Sleep Loss Impairs Decision Making

Hans P.A. Van Dongen, Ph.D. Director, Sleep and Performance Research Center Research Professor, College of Medical Sciences Washington State University Spokane, Spokane, WA Interview with:
Hans P.A. Van Dongen, Ph.D.
Director, Sleep and Performance Research Center
Research Professor, College of Medical Sciences
Washington State University Spokane, Spokane, WA

On behalf of the authors: Paul Whitney PhD, John Hinson PhD, Melinda Jackson PhD, Hans Van Dongen PhD

MedicalResearch: What is the background for this study? What are the main findings?

Research: Our main interest is in better understanding why people sometimes are able to manage perfectly well with sleep loss, while at other times sleep loss can have profoundly negative effects. We found that sleep deprivation reduces the effectiveness of signals used to tell when you are right or wrong, an effect we labeled feedback blunting.

Subjects in the study performed a decision making task that was simple but required feedback, i.e., a signal indicating the response was correct or incorrect, to perform correctly. We found that people who were sleep deprived were no longer able to use the feedback information to make correct responses. And when people had to adapt to unexpected changes in when to respond, sleep deprived people were completely unable to adapt to these changing circumstances.

The finding of feedback blunting in this study indicates that people who are sleep deprived not only have trouble sustaining attention to details in the environment (a well established effect of sleep loss), they also have trouble changing the focus of attention to deal with changing circumstances.

An interesting paradox in the research literature has been that people have been shown in many circumstances to perform complex tasks at a very high level while sleep deprived. Yet, we know from real-world experience that sleep deprived people can make catastrophic, life-threatening decisions that they would never have made if they were well rested. The current study is the first to shed light on this issue. It showed that sleep deprived people who get feedback, telling them that their actions are not effective, are less capable of changing their behavior.

The study is part of a line of research in which we are trying to identify how sleep loss changes specific components of cognition, and how these changes may lead to serious problems in everyday life activities. Being able to study and understand these effects of sleep deprivation under controlled conditions is an important step toward preventing human error under real world conditions.

MedicalResearch: What should clinicians and patients take away from your report?

Research: One important lesson is not to ignore the effect of sleep loss just because it hasn’t had much impact in the past. The study findings imply that when circumstances change from the everyday routine is when sleep deprivation will cause the biggest problems. Thus, getting adequate sleep is as important as any other measure taken to promote health and safety.

Sleep loss is inescapably linked with shift work, extended work hours, and emergency situations, as well as with sleep disorders and many other medical conditions. In today’s fast-paced society, people are often called upon to make critical decisions under dynamically changing circumstances and with potentially major consequences. Our study indicates that the circumstances that cause people to be sleep deprived are often precisely the circumstances when the effects of sleep deprivation can be the most dramatic.

There are two specific things to note.

First, sustaining attention, even for brief periods of time, is very difficult for people who are sleep deprived. Any task that requires sustained attention is likely to lead to problems under conditions of sleep loss. If you are doing something that is well practiced and there is no novelty or ambiguity to deal with, you can keep doing that task while sleep deprived, but occasional errors will pop up.

Second, any task that requires evaluating changes in the environment, e.g., new events, or changing or ambiguous circumstances, is going to be particularly difficult when people are sleep deprived. That means you may not recognize signals that would ordinarily allow you to avoid errors or prompt you to change your course of action. Serious problems arise even in well practiced activities when you must continually evaluate the environment and adapt to changing circumstances.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Research: Most conventional test used to measure the impact of sleep loss rely on either subjective measures of sleepiness or objective measures of inability to sustain attention. While useful, these approaches miss the importance of situations that demand attending to signals to change our current pattern of behavior. Future research focusing on people’s processing of feedback information can lead to improved assessment and prediction of failures that can arise from sleep loss.

In addition, we know that there are individual differences in susceptibility to sleep loss, and better understanding the mechanisms of sleep loss effects on performance is a key step in understanding these individual differences.

Feedback Blunting: Total Sleep Deprivation Impairs Decision Making that Requires Updating Based on Feedback

Journal Sleep: VOLUME 38, ISSUE 05

Paul Whitney, PhD; John M. Hinson, PhD; Melinda L. Jackson, PhD; Hans P.A. Van Dongen, PhD

[wysija_form id=”3″] Interview with:, & Hans P.A. Van Dongen, Ph.D. (2015). Sleep Loss Impairs Decision Making 

Last Updated on May 10, 2015 by Marie Benz MD FAAD