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Summary: To quantitatively describe the effects of sleep loss, we used meta-analysis, a technique relatively new
to the sleep research field, to mathematically summarize data from 19 original research studies. Results of our
analysis of 143 study coefficients and a total sample size of 1,932 suggest that overall sleep deprivation strongly
impairs human functioning. Moreover, we found that mood is more affected by sleep deprivation than either cog-
nitive or motor performance and that partial sleep deprivation has a more profound effect on functioning than either
long-term or short-term sleep deprivation. In general, these results indicate that the effects of sleep deprivation may
be underestimated in some narrative reviews, particularly those concerning the effects of partial sleep deprivation.
Key Words: Sleep deprivation-Partial sleep deprivation-Cognitive performance-Motor performance-Mood-
Meta-analysis.
Results of sleep research have traditionally been Meta-analytic reviews, because of their mathemati-
summarized through narrative reviews. In a narrative cal nature, tend to be fairly objective and consistent.
review, a prominent researcher examines the studies in Tn addition, meta-analysis has several statistical advan-
a given area and subjectively arrives at various con- tages. Since each individual study represents a sample
clusions. For example, Krueger (1) reviewed the ef- taken from a larger popUlation, sample results may not
fects of sleep deprivation on performance and con- always match those of the population (i.e. a sampling
cluded that sleep deprivation results in decreased re- error). Mathematically averaging across studies mini-
action times, less vigilance, an increase in perceptual mizes the influence of sampling error since the high
and cognitive distortions and changes in affect. and low random deviations tend to balance out. More-
An alternative approach to summarizing primary re- over, since some studies may be based on a relatively
search has emerged over the last couple of decades. small sample, problems with low power are avoided
Denoted as "meta-analysis," it is based on a mathe- since no formal significance testing is done at the in-
matical rather than a subjective combination of studies dividual study level. (Effectually, all individual sam-
(see 2,3). Like narrative reviews, meta-analytic re- ples are combined into one large sample which should
views can contribute meaningful information and con- be largely representative of the general population.)
clusions. Specifically, a meta-analysis can provide de- While meta-analysis has been gaining popularity in
tails regarding the strength and consistency of an ex- other fields, such as personnel management, clinical
perimental effect and the conditions or factors which psychology and education (e.g. 4-6), it has yet to gain
moderate the effect. widespread acceptance in the sleep research commu-
Each approach to summarizing research has its own nity. To date, only four articles have reported meta-
unique strengths. Narrative reviews are typically done analyses of primary sleep studies. Benca et al. (7) re-
by someone who has considerable experience and ex- viewed sleep patterns in psychiatric disorders. Hudson
pertise in that area, someone who is in a very good et al. (8) looked at polysomnographic measures in
position to understand the details and intricacies of good and bad sleep. Knowles and MacLean (9) as-
each study. Thus, more subjective factors, such as the sessed age-related changes in sleep. Lastly, Koslowsky
quality of each study, can easily be taken into consid- and Babkoff (10) examined the effect of total sleep
eration when forming conclusions. deprivation on work-paced and self-paced task perfor-
mance.
Accepted for publication January 1996. Moreover, consistent with the pattern observed in
Address correspondence and reprint requests to June J. Pilcher,
Ph.D., Department of Psychology, Bradley University, Peoria, IL other fields, some of the first meta-analyses to appear
61625, U.S.A. have been somewhat limited in scope. In regard to
318
SLEEP DEPRIVATION 319
sleep deprivation, there are a number of potentially addition, our analysis utilizes data from both partial
important moderator variables which could be taken and total sleep deprivation studies.
