Gender and age differences in psychomotor vigilance performance under differential sleep pressure conditions

The effects of sleep pressure and circadian phase on neurobehavioral function can be sensitively measured with the psychomotor vigilance task (PVT). We compared PVT performance in 16 young (8 men and 8 women, 20-31 years) and 16 elderly healthy subjects (8 men and 8 women, 57-74 years) during a 40-h sleep deprivation (SD, high sleep pressure) and a 40-h multiple nap protocol (NAP, low sleep pressure) under dim light and constant posture conditions in a balanced crossover design. Independent of age and sleep pressure conditions, women exhibited significantly slower reaction times (RTs) than men. This effect became more apparent with increasing time elapsed into both the 40-h NAP and SD protocol. However, women tended to have fewer premature key presses than men. Independent of gender, the elderly showed slower RTs than the young in the NAP protocol during the biological day (8-24 h) but not during the biological night (24-8 h). In the SD protocol, they had also significantly slower RTs but only during the first 16 h under low to moderate levels of sleep pressure conditions. The relative PVT performance decline after SD was significantly less pronounced in the elderly than in the young, so that both age groups exhibited similar performance decrements after 16 h into the SD protocol. Thus, nighttime- and sleep pressure-related RT slowing in the young "makes them old", or the elderly are less susceptible to circadian and wake-dependent PVT performance decrements. We interpret the gender effect as a different strategy in women when performing the PVT, although the instructions to be 'as fast as possible' were identical. Not only sleepiness and circadian phase, but also age and gender are major factors that may contribute to attentional failures in extended work shifts and during nighttime work shifts.     

Maternal postpartum sleepiness and fatigue: associations with objectively measured sleep variables

Objective

To explore whether standardized survey instruments and objective performance measures differentiate traditional constructs of sleepiness and fatigue among a sample of postpartum mothers. Additionally, we wanted to explore the independent associations among these measures with actigraphically measured nocturnal sleep variables.

Method

Seventy-nine postpartum mothers' subjective sleepiness, fatigue, and performance measures [Stanford Sleepiness Scale (SSS), Epworth Sleepiness Scale (ESS), Visual Analogue of Fatigue Scale (VAS), Profile of Mood States (POMS) subscale items, and the Psychomotor Vigilance Test (PVT)] and objective actigraphically measured sleep were collected during postpartum week 11. A principal components analysis was calculated, then regressions were calculated among resulting factors and among individual measures with total sleep time and sleep efficiency.

Results

Three factors accounted for 83.84% of model variance. Factor 1 (41.41%) included the SSS, ESS, and the VAS. Factor 2 (28.13%) included only PVT variables. Factor 3 (14.30%) included the two POMS subscale items. Factor 1 was associated with nocturnal sleep time and Factor 2 was associated with sleep efficiency. The ESS was independently associated with nocturnal sleep time, whereas, POMS-Vigor subscale and median reaction time, together, were associated with sleep efficiency.

Conclusion

Among postpartum mothers, standard instruments used to measure sleepiness, fatigue, and performance were distributed among three distinct factors that did not clearly identify traditional sleepiness and fatigue constructs. Objectively measured sleep time and sleep efficiency were associated with specific factors, as well as specific measures, that correspond to sleepiness and fatigue states.     

Topographic electroencephalogram changes associated with psychomotor vigilance task performance after sleep deprivation

ObjectivesThe psychomotor vigilance task (PVT) is a widely used method for the assessment of vigilance after sleep deprivation (SDEP). However, the neural basis of PVT performance during SDEP has not been fully understood. In particular, no studies have investigated the possible relation between EEG topographical changes after sleep loss and PVT performance. The aim of the present study is to assess the EEG topographic correlates of PVT performance after SDEP.MethodsDuring 40 h of SDEP, 16 healthy male subjects were evaluated in four sessions performed at the same time (11:00 a.m. and 11:00 p.m.) of the first and second day with: (a) subjective sleepiness recordings by means of the Karolinska Sleepiness Scale (KSS); (b) EEG recordings (5 min eyes-open condition); and (c) PVT.ResultsSDEP induced a slowing of PVT reaction times (RTs), higher level of subjective sleepiness and an increase of delta, theta, alpha and beta 1 EEG activity. Only slowest PVT RTs were influenced by circadian factors, with longer RTs in the morning. Both fastest PVT RTs and KSS scores were positively correlated with post-SDEP changes in EEG theta activity, mainly in centro-posterior areas, but not with other EEG frequencies. KSS scores and PVT measures were also positively correlated.ConclusionsThese findings suggest that SDEP differently affects PVT variables, and that an increase in theta activity may be the principal EEG basis of the post-SDEP slowing of fastest PVT RTs. Similar neural mechanisms seem to underlie both performance deterioration to PVT and the increase of subjective sleepiness.     

