To inform the debate over whether human sleep can be chronically reduced without consequences,
we conducted a dose-response chronic sleep restriction experiment in which waking
neurobehavioral and sleep physiological functions were monitored and compared to those
for total sleep deprivation.
The chronic sleep restriction experiment involved randomization to one of three sleep
doses (4 h, 6 h, or 8 h time in bed per night), which were maintained for 14 consecutive
days. The total sleep deprivation experiment involved 3 nights without sleep (0 h
time in bed). Each study also involved 3 baseline (pre-deprivation) days and 3 recovery
Both experiments were conducted under standardized laboratory conditions with continuous
behavioral, physiological and medical monitoring.
A total of n = 48 healthy adults (ages 21-38) participated in the experiments.
Noctumal sleep periods were restricted to 8 h, 6 h or 4 h per day for 14 days, or
to 0 h for 3 days. All other sleep was prohibited.
Chronic restriction of sleep periods to 4 h or 6 h per night over 14 consecutive days
resulted in significant cumulative, dose-dependent deficits in cognitive performance
on all tasks. Subjective sleepiness ratings showed an acute response to sleep restriction
but only small further increases on subsequent days, and did not significantly differentiate
the 6 h and 4 h conditions. Polysomnographic variables and delta power in the non-REM
sleep EEG-a putative marker of sleep homeostasis--displayed an acute response to sleep
restriction with negligible further changes across the 14 restricted nights. Comparison
of chronic sleep restriction to total sleep deprivation showed that the latter resulted
in disproportionately large waking neurobehavioral and sleep delta power responses
relative to how much sleep was lost. A statistical model revealed that, regardless
of the mode of sleep deprivation, lapses in behavioral alertness were near-linearly
related to the cumulative duration of wakefulness in excess of 15.84 h (s.e. 0.73
Since chronic restriction of sleep to 6 h or less per night produced cognitive performance
deficits equivalent to up to 2 nights of total sleep deprivation, it appears that
even relatively moderate sleep restriction can seriously impair waking neurobehavioral
functions in healthy adults. Sleepiness ratings suggest that subjects were largely
unaware of these increasing cognitive deficits, which may explain why the impact of
chronic sleep restriction on waking cognitive functions is often assumed to be benign.
Physiological sleep responses to chronic restriction did not mirror waking neurobehavioral
responses, but cumulative wakefulness in excess of a 15.84 h predicted performance
lapses across all four experimental conditions. This suggests that sleep debt is perhaps
best understood as resulting in additional wakefulness that has a neurobiological
"cost" which accumulates over time.