Review Article | Published:

The sleep-deprived human brain

Nature Reviews Neuroscience volume 18, pages 404418 (2017) | Download Citation

Abstract

How does a lack of sleep affect our brains? In contrast to the benefits of sleep, frameworks exploring the impact of sleep loss are relatively lacking. Importantly, the effects of sleep deprivation (SD) do not simply reflect the absence of sleep and the benefits attributed to it; rather, they reflect the consequences of several additional factors, including extended wakefulness. With a focus on neuroimaging studies, we review the consequences of SD on attention and working memory, positive and negative emotion, and hippocampal learning. We explore how this evidence informs our mechanistic understanding of the known changes in cognition and emotion associated with SD, and the insights it provides regarding clinical conditions associated with sleep disruption.

Key points

  • Sleep deprivation triggers a set of bidirectional changes in brain activity and connectivity, depending on the specific cognitive or affective behaviours engaged.

  • Changes in brain activity are observed when averaged across a session of task performance and during on-task performance, wherein marked brain network instability seems to be a neural hallmark of sleep deprivation.

  • Not all changes in brain function that are associated with sleep loss are maladaptive and thus represent deficiencies, as some predict resilience in behavioural ability and are therefore compensatory.

  • These basic scientific findings offer causal mechanistic insights into select neurological and psychiatric disorders in which abnormalities in sleep and cognition or emotion are highly comorbid, indicating that sleep intervention is an underappreciated and novel target for disease treatment and/or prevention.

  • The robust neural and behavioural phenotypes characterized by this Review can inform debates regarding sleep recommendations for both public and professional health policies, especially in light of the escalating sleep-loss epidemic prevalent throughout industrialized nations.

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Acknowledgements

This work was supported by awards R01-AG031164, R01-AG054019, RF1-AG054019 and R01-MH093537 to M.P.W. from the US National Institutes of Health.

Author information

Affiliations

  1. Department of Psychology, University of California, Berkeley.

    • Adam J. Krause
    • , Eti Ben Simon
    • , Bryce A. Mander
    • , Jared M. Saletin
    •  & Matthew P. Walker
  2. Helen Wills Neuroscience Institute, University of California, Berkeley, California 94720–1650, USA.

    • Stephanie M. Greer
    • , Andrea N. Goldstein-Piekarski
    •  & Matthew P. Walker

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Competing interests

The authors declare no competing financial interests.

Corresponding author

Correspondence to Matthew P. Walker.

Glossary

Sleep disruption

Abnormal sleep that can be described in measures of deficient sleep quantity, structure (reflected by, for example, sleep cycle architecture) and/or sleep quality (assessed using, for example, spectral electroencephalogram power).

Functional connectivity

In functional MRI, the statistical association between time series of blood-oxygen-level-dependent signal in two or more anatomically distinct brain regions.

Attention

The ability to selectively maintain focus on behaviourally relevant stimuli, while disregarding irrelevant stimuli.

Working memory

The ability to maintain, manipulate and integrate mental representations of relevant information even when it is no longer present in the environment.

Sleep pressure

Also called 'homeostatic sleep drive' or 'Process S'. A set of homeostatic neurobiological processes that increase the likelihood of sleep, or 'sleep propensity'.

Partial sleep restriction

The state associated with a reduction (but not total absence) of sleep in the prior night or nights, usually ranging from 1–6 hours of sleep reduction. Sleep restriction is chronic if it persists for more than 24 hours.

Default mode network

(DMN). Collection of brain areas, including midline frontoparietal regions, that usually disengage during externally driven, goal-directed task performance and re-engage upon task termination.

Frontoparietal attention network

A bilateral brain network with core regions in the frontal and parietal lobes that exerts top-down control of sensory cortex to bias stimulus processing.

Impulsivity

Acting without deliberation, or choosing short-term gains over long-term gains.

Viscerosensory

Relating to corporeal information propagated by the spinal cord to brain regions involved in the sensation and coordination of bodily functions and associated behaviours.

Iowa Gambling Task

A test of reward processing that challenges the participant to maximize their earnings by forgoing short-term gains in return for eventual long-term gains.

Total sleep deprivation

The state associated with a complete absence of sleep in the prior night or nights.

Balloon Analogue Risk Task

(BART). A computerized measure of risk-taking behaviour. Participants are rewarded for inflating a 'balloon' but lose their reward if they overinflate and 'burst' the balloon.

Wake propensity

The likelihood of an organism maintaining the state of sustained wakefulness.

Adenosine

An endogenous compound involved in biochemical and neuromodulatory processes, including metabolism and sleep–wake regulation. It accumulates extracellularly with time spent awake and dissipates during slow-wave sleep.

Sleep quality

Measured subjectively, by means of self-reported perception of prior sleep, and objectively, using sleep-stage or quantitative electroencephalography sleep measures.

Rapid eye movement

(REM). Also known as paradoxical sleep. Sleep characterized by high-frequency, low-amplitude desynchronized electroencephalogram (particularly in the theta band), rapid eye movements, muscle paralysis and dreaming.

Non-rapid eye movement

(NREM). A type of sleep that consists of sleep stages 1–4 and that occurs towards the beginning of a sleep episode, and reflects homeostatic sleep processes.

Slow-wave sleep

Stage 3 and stage 4 of non-rapid eye movement sleep that is characterized by low-frequency (0.8–4 Hz), high-amplitude synchronized electroencephalogram (called delta waves).

Sleep spindles

Synchronized phasic bursts of electrical activity often measured in the cortex or scalp surface electroencephalogram lasting several seconds in the 11–15 Hz frequency range.

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DOI

https://doi.org/10.1038/nrn.2017.55

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