Original Research ARTICLE
An iPad based assessment of cognitive performance during daytime, sleep and restricted sleep in childhood
- 1Kings College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, United Kingdom
- 2St Thomas' Hospital, Evelina London Children's Hospital, United Kingdom
Background: Consolidation of learning occurs during sleep but when it is disturbed there may be an adverse impact upon these functions. While research has focused upon how sleep affects cognition in adulthood, the effects of disrupted sleep are likely to impact more heavily on learning among children and adolescents. We aimed to investigate whether a night’s sleep impacts upon executive function compared with an equivalent wakefulness period. We also wanted to know whether restricting sleep would reduce these effects on performance. To investigate this issue in children, we adapted existing research methods to make them more suitable for this population.
Methods: Using a cross-over trial design, twenty-two children aged 7-14 completed an updated but previously validated, continuous performance task (CPT) designed to be appealing to children, containing emotional and neutral targets and presented on an iPad. We measured omission and commission errors, mean and variability of reaction times immediately and after a delay spent in the following three ways: 11-hour intervals of unrestricted and restricted sleep in the style of a ‘sleepover’ and daytime wakefulness. We examined differences in immediate and delayed testing for each dependent variable. Both sleep nights were spent in a specialist sleep lab where polysomnography data were recorded.
Results: While there were no significant main effects of sleep condition, as expected we observed significantly faster and more accurate performance in delayed compared with immediate testing across all conditions for omission errors, reaction time and variability of reaction time. Importantly, we saw a significant interaction for commission errors to emotional targets (p=.034): while they were comparable across all conditions during immediate testing, for delayed testing there were significantly more errors after wakefulness compared with unrestricted sleep (p=.019) and at a trend level for restricted sleep (p=.063). Performance improvement after restricted sleep was inversely correlated with sleep opportunity time (p=.03), total sleep time (p=.01) and total non-REM time (p=.005).
Conclusions: This tool, designed to be simple to use and appealing to children, revealed a preserving effect of typical and disrupted sleep periods on performance during an emotionally themed target detection task compared with an equivalent wakefulness period.
Keywords: Sleep, Learning, Executive Function, Children and adolescents, development, emotional processing, target detection, memory consolidation
Received: 17 Aug 2017;
Accepted: 13 Feb 2018.
Edited by:Kathrin Finke, Friedrich Schiller Universität Jena, Germany
Reviewed by:Paul Dockree, Trinity College, Dublin, Ireland
Esther Adi-Japha, Bar-Ilan University, Israel
Copyright: © 2018 Smith, Colonna, Smith, VanDenEshof, Orgill, Gringras and Pal. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dr. Anna B. Smith, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, Kings College London, 125 Coldharbour Lane Camberwell, London, SE5 9NU, London, United Kingdom, firstname.lastname@example.org