Waking quantitative electroencephalogram and auditory event-related potentials following experimentally induced sleep fragmentation.

STUDY OBJECTIVES: Experimental sleep fragmentation involves inducing arousals by administering intrusive auditory stimuli throughout the night. It is intended to model the frequent and periodic disruption experienced in common sleep disorders. Sleep fragmentation leads to daytime sleepiness, although evidence of performance impairment has been inconsistent. The purpose of this study was to investigate brain physiology associated with this level of sleep disruption. Specifically, quantitative analysis of electroencephalography was carried out, and auditory event-related potentials were recorded during daytime performance assessment following sleep fragmentation in good sleepers.

DESIGN: Participants spent 4 consecutive 24-hour periods in the laboratory. On nights 2 and 3, sleep was fragmented using auditory stimuli that were delivered with increasing intensity until an arousal was noted. This design aimed to investigate the cumulative effects of sleep fragmentation on daytime functioning.

SETTING: Data were collected in a sleep research laboratory during a 96-hour protocol.

PARTICIPANTS: Eight healthy adults (mean age = 33.25) with no sleep complaints.

MEASUREMENTS AND RESULTS: During the day, participants performed a 40-minute computerized test battery at 2-hour intervals (9:00 am -7:00 pm). The battery was presented in a fixed order and included measures of mood, sleepiness, reaction time, and serial addition or subtraction. Results indicated that subjective sleepiness and mood were impaired following sleep-fragmentation nights, compared to both baseline and recovery conditions. No performance deficits were apparent. The alpha:theta ratio, reflecting relative slowing of the electroencephalogram, was dramatically reduced following the second night of sleep fragmentation. Reductions in N1 amplitude of the event-related potentials indicated that attention was impaired with respect to early encoding processes following sleep fragmentation.

CONCLUSIONS: Electroencephalographic and event-related potentials data illustrate impairment in information-processing capabilities associated with reduced arousal elicited by experimental sleep fragmentation. This subtle degree of sleep disruption, where total sleep time is not reduced, leads to sustained impairment in alertness and attention.