task switching performance

  Difference in reaction time between switch trial and repetition trial in task-switching task

  Four sessions during the 15-day protocol (after baseline night 1, after sleep restriction night 3 (first sleep restriction period), after recovery night 2 (first recovery period) and after sleep restriction night 3 (second sleep restriction period))

• Effect of sleep restriction on attentional bias to threat assessed using visual cues that are coupled either to an aversive sound (threat cue) or a neutral sound (neutral cue)

  Correct responses to a target that is presented at the same (valid) or opposite (invalid) location of stimulus

  Three session during the 15-day protocol (after baseline night 1, after sleep restriction night 5 (first sleep restriction period), after recovery night 1 (first recovery period))

• Effect of verbal reward on procedural memory assessed using a finger tapping task

  Accuracy of performance on the finger-tapping task

  Two sessions during the 15-day protocol (before baseline night 1 and after baseline night 1)

Secondary Outcomes (10)

• Change in total sleep duration at night assessed with polysomnography from baseline nights to the first and second cycles of sleep restriction and recovery

  Nocturnal sleep on nights 1 & 2 (baseline), 3, 5 & 7 (first sleep restriction period), 8 (first recovery period), 10 & 12 (second sleep restriction period), & 13 (second recovery period)

• Change in N1 sleep duration at night assessed with polysomnography from baseline nights to the first and second cycles of sleep restriction and recovery

  Nocturnal sleep on nights 1 & 2 (baseline), 3, 5 & 7 (first sleep restriction period), 8 (first recovery period), 10 & 12 (second sleep restriction period), & 13 (second recovery period)

• Change in N2 sleep duration at night assessed with polysomnography from baseline nights to the first and second cycles of sleep restriction and recovery

  Nocturnal sleep on nights 1 & 2 (baseline), 3, 5 & 7 (first sleep restriction period), 8 (first recovery period), 10 & 12 (second sleep restriction period), & 13 (second recovery period)

• Change in N3 sleep duration at night assessed with polysomnography from baseline nights to the first and second cycles of sleep restriction and recovery

  Nocturnal sleep on nights 1 & 2 (baseline), 3, 5 & 7 (first sleep restriction period), 8 (first recovery period), 10 & 12 (second sleep restriction period), & 13 (second recovery period)

• Change in Rapid Eye Movement (REM) sleep duration at night assessed with polysomnography from baseline nights to the first and second cycles of sleep restriction and recovery

  Nocturnal sleep on nights 1 & 2 (baseline), 3, 5 & 7 (first sleep restriction period), 8 (first recovery period), 10 & 12 (second sleep restriction period), & 13 (second recovery period)

Study Arms (2)

Nap

EXPERIMENTAL

After each night with a 5-hour sleep opportunity, participants have a daytime nap opportunity of 1.5 hours.

Behavioral: Nap

No nap

NO INTERVENTION

After each night with a 6.5-hour sleep opportunity, participants do not have a daytime nap opportunity, but instead watch documentaries.

Interventions

Nap BEHAVIORAL

Looking at the difference between continuous sleep opportunities and split-sleep opportunities.

Nap

Eligibility Criteria

• Age: 15 Years - 19 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• healthy
• no sleep disorder
• body mass index not greater than 30

You may not qualify if:

• smoker
• habitual short sleeper (time in bed during term time of less than 6 hours and no sign of sleep extension of greater than 1 hour on weekends)
• consumption of more than 5 cups of caffeinated beverages a day
• travelling across more than 2 time zones in the month prior to the study protocol
• diagnosed with any psychiatric conditions

Sponsors & Collaborators

• Duke-NUS Graduate Medical School: lead
• National Medical Research Council (NMRC), Singapore: collaborator

Study Sites (1)

Duke-NUS Medical School

Singapore, 169857, Singapore

Location

Related Publications (5)

• Leong RLF, Tian L, Yu N, Teo TB, Ong JL, Chee MWL. Bidirectional associations between the duration and timing of nocturnal sleep and daytime naps in adolescents differ from weekdays to weekends. Sleep. 2024 Sep 9;47(9):zsae147. doi: 10.1093/sleep/zsae147.

  PMID: 38938171 DERIVED

• Lo JC, Ang JWA, Koa TB, Ong JL, Lim J. Predicting vigilance vulnerability during 1 and 2 weeks of sleep restriction with baseline performance metrics. Sleep Adv. 2022 Oct 25;3(1):zpac040. doi: 10.1093/sleepadvances/zpac040. eCollection 2022.

  PMID: 37193393 DERIVED

• Lo JC, Koa TB, Ong JL, Gooley JJ, Chee MWL. Staying vigilant during recurrent sleep restriction: dose-response effects of time-in-bed and benefits of daytime napping. Sleep. 2022 Apr 11;45(4):zsac023. doi: 10.1093/sleep/zsac023.

  PMID: 35089345 DERIVED

• Lee XK, Chee NIYN, Ong JL, Teo TB, van Rijn E, Lo JC, Chee MWL. Validation of a Consumer Sleep Wearable Device With Actigraphy and Polysomnography in Adolescents Across Sleep Opportunity Manipulations. J Clin Sleep Med. 2019 Sep 15;15(9):1337-1346. doi: 10.5664/jcsm.7932.

  PMID: 31538605 DERIVED

• Lo JC, Twan DCK, Karamchedu S, Lee XK, Ong JL, Van Rijn E, Gooley JJ, Chee MWL. Differential effects of split and continuous sleep on neurobehavioral function and glucose tolerance in sleep-restricted adolescents. Sleep. 2019 May 1;42(5):zsz037. doi: 10.1093/sleep/zsz037.

  PMID: 30753648 DERIVED

Study Officials

• Michael WL Chee, MBBS

  Duke-NUS Graduate Medical School

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: BASIC SCIENCE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator, Professor

Study Record Dates

• First Submitted: October 2, 2017
• First Posted: November 7, 2017
• Study Start: November 28, 2017
• Primary Completion: January 20, 2018
• Study Completion: January 20, 2018
• Last Updated: February 1, 2018

Record last verified: 2018-01

Data Sharing

• IPD Sharing: Will not share

Locations

SG (1)