Elsevier

Sleep Medicine Reviews

Volume 5, Issue 6, December 2001, Pages 463-475
Sleep Medicine Reviews

CLINICAL REVIEW
Frontal lobe function, sleep loss and fragmented sleep

https://doi.org/10.1053/smrv.2001.0203Get rights and content

Abstract

Recent experimental studies involving total sleep loss, sleep reduction and clinically related sleep fragmentation report impaired performance on tasks of frontal lobe or executive function, including measures of verbal fluency, creativity and planning skills. Severity of sleep disturbance in obstructive sleep apnoea syndrome (OSAS) is correlated with level of executive impairment, with some residual impairment despite treatment (continuous positive airway pressure – CPAP). Executive impairment appears to be more closely related to hypoxaemic events rather than daytime sleepiness. Studies of electroencephalographic (EEG) changes throughout the course of sleep and following sleep deprivation as well as functional neuroimaging and psychophysiological changes (event-related potentials – ERPs) following sleep deprivation provide further indication of the relative importance of the frontal regions of the brain to sleep. However, neurocognitive studies present many inconsistencies, task classification is often ambiguous and, in the absence of any unifying explanation at the level of cognitive mechanisms, the overall picture is one of a disparate range of impairment following sleep loss and sleep fragmentation. Poorly defined concepts of frontal lobe function, executive function, memory and attention, using tasks largely developed with more severe deficit levels in mind, create further difficulties in interpreting current findings.

References (60)

  • Y Harrison et al.

    Sleep deprivation impairs short and novel language tasks having a prefrontal focus

    J Sleep Res

    (1998)
  • Y Harrison et al.

    Sleep loss and temporal memory

    Q J Exp Psychol

    (2000)
  • J Herscovitch et al.

    Changes in cognitive processing following short-term cumulative partial sleep deprivation and recovery oversleeping

    J Clin Neuropsychol

    (1980)
  • CS Nelson et al.

    Residents' performance before and after night call as evaluated by an indicator of creative thought

    JAOA

    (1995)
  • AC Randazzo et al.

    Cognitive function following acute sleep restriction in children ages 10–14

    Sleep

    (1998)
  • B Naëgelé et al.

    Deficits of cognitive executive functions in patients with sleep apnea syndrome

    Sleep

    (1995)
  • B Naëgelé et al.

    Cognitive executive dysfunction in patients with obstructive sleep apnea syndrome (OSAS) after CPAP treatment

    Sleep

    (1998)
  • MA Bedard et al.

    Obstructive sleep apnea syndrome: pathogenesis and neuropsychological deficits

    J Clin Exp Neuropsychol

    (1991)
  • MA Bedard et al.

    Persistent neuropsychological deficits and vigilance impairment in sleep-apnea syndrome after treatment with continuous positive airways pressure (CPAP)

    J Clin Exp Neuropsychol

    (1993)
  • J Borak et al.

    Effects of CPAP treatment on psychological status in patients with severe obstructive sleep apnoea

    J Sleep Res

    (1996)
  • HM Engleman et al.

    Cognitive function in the sleep apnea/hypopnoea syndrome

    Sleep

    (2000)
  • S Redline et al.

    Neuropsychological function in mild sleep-disordered breathing

    Sleep

    (1997)
  • C Petiau et al.

    Modification of fronto-temporal connectivity during a verb generation task after a 30 hour total sleep deprivation. A PET study

    J Sleep Res

    (1998)
  • SPA Drummond et al.

    Altered brain response to verbal learning following sleep deprivation

    Nature

    (2000)
  • M Thomas et al.

    Neuronal basis of alertness and cognitive performance impairments during sleepiness. I Effects of 24 h of sleep deprivation on waking human regional brain activity

    J Sleep Res

    (2000)
  • C Cajochen et al.

    Frontal predominance of a relative increase in sleep delta and theta EEG activity after sleep loss in humans

    Sleep Res Online

    (2000)
  • E Werth et al.

    Frontal-occipital EEG power gradients in human sleep

    J Sleep Res

    (1997)
  • Y Harrison et al.

    The impact of sleep deprivation on decision making: a review

    J Exp Psychol App

    (2000)
  • Rabbitt, P, Methodologies and models in the study of executive function, Rabbit, P, Methodology of Frontal and...
  • R Heaton et al.

    Wisconsin Card Sorting Test manual: Revised and expanded

    (1993)
  • Cited by (325)

    • Acute sleep deprivation in humans

      2023, Encyclopedia of Sleep and Circadian Rhythms: Volume 1-6, Second Edition
    • Executive and frontal lobe function

      2023, Encyclopedia of Sleep and Circadian Rhythms: Volume 1-6, Second Edition
    View all citing articles on Scopus
    f1

    Correspondence to be addressed to: Yvonne Harrison. E-mail: [email protected]

    View full text