Daytime sleepiness associated with poor sustained attention in middle and late adulthood

ObjectiveWe aimed to determine the association between psychomotor vigilance task (PVT) performance and sleep-related factors including sleep duration, daytime sleepiness, poor sleep quality, insomnia, and habitual snoring in a population-based sample.MethodsThis was a cross-sectional analysis from the ongoing prospective cohort study, the Korean Genome and Epidemiology Study. We measured PVT performance and documented demographics, sleep-related factors, life style, and medical conditions in community dwelling adults (N = 2499; mean age 57.1 ± 7.3; male 1259). Associations between PVT parameters and sleep-related factors were tested, adjusting for age, gender, smoking, alcohol use, education, body mass index, hypertension, diabetes, depression, and the interval between mid-sleep time and PVT test.ResultsHigh Epworth Sleepiness Scale (ESS, ≥8) was associated with slower mean reciprocal response speed (mean RRT) (3.69 ± 0.02 vs. 3.77 ± 0.01, p < 0.001), higher probability for increased lapses (≥4) (OR 1.48, CI 1.12–1.88, p = 0.001), and more negative RRT slope (−0.036 ± 0.002 vs. −0.030 ± 0.001, p = 0.02). Older age, female gender, low education level, depressive mood, and the interval between mid-sleep and PVT test were also associated with poor performance. Sleep duration, habitual snoring, insomnia, or poor sleep quality (the Pittsburgh Sleep Quality Index score > 5) was not related to PVT parameters.ConclusionsAt the population level, our results revealed important modifiers of PVT performance, which included subjective reports of daytime sleepiness.     

The impact of extended sleep on daytime alertness, vigilance, and mood

BACKGROUND AND PURPOSE: To measure the effects of prolonged sleep extension on daytime alertness, vigilance, and mood in healthy young adults. Little research has documented the effects of increased sleep on daytime function despite a high prevalence of daytime fatigue and sleepiness in the adult population. Past extension studies report conflicting results with regard to Multiple Sleep Latency Test (MSLT) scores, vigilance, and mood ratings. No study has challenged subjects to maximum sleep extension, defined by an MSLT score of 20. PATIENTS AND METHODS: Fifteen healthy college students reporting minimal daytime sleepiness were allowed to sleep as much as possible during a sleep extension period. MSLT scores, psychomotor vigilance task (PVT) reaction times, and profile of mood states (POMS) ratings were measured at baseline, mid-extension, and end-extension. RESULTS: There was a significant increase in both journal and actigraphy sleep totals during all extension segments (P<0.01). MSLT scores increased significantly from baseline to both mid- and end-extension (P<0.01). Five of eight tabulated PVT measures also improved significantly at mid- and end-extension with respect to baseline (P<0.05). POMS vigor and fatigue scores showed a similar improvement (P<0.01). Seven subjects achieved an MSLT score of 20. Six subjects showed substantial improvements while two subjects obtained relatively little extra sleep and showed little or no MSLT improvement. The maximum extension group displayed exceptional improvements in vigilance and POMS ratings. CONCLUSIONS: Extended sleep leads to substantial improvements in daytime alertness, reaction time, and mood.     

Diurnal fluctuation of sleep propensity across the menstrual cycle

Most women experience sleep changes across the menstrual cycle. We applied the ultra-short sleep-wake schedule to healthy females to compare their 24-h sleep propensity rhythms in the follicular and luteal phases. The daytime (09.00-16.30 h) subjective sleepiness and the number of slow wave sleep-containing nap trials increased in the luteal phase compared to the follicular phase, but the mean sleep propensity did not change. During the periods of 17.00-00.30 h and 01.00-08.30 h there were no differences between the two phases. These results suggest that increased daytime sleepiness in the luteal phase may be related to brain mechanisms controlling slow wave sleep.     

