Michael Varkevisser

Chronic insomnia and performance in a 24-h constant routine study

Insomniacs report daytime functioning problems, but studies of neurobehavioral functioning in insomniacs have shown little objective evidence of impairment. In addition, very little is known about the influence of the circadian clock on performance in chronic insomniacs. In the present study, we investigated whether chronic insomnia is associated with an overall performance deficit, and what the effect is of circadian rhythmicity, under strictly controlled laboratory conditions. A 24‐h experiment was carried out under constant routine conditions. Psychomotor performance, body temperature, and subjective functioning of 11 insomniacs and 13 healthy subjects were assessed. The insomniacs showed significant overall performance impairments in vigilance, working memory, and motor control. In addition, body temperature, performance and subjective functioning showed a circadian pattern similar to healthy subjects, with trough values in the late night/early morning and peak values in the early evening. Self‐reported functioning among the insomniacs indicated mood disturbances, concentration problems, elevated fatigue and elevated sleepiness. The results indicated that chronic insomnia is associated with a substantial lowering of the 24‐h level of performance and subjective functioning, irrespective of the type of task and/or the particular parameter, and without differential effects of circadian rhythmicity. Apparently, chronic insomnia has a negative impact upon performance as measured under strictly controlled, unmasked conditions.

Chronic Insomnia and Daytime Functioning: An Ambulatory Assessment

In this ambulatory study, the relation between daytime functioning and chronic insomnia was investigated. The study sample consisted of 39 chronic insomniacs and 20 healthy control participants. Performance (vigilance, working memory, motor control) and well-being (concentration, fatigue, mood, sleepiness) were assessed by means of a validated test battery, and intra-individual sleep variability was taken into account. Subjective well-being was found to be compromised in insomniacs as compared to control participants, but no differences in the level of performance were found. Evening cortisol levels did not indicate increased levels of arousal in the insomniacs. Although the absence of an effect of chronic insomnia on objectively measured performance may be due to experimental or statistical factors, this study hypothesizes that the insomniacs studied in the field may have been able to exert compensatory effort to overcome their self-perceived fatigue.

24-Hour Assessment of Performance on a Palmtop Computer: Validating a Self-Constructed Test Battery

A test battery was constructed on a palmtop computer for ambulatory purposes. This study explored whether the test battery could assess circadian rhythmicity under constant routine conditions. Performance, body temperature, and subjective sleepiness of 12 healthy subjects were measured. The test battery consisted of a sleepiness questionnaire and three performance tests: a vigilance detection test, a working memory test, and a choice-reaction time test. The subjects were divided into early-start and late-start groups and were subjected to the constant-routine protocol. All tests showed a trough in performance in the early morning around 07:00h and a peak in the evening between 21:00 and 23:00h. In addition, an afternoon decrement in performance was observed between 15:00 and 17:00h. On average, the circadian (peak-to-trough) variation of the performance variables amounted to 16.9%±1.7 SEM of the maximum across subjects. The late starters showed a larger impairment in performance during the morning than the early starters. This could be attributed to prior wakefulness. The characteristics of the performance rhythms found in this study replicate findings in several other studies carried out under constant routine conditions. In conclusion, the present test battery appeared to be a good tool for future assessment of performance under natural conditions.