center23002457459410012100center818008745855Catherine Ryan Subject

center23002457459410012100center818008745855Catherine Ryan
Subject: Life SciencesSchool: Holy Rosary School
941009200Catherine Ryan
Subject: Life SciencesSchool: Holy Rosary School
center7000074841109410010000center300003207385Sleep Deprivation studyDraft
9410036300Sleep Deprivation studyDraft

Table of Contents
TOC o “1-3” h z u Introduction PAGEREF _Toc518729631 h 2Aim PAGEREF _Toc518729632 h 3Hypothesis PAGEREF _Toc518729633 h 3Literature Review PAGEREF _Toc518729634 h 4Source 1 PAGEREF _Toc518729635 h 4Source 2 PAGEREF _Toc518729636 h 6Source 3 PAGEREF _Toc518729637 h 8Source 4 PAGEREF _Toc518729638 h 10Source 5 PAGEREF _Toc518729639 h 12Methodology PAGEREF _Toc518729640 h 14Presentation of Findings PAGEREF _Toc518729641 h 16Processing of Findings PAGEREF _Toc518729642 h 19Conclusion PAGEREF _Toc518729643 h 21References PAGEREF _Toc518729644 h 22Appendix PAGEREF _Toc518729645 h 27

IntroductionSleep deprivation is becoming an increasing problem in the adolescents of today. It is problematic as several studies that have been conducted, which tend to show that sleep deprivation affects the mental and cognitive behaviour of individuals. CITATION Adr10 l 7177 (Adrienne M Tucker, et al., 2010) This research is needed since most of the experiments that have previously been carried out involve adults as the test subjects which doesn’t help to understand the effects of sleep deprivation on adolescents as their brains behaviour is vastly different from that of an adult as their brains are still developing whilst adults’ brains are fully developed. This study may also help people find possible solutions to the effects of sleep deprivation helping people to improve their health and performance in school and work.

Articles such as ‘Effects of Sleep Deprivation on Dissociated Components of Executive Functioning’ are write ups of studies that prove that a lack of sleep causes detrimental effects of varying results to the regular functioning of the brain when performing tasks CITATION Adr10 l 7177 (Adrienne M Tucker, et al., 2010). The ‘Consequences of Sleep Deprivation’ also showed links between sleep deprivation and other health issues such as stress and blood pressure both of which exhibited negative results. CITATION Pet11 l 7177 (Peter Franzen, et al., 2011)This study contains a mix of primary and secondary research findings through publishes articles and questionnaires filled out by male and female adolescents of ages 15-19. These questionnaires aim to find out how adolescents think they are affected by sleep deprivation in their mental performance, physical abilities and emotions. The questionnaires take roughly 10 minutes to fill out and can be done at home then returned to the investigator. The answers to said questionnaire will be able to give rough averages on what parts of an adolescent’s lifestyle are mostly affected by sleep deprivation and when cross referenced with the articles clear links can be made between existing studies on sleep deprivation in adults and this study on sleep deprivation in adolescents. This task is contributing to the already growing topic of sleep deprivation studies by being uniquely focused on adolescents to try give insight to the effects on developing rather than developed brains. The study is focused predominantly on adolescents as it seems to be an age demographic affected to a large extent by sleep deprivation without many findings of the results thereof. This is being conducted to fully understand what effects, whether negative or positive, sleeping under the recommended amount every night has on the development of adolescents.

AimTo determine the effects sleep deprivation has on the physical, mental and emotional health of an adolescent.

HypothesisSleep deprivation reduces adolescent’s mental and physical performances and is detrimental to their emotional health.

