Circadian and wake-dependent influences on subjective sleepiness, cognitive throughput, and reaction time performance in older and young adults.

STUDY OBJECTIVES To assess circadian and homeostatic influences on subjective sleepiness and cognitive performance in older adults when sleep and waking are scheduled at different times of day; to assess changes in subjective sleepiness and cognitive performance across several weeks of an inpatient study; and to compare these findings with results from younger adults. DESIGN Three 24-h baseline days consisting of 16 h of wakefulness and an 8-h sleep opportunity followed by 3-beat cycles of a 20-h forced desynchrony (FD) condition; 18 20-h "days," each consisting of 13.33 h of scheduled wakefulness and 6.67 h of scheduled sleep opportunity. SETTING Intensive Physiological Monitoring Unit of the Brigham and Women's Hospital General Clinical Research Center. PARTICIPANTS 10 healthy older adults (age 64.00 +/- 5.98 y, 5 females) and 10 healthy younger adults (age 24.50 +/- 3.54 y, 5 females). INTERVENTIONS Wake episodes during FD scheduled to begin 4 h earlier each day allowing for data collection at a full range of circadian phases. MEASUREMENTS AND RESULTS Subjective sleepiness, cognitive throughput, and psychomotor vigilance assessed every 2 h throughout the study. Core body temperature (CBT) data collected throughout to assess circadian phase. Older subjects were less sleepy and performed significantly better on reaction time (RT) measures than younger subjects. Decrements among younger subjects increased in magnitude further into the experiment, while the performance of older subjects remained stable. CONCLUSIONS Our findings demonstrate that the waking performance and alertness of healthy older subjects are less impacted by the cumulative effects of repeated exposure to adverse circadian phase than that of young adults. This suggests that there are age-related changes in the circadian promotion of alertness, in the wake-dependent decline of alertness, and/or in how these 2 regulatory systems interact in healthy aging.

[1]  S. Doran,et al.  Sustained attention performance during sleep deprivation: evidence of state instability. , 2001, Archives italiennes de biologie.

[2]  C. Czeisler,et al.  Healthy Older Adults Better Tolerate Sleep Deprivation Than Young Adults , 2009, Journal of the American Geriatrics Society.

[3]  M. Schemper,et al.  Alterations in nocturnal serum melatonin levels in humans with growth and aging. , 1988, The Journal of clinical endocrinology and metabolism.

[4]  P. Lavie,et al.  Circadian characteristics of sleep propensity function in healthy elderly: a comparison with young adults. , 1997, Sleep.

[5]  J. Wolfe,et al.  PSYCHOLOGICAL SCIENCE Research Article SEARCHING NIGHT AND DAY: A Dissociation of Effects of Circadian Phase and Time Awake on Visual Selective Attention and Vigilance , 2022 .

[6]  P. Lavie,et al.  Ultrashort sleep-waking schedule. III. 'Gates' and 'forbidden zones' for sleep. , 1986, Electroencephalography and clinical neurophysiology.

[7]  H. Iguichi,et al.  Age-dependent reduction in serum melatonin concentrations in healthy human subjects. , 1982, The Journal of clinical endocrinology and metabolism.

[8]  J. E. Mazur,et al.  Learning as accumulation: a reexamination of the learning curve. , 1978, Psychological bulletin.

[9]  D. Dijk,et al.  Low-dose repeated caffeine administration for circadian-phase-dependent performance degradation during extended wakefulness. , 2004, Sleep.

[10]  M. H. Bonnet.  Performance and sleepiness following moderate sleep disruption and slow wave sleep deprivation , 1986, Physiology & Behavior.

[11]  J. C. Zimmerman,et al.  Chronobiology of aging: Temperature, sleep-wake rhythms and entrainment , 1982, Neurobiology of Aging.

[12]  Ramin Khatami,et al.  Age-related changes in the time course of vigilant attention during 40 hours without sleep in men. , 2006, Sleep.

[13]  C A Czeisler,et al.  Short‐term memory, alertness and performance: a reappraisal of their relationship to body temperature , 1992, Journal of sleep research.