The relationships between improvements in daytime sleepiness,fatigue and depression and psychomotor vigilance task testing with CPAP use in patients with obstructive sleep apnea

ObjectiveThe purpose of this study was to determine if the subjective improvements in daytime sleepiness, fatigue and depression experienced by patients with obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP) therapy predict an objective improvement in vigilance, and whether patients with mild-to-moderate OSA differ from patients with severe OSA in this regard.MethodsA total of 182 patients underwent psychomotor vigilance task (PVT) testing and measurements of subjective daytime sleepiness, fatigue and depression at baseline and after a minimum of one month of adherent CPAP use at an adequate pressure.ResultsPatients with both mild-to-moderate (n = 92) and severe (n = 90) OSA experienced improvements in subjective daytime sleepiness, fatigue and depression, but objective improvement in vigilance was only seen in patients with severe OSA. In patients with severe OSA, while a correlation was found between improvements in daytime sleepiness and some PVT parameters, changes in subjective daytime sleepiness, fatigue and depression scores were not predictive of objective improvement in vigilance while controlling for all these subjective symptoms and for age, gender, body mass index, apnea-hypopnea index/respiratory event index and total sleep time/total recording time with pulse oximetry below 90%.ConclusionsWe found no predictive relationship between subjective improvements in daytime sleepiness, fatigue and depression and objective vigilance with CPAP use in patients with OSA. These results suggest that subjective complaints of daytime impairment and objective measures of vigilance in patients with OSA should be assessed separately while evaluating the efficacy of CPAP therapy on daytime functioning.     

Diurnal fluctuation of sleep propensity and hormonal secretion across the menstrual cycle.

BACKGROUND: The fact that most women experience sleep changes across the menstrual cycle is thought to be associated with changes in circadian rhythms; however, few studies have investigated this relationship. METHODS: We applied an ultrashort sleep-wake schedule to eight healthy women and studied diurnal fluctuations in sleep propensity, sleepiness, rectal temperature, and serum concentrations of melatonin, thyroid-stimulating hormone, and cortisol in the follicular and luteal phases. RESULTS: In the luteal phase, amplitude of core body temperature, total melatonin secretions, and amplitudes of TSH and cortisol rhythms were significantly decreased, whereas sleepiness and occurrence of slow-wave sleep during the daytime were significantly increased. Differences in the amount of daytime slow-wave sleep across the menstrual cycle were positively correlated with differences in the daily mean rectal temperature. CONCLUSIONS: The findings suggest that the amplitude of circadian oscillation may be dampened in the luteal phase. Increased daytime sleepiness in the luteal phase may be associated with increased daytime slow-wave sleep, due possibly to changes in thermoregulation in the luteal phase.     

Menstrual factors in sleep

The changing endocrine profile in premenopausal women alters aspects of sleep and circadian rhythms. Subjectively women appear to feel a greater need for sleep and report poor and insufficient sleep more often than men. This greater sleep requirement may manifest with a higher amplitude of slow-wave sleep in the EEG in women. Healthy young women, with biphasic body temperature rhythms of ovulatory menstrual cycles, have more stage 2 sleep, higher spindle frequency activity and less rapid-eye movement (REM) sleep when progesterone predominates in the luteal phase. These sleep-EEG changes may largely be caused by neurosteroids acting on the brain. Sleep regulatory mechanisms, indicated by the onset to sleep, slow-wave sleep (SWS) and slow-wave activity, appear to be unaffected by menstrual phase in women with normal cycles. Women with premenstrual mood symptoms have more stage 2 sleep and seemingly less SWS and REM sleep, a blunted circadian rhythm of melatonin and an earlier minimum body temperature than asymptomatic women. Subjective repercussions include increased daytime sleepiness, lethargy and fatigue. Treatment strategies for menstrual-associated complaints include using oral contraceptives and sleep deprivation but the physiology and pharmacology of normal menstrual changes, the disorders and their treatment need to be better understood.     