into account. For example, there are three types of
measures commonly used to assess the effects of sleep
deprivation: cognitive performance, motor perfor- METHOD
mance and mood. And, there may be additional vari-
Location of study data
ables operating within each of these measures which
may further change the effects of deprivation on func- The data for our meta-analyses were located by ex-
tioning. tensive literature searches on the computerized data-
Some evidence does, in fact, suggest that perfor- bases PsychLit (1987-1993) and Med On-Line (1986-
TABLE 1. Coding characteristics respectively, for the experimental group and Nc and Sc
are the sample size and standard deviation for the con-
Type of sleep deprivation
A. Short-term sleep deprivation (:545 hours) trol group.
B. Long-term sleep deprivation (>45 hours) . .
C. Partial sleep deprivation «5 hours sleep III a 24-hour penod
(NE)SE2 + (Nd Sc 2
Sw = (2)
Type of dependent measure NE + Nc
A. Cognitive task performance Careful attention was paid to the sign of the effect
B. Motor task performance
C. Mood assessment size during coding, since d values mathematically can
Type of task
be positive or negative. Studies were uniformly coded
A. Simple task such that a negative d represented situations where the
the average number of standard deviations the exper- Schmidt (2) noted, the more different the individual
imental distributions was offset from the control dis- means are from the overall mean, the more influence
tribution) and the variability observed around this av- that characteristic has on the strength of the experi-
erage. All computations are done weighting by sample mental effect.]
size, since studies based on a larger sample are more Similarly, we separated the studies into the three
stable than those based on a smaller sample (2,3). categories of dependent measure (cognitive task per-
It should be noted that Huffcutt et al.'s program formance, motor task performance and mood scales)
does not provide any tests of statistical significance. and conducted a separate meta-analysis for each cat-
Formal significance testing is typically not done in a egory. Finally, we conducted a meta-analysis in which
meta-analysis, as the meta-analytic procedures were we combined across the two prominent design char-
Deprived Nondeprived
TABLE 2. Meta-analyses of sleep deprivation overall and Group Group
by study design characteristic
\ \. ('
;'
being considerably worse on short tasks than on long non-sleep-deprived subjects (i.e. a 1.37 standard de-
tasks and slightly worse on simple tasks than on com- viation difference between the distributions). Although
plex tasks. For partial deprivation, subjects did worse most of the sleep research community may concur
on tasks that were simple than those that were complex with these results, there are a surprising number of
and worse on tasks that were longer. However, the rel- scientists outside the sleep research field who have
atively small samples involved makes these findings concluded that sleep deprivation has no profound ef-
much more tentative. fect on performance and only a marginal effect on
Results of the supplemental analyses of motor per- mood. For example, many widely known professionals
formance tasks are presented in Table 5. As shown, outside the sleep research field writing introductory
there were no studies involving complex motor tasks texts in psychology and physiological psychology
in the final data set. For length of task, performance have stated that the effects of sleep deprivation on hu-
was worse on long tasks for all three types of depri- man functioning are minimal (55-59).
vation. Once again, the relatively small samples in- Another major finding of our investigation was that
volved makes these findings tentative. the effects of sleep deprivation vary according to two
key moderator variables. First, we found a substantial
DISCUSSION difference across the three dependent measures. Spe-
cifically, we found that cognitive performance was
Our results confirm that sleep deprivation has a sig- more affected by sleep deprivation than motor perfor-
nificant effect on human functioning. By quantitatively mance and that mood was much more affected than
combining across primary studies, we found that the either cognitive or motor performance. It is important
mean level of functioning of sleep-deprived subjects to note, however, that even on motor tasks the sleep-
was comparable to, that of only the 9th percentile of deprived subjects performed considerably worse than
the non-sleep-deprived subjects. This pattern of dif- ological concerns could account for all of the decre-
ferences among the three types of dependent measures ment found in cognitive tasks and mood.
is not surprising and is consistent with the viewpoints One clear direction for future research is to address
of many sleep researchers (1,11,19,24). why partial sleep deprivation may have such a pro-
That mood was more influenced than the objective nounced effect on mood and cognitive performance.
performance measures is not surprising. Since mood For example, partial sleep deprivation may alter cer-
is usually assessed using self-reporting methodology, tain circadian rhythm effects on performance and
it is possible that the subjects could be overestimating mood. While total sleep deprivation has been found to
the effect of sleep deprivation on their mood. How- interact with circadian rhythms (61,62), few studies
ever, it is important to note that on average, the sleep- have investigated the effects of partial sleep depriva-
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