Literature ReviewSource 1Title of article: Sleep and its importance in adolescence and in common adolescent somatic and psychiatric conditions
Reference: International Journal of Medicine
Authors: Serge Brand and Roumen Kirov CITATION Ser11 l 7177 (Kirov, 2011)This article contained information regarding the biological nature of sleep including the sleep cycle and all the hormones and parts of the brain involved in the sleep cycle. The circadian and ultradian cycles are monitored when doing studies involving sleep as they are part of the sleep-wake cycle and consist of REM sleep and a lighter sleep type. The article touched on a few links between sleep and cognitive behaviour, memory, emotions and maintenance of homeostasis. For instance, it was noted that lack of sleep caused more cases of accidental injury or decisions that could be detrimental to the health of the individual. The study also witnessed academic deterioration in an adolescent who was not getting enough sleep and the worsening of effects of mental illnesses such as anxiety, depression, OCD and eating disorders. The article concludes that sleep is exceptionally vital to physiological, cognitive and psychological processes therefore it can be inferred that a lack of sleep will affect these processes.
The article delved deeply into adolescent’s sleep patterns and the necessity of sleep in a developing adolescent. In the article many studies were referenced to show the findings, many of which were incomplete CITATION Gol04 l 7177 (Golan N, 2004) CITATION Kir04 l 7177 (Kirov R, 2004)CITATION htt07 l 7177 (Anon., 2007). The article revealed the effect of psychological disorders on sleep patterns more than the effects of sleep deprivation on psychological disorders although this was briefly mentioned, CITATION Kon10 l 7177 (Konofal E, 2010) CITATION Kim10 l 7177 (Kim KR, 2010) CITATION Win11 l 7177 (Winkelman JW, 2011).

The article suggested a seeming perpetual cycle regarding the effects of sleep deprivation on pre-existing psychological conditions CITATION Bre96 l 7177 (Breslau N, 1996) CITATION Got10 l 7177 (Gotlib IH, 2010). It was proposed that the psychological disorders caused disrupted or incomplete sleep which in turn aggravated the symptoms of that disorder following the sleep alteration CITATION Kob04 l 7177 (Kobayashi T, 2004) CITATION Hat04 l 7177 (Hatzinger M, 2004).

The source was not very useful as this study is on the effects of sleep deprivation while the article only briefly mentioned those whilst focusing most of the attention on factors that cause sleep deprivation. The source is reliable as it was written by two medical professionals in the fields of neurobiology and sleep research who cited many other credible investigations in this field CITATION Die10 l 7177 (Diekelmann S, 2010) CITATION Bód05 l 7177 (Bódizs R, 2005) CITATION Kir11 l 7177 (Kirov R, 2011) CITATION Man11 l 7177 (Mander BA, 2011) CITATION Sch06 l 7177 (Schabus M, 2006) CITATION Sch08 l 7177 (Schabus M, 2008) CITATION Cir08 l 7177 (Cirelli C, 2008). The source was very limited though as a lot of the studies used yielded incomplete results due to medication being taken by the subjects for their disorders had different effects on the subjects and hence each subject’s result. CITATION Mon07 l 7177 (Monti JM, 2007) CITATION Rye04 l 7177 (DB, 2004) The information in this article is valid although it does not correlate strongly to the research question and so, as stated above, was not very useful.

Source 2Title of article: Effects of Sleep Deprivation on Dissociated Components of Executive Functioning
Reference: Oxford Academic
Authors: Adrienne M Tucker, Paul Whitney, Gregory Belenky, John M Hinson, Hand PA van Dongen CITATION Placeholder1 l 7177 (Adrienne M Tucker, et al., 2010)This article was the write up of a sleep deprivation study conducted to see the effects sleep deprivation has on executive cognitive functioning controlled by the prefrontal cortex. It includes the outline of how the experiment was conducted and reviews the result in great detail.

The results were compared to baseline tests of the same nature and a control group to ensure accurate findings and here is what was discovered: sleep deprivation was detrimental to the outcome of some of the tasks performed but the tasks performed were not only executive in nature, when they used algorithms to separate the executive from the non-executive functions they found that most of the negative effects were in relation to the non-executive functions CITATION Whi04 l 7177 (Whitney P, 2004) and some of the effects of sleep deprivation were even positive to the executive functions CITATION Lim08 l 7177 (Lim J, 2008).