Risk factors for excessive sleepiness in older adults

OBJECTIVE: To determine risk factors for excessive daytime sleepiness in older adults. METHODS: This is a cross-sectional study assessing multiple risk factors for excessive daytime sleepiness in older subjects (mean age, 78 years; range 65-98 years) with (n=149) and without (n=144) complaints of frequent excessive daytime sleepiness. Assessment of risk factors included full in-laboratory sleep studies. RESULTS: Excessive sleepiness among the elderly is multifactorial. Multivariable modeling identified the following as simultaneously significant risk factors for excessive sleepiness: severe sleep-disordered breathing (apnea-hypopnea index, >30 episodes/hr), self-report of poor sleep quality, increased percentage of time in rapid eye movement sleep, pain at night at least three times per week, wheezing or whistling from chest at night, and medications with sleepiness as a side effect. Male sex also was associated with increased risk, whereas alcohol use (more than seven beverages per week) reduced the risk for sleepiness. Multiple risk factors were more commonly present in those with complaints of sleepiness. The presence of periodic limb movements, which are common in older adults, was not associated with sleepiness. INTERPRETATION: There is a distinct differential diagnosis of excessive daytime sleepiness in older adults. Many of the risk factors that we identified are treatable.     

Challenging the sleep homeostat: sleep in depression is not premature aging

ObjectivesThe close relationship between major depression and sleep disturbances led to the hypothesis of a deficiency in homeostatic sleep pressure in depression (S-deficiency hypothesis). Many observed changes of sleep characteristics in depression are also present in healthy aging, leading to the premise that sleep in depression resembles premature aging. In this study, we aimed at quantifying the homeostatic sleep–wake regulation in young women with major depression and healthy young and older controls under high sleep pressure conditions.MethodsAfter an 8-h baseline night nine depressed women, eight healthy young, and eight healthy older women underwent a 40-h sustained wakefulness protocol followed by a recovery night under constant routine conditions. Polysomnographic recordings were carried out continuously. Sleep parameters as well as the time course of EEG slow-wave activity (SWA) (EEG spectra range: 0.75–4.5 Hz), as a marker of homeostatic sleep pressure, were analyzed during the recovery night.ResultsYoung depressed women exhibited higher absolute mean SWA levels and a stronger response to sleep deprivation, particularly in frontal brain regions. In contrast, healthy older women exhibited not only attenuated SWA values compared to the other two groups, but also an absence of the frontal SWA predominance.ConclusionsHomeostatic sleep regulation and sleep architecture in young depressed women are not equal to premature aging. Moreover, our findings demonstrate that young moderately depressed women exhibit no deficiency in the sleep homeostatic process S as predicted by the S-deficiency hypothesis, but, rather, live on an elevated level of homeostatic sleep pressure.     

Spectral composition of NREM sleep in healthy subjects with moderately increased daytime sleepiness.

OBJECTIVE: This study addressed the relationship between daytime sleepiness and spectral composition of the preceding NREM sleep.METHODS: Nineteen healthy volunteers (mean age: 36.5 years; SD: 10.1) underwent polysomnography during two consecutive nights and the multiple sleep latency test (MSLT) on the following day. Daytime sleepiness was also assessed by the Epworth sleepiness scale (ESS). The sleep recordings were visually scored according to standard criteria. The quantitative sleep EEG analysis was performed using a fast Fourier transform routine. The sleep parameters were compared between subjects with short and long MSLT sleep latencies (cut-off=10 min) and between subjects with low and high ESS scores (cut-off=6 points).RESULTS: Subjects with short MSLT sleep latencies showed a reduced theta EEG activity. There was no evidence of reduced synchronization of sleep EEG in subjects with high ESS scores.CONCLUSIONS: Moderately increased daytime sleepiness as indicated by MSLT sleep latency less than 10 min is accompanied by decreased power of theta activity during NREM sleep indicating a deficit of sleep EEG synchronization.     

Sleep disturbance and deficits of sustained attention following stroke

Objective: To simultaneously investigate the prevalence of and impact that the poststroke complications of daytime sleepiness, poor sleep quality, depression, and fatigue may be having upon deficits of sustained attention, as assessed using the Psychomotor Vigilance Task (PVT). Method: Twenty-two patients with stroke (mean age: 68.23 ± 12.17 years) and 20 healthy control participants (mean age: 68.1 ± 9.5 years) completed subjective measures of daytime sleepiness, sleep quality, fatigue, and depression and an objective measure of sustained attention as assessed using the PVT. Results: Patients with stroke compared to controls showed heightened levels of fatigue (p = .001, η² = .29) and depression (p = .002, η² = .23), plus greater deficits of sustained attention as reflected by poorer performance across all PVT outcome measures including: slower mean reaction times (p = .002, η² = .22); increased number of lapses (p = .002, η² = .24); and greater variability in reaction time (RT) responses (p = .016, η² = .15). Reaction time distribution analysis suggested that daytime sleepiness and sleep quality had little influence across PVT performance; however, depressive symptomology was associated with longer RT responses, indicative of inattention, and fatigue impacted upon the entire distribution of PVT responses. Conclusions: PVT performance illustrated significant deficits across the domain of sustained attention for patients with stroke in comparison to healthy controls, in terms of inattention as well as slower sensory–motor speed. The common poststroke complications of depressive symptomology and fatigue appear to be associated with these deficits in sustained attention, warranting further investigation.     