[14]  D. Dijk,et al.  Age-related increase in awakenings: impaired consolidation of nonREM sleep at all circadian phases. , 2001, Sleep.

[15]  Peter Achermann,et al.  Simulation of daytime vigilance by the additive interaction of a homeostatic and a circadian process , 1994, Biological Cybernetics.

[16]  Daniel J Buysse,et al.  Amplitude reduction of the circadian temperature and sleep rhythms in the elderly. , 1996, Chronobiology international.

[17]  V. Leirer,et al.  Development and validation of a geriatric depression screening scale: a preliminary report. , 1982, Journal of psychiatric research.

[18]  M. Bonnet.  The effect of sleep fragmentation on sleep and performance in younger and older subjects , 1989, Neurobiology of Aging.

[19]  D. Dijk,et al.  Circadian regulation of human sleep and age-related changes in its timing, consolidation and EEG characteristics. , 1999, Annals of medicine.

[20]  D. Dijk,et al.  Ageing and the circadian and homeostatic regulation of human sleep during forced desynchrony of rest, melatonin and temperature rhythms , 1999, The Journal of physiology.

[21]  H. Colten,et al.  Sleep Disorders and Sleep Deprivation , 2006 .

[22]  D. Thorne,et al.  Circadian variation in human performance evaluated by the Walter Reed performance assessment battery. , 1990, Chronobiology international.

[23]  J. Ware,et al.  Random-effects models for longitudinal data. , 1982, Biometrics.

[24]  R. Kronauer,et al.  Stability, precision, and near-24-hour period of the human circadian pacemaker. , 1999, Science.

[25]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[26]  C. Czeisler,et al.  Association of sleep-wake habits in older people with changes in output of circadian pacemaker , 1992, The Lancet.

[27]  David F. Dinges,et al.  Microcomputer analyses of performance on a portable, simple visual RT task during sustained operations , 1985 .

[28]  Mirjam Münch,et al.  Gender and age differences in psychomotor vigilance performance under differential sleep pressure conditions , 2006, Behavioural Brain Research.

[29]  M. Johns,et al.  A new method for measuring daytime sleepiness: the Epworth sleepiness scale. , 1991, Sleep.

[30]  T. Balkin,et al.  Age and individual variability in performance during sleep restriction , 2006, Journal of sleep research.

[31]  D. Dijk,et al.  Sleep-facilitating effect of exogenous melatonin in healthy young men and women is circadian-phase dependent. , 2006, Sleep.

[32]  S. Strogatz,et al.  Circadian regulation dominates homeostatic control of sleep length and prior wake length in humans. , 1986, Sleep.

[33]  T H Monk,et al.  The effects of age and gender on sleep EEG power spectral density in the middle years of life (ages 20-60 years old). , 2001, Psychophysiology.

[34]  Jeanne F Duffy,et al.  Sleep inertia varies with circadian phase and sleep stage in older adults. , 2008, Behavioral neuroscience.

[35]  A. Wirz-Justice,et al.  Age-related attenuation of the evening circadian arousal signal in humans , 2005, Neurobiology of Aging.

[36]  S. Ancoli-Israel,et al.  Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey. , 2004, Journal of psychosomatic research.

[37]  D. Dijk,et al.  Later endogenous circadian temperature nadir relative to an earlier wake time in older people. , 1998, The American journal of physiology.

[38]  Michael V. Vitiello,et al.  Circadian temperature rhythms in young adult and aged men , 1986, Neurobiology of Aging.

[39]  Charles A. Czeisler,et al.  Sleep and Wakefulness Out of Phase with Internal Biological Time Impairs Learning in Humans , 2006, Journal of Cognitive Neuroscience.

[40]  K E Klein,et al.  Air operations and circadian performance rhythms. , 1976, Aviation, space, and environmental medicine.

[41]  D. Dijk,et al.  Circadian temperature and melatonin rhythms, sleep, and neurobehavioral function in humans living on a 20-h day. , 1999, The American journal of physiology.

[42]  D. Kupfer,et al.  Sleep in normal and pathological aging , 1983, Experientia.

[43]  G. Kecklund,et al.  Relations between performance and subjective ratings of sleepiness during a night awake. , 1994, Sleep.