Comparison lines were drawn between this experiment and others of the same nature to duplicate results CITATION Van051 l 7177 (Van Dongen HPA, 2005) or explain how different results were obtained CITATION Jon01 l 7177 (Jones K, 2001). The other previously done experiments also helped to give controls against which they could compare some of the less result producing aspects of the study. CITATION Van03 l 7177 (Van Dongen HPA, 2003)This article was very valid as it related very closely to the research question and provided insight into how results for such a question can be obtained. It was written and performed by credible scientists under strict conditions and it was very logical and well thought out. It is extremely useful as it gives a platform from which more answers to the proposed question can be added. The source is reliable as it is the write up of a professional scientific premise meaning it would not have been published if it were not credible or accurate, it is also backed up by the numerous studies of the same nature which produced similar results and were referred to frequently in the study CITATION Van05 l 7177 (Van Dongen HPA, 2005). Some limitations occur due to the narrowness of the question this experiment was answering but that helped to get very precise results. Other limitations arise from the fact that the results obtained were not for the initial intent of the experiment so were not discussed in detail in the findings as the researchers could not be sure that they were correct. Limitations may also arise from inconsistencies in results between this study and others of the same nature relating to executive functions but due to the results relating to non-executive functions being consistent it can be seen as viable. The authors also noted that due to their tests being so specific this is not an accurate representation for all executive functions but rather the few explored in this experiment, which is limiting.

Source 3
Title of article: The effects of sleep and sleep deprivation on task-switching performance
Reference: Wiley Online Library
Authors: Alessandro Couyomdjian, Stefano Sdoia, Daniela Tempesta, Giuseppe Curcio, Elisabetta Rastellini, Luigi de Gennaro, Michelle Ferrara CITATION Placeholder2 l 7177 (Alessandro Couyoumdjian, 2010)This article was the write up of a study done to investigate the effects of sleep deprivation of the ability of the mind to rapidly switch between tasks. Task switching as a whole can be split up into three individual tasks each of which were assessed individually in this study. This ability is controlled by the prefrontal cortex CITATION Mei96 l 7177 (Meiran, 1996).

The study yielded the results that the general task-switching ability is negatively affected by just one night of sleep deprivation but was fully restored after one night of recovery sleep. It also showed that in isolating each of the tasks results no crucial interaction between them and sleep deprivation were observed. The article contains many references to other similar studies against which the results were compared CITATION Dru99 l 7177 (Drummond, 1999) CITATION Dru00 l 7177 (Drummond, 2000) CITATION Har98 l 7177 (Harrison, 1998) CITATION Har99 l 7177 (Harrison, 1999) CITATION Har01 l 7177 (Harrison, 2001) CITATION Har00 l 7177 (Harrison, 2000) CITATION Wim92 l 7177 (Wimmer, 1992). The authors made several predictions about the different functionalities of the different part of the prefrontal cortex but with no evidence backing these statements up they can be ignored in this study.
The conclusion was that sleep deprivation adversely affects the prefrontal cortex since that is where most high cognitive functions take place and therefore it needs the most rest. This corresponds with a hypothesis stating that sleep plays an important role in neuronal networks which therefore makes the prefrontal cortex particularly susceptible to sleep deprivation due to its hyperactivity during periods of wake CITATION Kru08 l 7177 (Krueger, 2008).

This source was valid as it closely links to the research question posed but it is very limited as it focuses on only one cognitive function. The conclusion is reliable to an extent as it is drawn from little data since the prefrontal cortex is in control of many functions and this experiment only tested the effects of sleep deprivation on one, but other studies are able to replicate the results. The authors appear to be credible as this experiment was completed by a university within legal parameters. The source will be useful as it contains more insight into an answer for the question posed. It is logical and so will be valid to an extent provided the conclusion is not used individually due to its lack of supporting evidence.

Source 4Title of article: Consequences of sleep deprivation
Reference: APAPsycNet
Author: Jolanta Orzel-Gryglewska CITATION Placeholder3 l 7177 (Orzel-Gryglewska, 2010)This article refers to studies completed throughout the years on both animals and humans. The article speaks of the health effects sleep deprivation has in humans.