Factors associated with objective (actigraphic) and subjective sleep quality in young adult women

OBJECTIVE: The aim of this study was to describe factors associated with actigraphic and subjective sleep quality in young women. METHODS: Participants were 73 regularly menstruating women, 20-40 years old, who were not taking oral contraceptives, pregnant, or shift workers. Women contributed an average of 7 nights of actigraphy data during the luteal menstrual cycle phase, resulting in a total of 595 nights of data. RESULTS: One night of actigraphy data was unreliable for measuring total sleep time, sleep onset, and time in bed (intraclass correlation < or =.15) but was acceptable for measuring sleep efficiency and total wake time (intraclass correlation [ICC]=.52). Going to bed late, medication use, employment, increased daylight hours, longer menstrual cycle length, and higher body mass index (BMI) were associated with poorer actigraphic sleep measures. Employment, age, and perceived stress were associated with subjective sleep quality. CONCLUSION: Multiple factors were associated with sleep quality in these young women who were sleeping at home. However, the associations differed for subjectively versus actigraphically assessed sleep quality. Actigraphy is feasible for measuring sleep, but multiple recording nights may be needed to obtain reliable estimates.     

Levodopa-induced sleepiness in the Parkinson variant of multiple system atrophy.

Recent observations suggest that levodopa can induce irresistible sleep onset in multiple system atrophy (MSA). Therefore, we assessed sleepiness during a levodopa challenge in 17 MSA compared with 23 Parkinson's disease (PD) patients using the Stanford Sleepiness Scale (SSS). SSS scores during the levodopa challenge compared with baseline were significantly increased in the MSA compared with the PD group. These findings suggest greater potential of levodopa to induce sleepiness in MSA compared with PD, which may be related to differences in basal ganglia and brainstem pathology between the two disorders.     

Parental Sleep Concerns in Autism Spectrum Disorders: Variations from Childhood to Adolescence

Sleep problems of adolescents and older children with Autism Spectrum Disorder (ASD) were compared to toddlers and young children in 1,859 children. Sleep was measured with the Children’s Sleep Habits Questionnaire. Total sleep problems were significant across all age groups, however the factors contributing to these problems differed. Adolescents and older children had more problems with delayed sleep onset, shorter sleep duration, and daytime sleepiness; while younger children had more bedtime resistance, sleep anxiety, parasomnias, and night wakings. The results suggest that sleep problems persist through adolescence in ASD with differences in types of problems experienced and emphasize the need for clinicians to address sleep behaviors not only in young children with ASD but throughout the age span.     

Alertness and psychomotor performance effects of the histamine-3 inverse agonist MK-0249 in obstructive sleep apnea patients on continuous positive airway pressure therapy with excessive daytime sleepiness: a randomized adaptive crossover study

Objectives

We aimed to evaluate the efficacy of the selective H3 receptor inverse agonist MK-0249 to treat excessive daytime sleepiness (EDS).

Methods

In this three-period, double-blind, crossover study, 125 patients (100 men, 25 women; mean age, 48.6 years) with obstructive sleep apnea receiving nasal continuous positive airway pressure therapy who had refractory EDS were randomized to 2 weeks each of daily MK-0249 (5, 8, 10, or 12 mg, adaptively assigned), modafinil 200 mg, and placebo. At baseline and after each treatment period, six maintenance of wakefulness tests (MWT) and Psychomotor Vigilance Tasks (PVT) were conducted at 2-h intervals, beginning 1 h postdose (∼09:00). The Epworth sleepiness scale (ESS), Clinical Global Impression of Severity (CGIS) and Digit Symbol Substitution Test (DSST) also were assessed. The primary end point was MWT sleep latency averaged over the first four time points (MWT-early).

