Preliminary evidence of the cognitive cost of insomnia: understanding adaptive decision-making during sleep deprivation.

Study Objectives The aim of this laboratory-based study was to understand the effect of total sleep deprivation (TSD) on decision-making using a reversal learning task with unannounced contingency reversals in those with chronic insomnia compared to healthy sleepers. Methods Twenty-eight individuals...

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Publicado en:Sleep Advances Vol. 7; no. 2; pp. 1 - 9
Autores principales: Logioia, Gisella, Kurinec, Courtney A, Hansen, Devon A
Formato: research tables/charts Journal Article
Publicado: Oxford University Press / USA 2026
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Oxford University Press / USA
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        10.1093/sleepadvances/zpag016
        195378574
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        atl: Preliminary evidence of the cognitive cost of insomnia: understanding adaptive decision-making during sleep deprivation.
      aug:
        au:
          Logioia, Gisella
          Kurinec, Courtney A
          Hansen, Devon A
        affil: Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
      sug:
        subj:
          Decision Making Evaluation
          Cognition
          Learning Methods
          Task Performance and Analysis
          Sleep Deprivation Complications
          Insomnia
          Chronic Disease
          United States
          Funding Source
          Human
          Case Control Studies
          Recovery
          Analysis of Variance
          Comparative Studies
          International Classification of Diseases
          Physical Examination
          Male
          Female
          Adult
          Descriptive Statistics
          Unpaired T-Tests
          Questionnaires
          Scales
          Severity of Illness Indices
          Diaries
          Actigraphy
          Models, Statistical
          Post Hoc Analysis
          Adult: 19-44 years
          Male
          Female
      ab: Study Objectives The aim of this laboratory-based study was to understand the effect of total sleep deprivation (TSD) on decision-making using a reversal learning task with unannounced contingency reversals in those with chronic insomnia compared to healthy sleepers. Methods Twenty-eight individuals completed the study, 15 with chronic insomnia (7 underwent TSD) and 13 healthy sleepers (7 underwent TSD). Participants were in the laboratory for 5 days/4 nights. Following baseline sleep, participants underwent 38 h of TSD or another nighttime sleep opportunity, followed by a recovery sleep opportunity for all participants. Mixed-effects ANOVAs with fixed effects of condition (healthy TSD, insomnia TSD, healthy control, or insomnia control), session (baseline or TSD/control), phase (pre or post-reversal), block (1-4), and their interactions were run to assess performance. Results There were significant effects of day, condition, phase, and their interaction (all p <.01). Participants performed better when rested and pre-reversal (i.e. before the rule change). While both TSD groups showed poorer performance post-reversal (i.e. after the rule change) during TSD, the TSD insomnia group showed relatively intact performance pre-reversal. Conclusions TSD led to significant overall impairment on a reversal learning decision task for healthy sleepers and those with insomnia. However, the nature of impairment differed between groups. Hyperarousal may have conferred a protective effect on those with insomnia, resulting in preserved decision-making pre-reversal. These findings have important implications for our understanding of the nature of cognitive impairment associated with chronic insomnia. Statement of Significance This study demonstrates that while total sleep deprivation impairs decision making in both individuals with insomnia and healthy controls, it also provides preliminary evidence that people with insomnia show some level of protection prior to task reversal. This finding supports the idea that chronic hyperarousal in insomnia may confer paradoxical short-term cognitive resilience under sleep loss. Understanding this protective effect is important because it challenges assumptions that insomnia may uniformly degrade cognition, and it raises critical questions about the physiological mechanisms involved. Future research is needed to clarify whether this resilience comes at a long-term cost to brain and body health, and how it may inform interventions for sleep disorders and cognitive function in vulnerable populations.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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