Sleep deprivation has been known to cause a few ailments including, high blood pressure, deterioration of vision and perception, weakened concentration, impaired memory, longer reaction time, lessened capabilities, increased errors, poor memory and schematic thinking resulting in wrong decisions, lessened interpersonal responses, and increased aggressiveness. In severe cases of sleep deprivation, the effects can be as bad as intoxication of up to 0.10% blood alcohol level. Sleep deficiency has also been noticed to intensify muscle tonus and coexisting tremor, create monotonous and unclear speech, and lower one’s pain threshold CITATION 10In l 7177 (Anon., 2010).
In most of the studies it was shown that the effects dissipate greatly after one night of recovery sleep which indicate that the effects will not be long term and do not adversely affect the cells, neurons or vital organs, although it should be noted that in the animal study several animals died from the extreme sleep deprivation, this was not the case with humans as testing never became that extreme but could possibly be the effect. Several long-term effects that were mentioned as becoming higher risk due to sleep deprivation include: obesity, hypertension, and lessened hormone release.

This article was very useful as it explored many effects of sleep deprivation which gives a wide range of answers to the question asked. The source is valid as it closely relates to the topic at hand and was published in a medical journal making it a very credible source and it was logical and referenced many experiments on the topic CITATION Bon01 l 7177 (Bonnet MH, 2001) CITATION Ban07 l 7177 (Banks S, 2007) CITATION Pat96 l 7177 (Patrick GT, 1896) CITATION Kol68 l 7177 (Kollar EJ, 1968) CITATION Wil62 l 7177 (RT, 1962) CITATION One01 l 7177 (Onen SH, 2001) CITATION Har97 l 7177 (Harrison Y, 1997) CITATION Bjo07 l 7177 (Bjorvatn B, 2007). The source does not seem limited as it has been compiled from a great number of sources and does not focus on only one effect.

Source 5Title of article: Cardiovascular reactivity to acute psychological stress following sleep deprivation
Reference: HHS
Authors: Peter L Franzen, Peter J Gianaros, Anna L Marsland, Marticia H Hall, Greg J Siegle, Ronald E Dahl, Daniel J BuysseCITATION Placeholder4 l 7177 (Peter Franzen, et al., 2011)This article was the write up of an experiment conducted to research the effects that sleep deprivation has on stress and consequently blood pressure. This experiment was overseen by medical professionals who induced stressful situations to measure the blood pressure of the individuals and compare this blood pressure to the blood pressure recorded in non-stressful situations(baseline). It was stated in the write up that stress and sleep deprivation seem to work correspondingly each inducing the other CITATION Ake06 l 7177 (T, 2006). In the tests variables that would interfere with blood pressure readings such as delivery of a speech were accounted for to ensure accurate results.
The results showed that in some of the induced stressful situations blood pressure was increased and sleep deprivation amplified those results. It was also noted that the baseline systolic blood pressure was higher during the sleep deprivation part of the study. This shows that sleep deprivation enhances the stress felt by an individual showing an emotional effect of sleep deprivation. It was proposed that stress and sleep deprivation together may increase an individual’s probability of suffering from a cardiovascular disease in the future, but more study is required for this CITATION Mat04 l 7177 (Matthews KA, 2004) CITATION Car01 l 7177 (Carroll D, 2001) CITATION Tre03 l 7177 (Treiber FA, 2003). The authors do note that their results directly contradict results obtained in other studies CITATION Pag09 l 7177 (Pagani M, 2009) but reproduces results of other studies CITATION Lus96 l 7177 (Lusardi P, 1996) CITATION Toc96 l 7177 (Tochikubo O, 1996) and that various studies of this type are producing a wide variety of results. The results they witnessed seem to be closely related to age of participants, older participants are more at risk than younger ones, as recorded in another study CITATION Rob11 l 7177 (Robillard R, 2011).