Results

MWT-early mean change from baseline sleep latency at week 2 was 1.2 min for placebo, 2.1 min for MK-0249 (top two doses pooled; P > .05 vs placebo), and 5.9 min for modafinil (P ? .001 vs placebo). MK-0249 showed improvements vs placebo on secondary and exploratory end points of ESS, CGIS, PVT, and DSST. Insomnia adverse events (AEs) were greater for MK-0249 (combined doses, 17.5%) than for placebo (0.9%) or modafinil (1.8%).

Conclusion

MK-0249 did not significantly affect MWT sleep latency. However, the pattern of improvement on subjective ratings and psychomotor performance end points suggested that MK-0249 was associated with changes in aspects of cognition and performance not captured by the MWT.     

Dopamine agonists and sleepiness in PD: review of the literature and personal findings

BACKGROUND AND PURPOSE: This study is aimed at evaluating daytime sleepiness in a series of Parkinson's disease (PD) patients chronically treated with dopamine agonists (DAs) alone or in combination with L-Dopa. PATIENTS AND METHODS: A preliminary series of 22 non-demented, adult PD patients (mean age 68.9, 13 men and 9 women) were evaluated by means of structured sleep interview, Epworth sleepiness scale (ESS) and 24-h ambulatory polysomnography (A-PSG). RESULTS: Sleep attacks (SAs) were reported by 32% of the patients, in three of them (43%) after DA treatment was initiated (alone or in addition to L-Dopa). In two patients, both with chronic use of ropinirole, we documented NREM SAs during a continuous ambulatory polysomnography (A-PSG) performed in the patients' real-life settings. The subjects experiencing SAs showed a higher degree of daytime sleep propensity than those without SA, having higher ESS scores and a higher proportion of microsleeps and intentional naps on A-PSG. Interestingly, we found that nocturnal total sleep time is higher in PD patients with SAs than in the others. CONCLUSIONS: All in all, our data indicate that SAs are an extreme manifestation of increased daytime sleepiness. The occurrence of SAs in our series of PD patients is unlikely to depend simply on the demands of homeostatic mechanisms.     

Self-reported sleep across the menstrual cycle in young, healthy women

OBJECTIVE: To establish the association between subjective sleep and phase of the menstrual cycle in healthy, young, ovulating women. METHODS: Twenty-six women (mean age: 21 years) who did not suffer from any menstrual-associated disorders, and in whom we had detected ovulation, completed daily questionnaires about their sleep over 1 month. RESULTS: The women reported a lower sleep quality over the 3 premenstrual days and 4 days during menstruation, compared to the mid-follicular and early/mid luteal phases. Total sleep time, sleep onset latency, number and duration of awakenings, and morning vigilance were not affected by the menstrual cycle. CONCLUSION: The normal, ovulatory cycle is associated with changes in the perception of sleep quality but not sleep continuity in healthy, young women. The temporal relationship of sleep complaints with menstrual phase should be considered in the evaluation of sleep disorders, particularly insomnia, in women.     

Longitudinal course of insomnia: Age-related differences in subjective sleepiness and vigilance performance in a population-based sample

Objective

The present study utilized a population-based sample investigating the following aims: (1) compare the longitudinal course of insomnia in middle-aged and older adults and (2) examine age-related differences on subjective complaint and objective performance in middle-aged and older adults based on the course of insomnia.

Methods

1657 middle-aged adults (48.16% male, mean age = 55.35 ± 4.03 years) and 405 older adults (48.40% male, mean age = 70.13 ± 3.88 years) from the Korean Genome and Epidemiology Study (KoGES) were classified into 4 groups — no insomnia (NI), single episode insomnia (SEI), remitted persistent insomnia (PI-R), and ongoing persistent insomnia (PI-O) based on their course of insomnia over 5 time points spaced two years apart. Their performance on the psychomotor vigilance task (PVT) and subjective daytime sleepiness were compared across different insomnia groups, and the results were compared between middle-aged adults and older adults.

Results

Analysis of covariance indicated that subjective daytime sleepiness was significantly different across the insomnia groups in middle-aged adults based on insomnia group (P = < .0001), but, did not affect objective vigilance performance. In contrast, older adults displayed significantly different PVT response time, but not daytime sleepiness, based on insomnia group (P = 0.03).

Conclusion

Insomnia impacts psychomotor performance and subjective sleepiness differently, based on age group. There may be underlying processes associated with the aging that amplifies the impact of insomnia on vigilance performance, yet lessens perceived sleepiness in older adults.