This source is useful as it has a close link to the proposed question although it isn’t very valid as the target group was very small and the results do not seem to be averaged as other studies have turned up different results. The people who wrote this source are credible doctors or master’s degree holders and the experiment was a valid one, the results are just not entirely accurate since there were too many variables not accounted for. It is limited regarding the variables that may have skewed the results and the sample size.

MethodologyThis study involved 35 adolescents both male and female. There were no requirements for the participants other than they had to be adolescents between the ages of 15 and 19 since this study focused on adolescents. All of the participants were either in school or students in university meaning the results reflect their finding on their performance in their particular branch of education.

How the experiment was conducted:
Questionnaires were created with questions pertaining to physical, emotional and mental (learning based) alterations caused by sleep deprivation.

Consent forms were also made since many of the participants would be under 18 years old.

The questionnaires were handed out to 35 adolescents and the consent forms were handed out only to those of the group who were under 18 years old at the time.

They all completed the questionnaire which on average took no longer than 10 minutes.

The questionnaires, along with the consent forms where necessary, were handed back to the researcher.

The researcher then reviewed each questionnaire and determined whether they were usable or not, all of the questionnaires were usable (no questions left blank, no joke answers or crude language)
The researcher then compiled what information could be put into graphs or tables into graphs and tables to observe trends.

No ethical concerns came up as this topic doesn’t affect any groups directly but rather the entire population collectively. All of the participants that were underage had consent forms signed by a parent or guardian who was deemed legally fit to provide informed consent. The participants who were not underage gave verbal consent to take part in the study. In the researcher’s opinion all the participants were in full control of their mental faculties and so could provide accurate information to the best of their abilities. No risk to the participants was involved in this study and the questionnaires were completed anonymously. The language of the questions was unbiased although several questions were multiple choice meaning the researcher may have prompted several answers, but the participants were under no obligation to select any specific answers and if they deemed it necessary had space to write their own answers that weren’t provided in the options.

Presentation of FindingsFigure 1
A table to show the number of participants getting certain amounts of sleep
Amount of Sleep(hours) Number of participants
0-4 3
5-7 27
8+ 5
The information shows that the majority of people get between 5 and 7 hours of sleep a night with a few getting 8 or more hours and even fewer getting under 4 hours.

Figure 2

*The most common other symptoms were: feeling sick/nauseous and body aches including headaches.

Two of the most common effects on the mental state of the patient included trouble concentrating and becoming more emotional than usual. The graph then shows that the patients were more effected shown in the amount of time they took to complete tasks and then in having poor short-term memory. The lowest group said other which included mostly physical illnesses rather than effects on the mental state of the patients.

Figure 3

*All the symptoms grouped as ‘other’ were negative effects on the mood such as groggy, unsociable and emotional.

This graph shows that the common emotional indicators of stress in order of most to least common are: being tired, irritable, more prone to mood swings, more prone to stress. Those were all very common in the test group the far less common included sad, depressed, overly energetic, and happy. Other was also present in a very small group and generally outlined more negative effects on the emotional state of the participant.

Figure 4
A table to show the number of participants and how they perform academically on less sleep than required
Academic Performance in comparison to normal Number of participants
Better 6
Worse 29
This table shows that the students and scholars found themselves to be performing worse under less that the required amount of sleep on average.

Figure 5
A table to show the number of participants who felt they were physically affected by the lack of sleep
Physically Affected Number of Participants
Yes 23
No 12
This table indicates that an adolescent is far more likely to find themselves affected physically from sleep deprivation than not.

Processing of FindingsIn figures 2-5 it can be witnessed that the trends all indicate negative effects on the individuals who have had under the required amount of sleep. Figure 1 shows the trend of poor sleeping habits showing that most people get between 5 and 7 hours of sleep a night and although this is close to the recommended 8 hours the lack of sleep, even by only 1 hour can still affect performance. Figure 2 shows how people’s ability to concentrate and perform tasks as normal is compromised when working after under 8 hours of sleep. Figure 3 shows how the emotions of people can be greatly altered by not getting enough sleep and can often cause irritability and general moodiness as well as cause more stress than usual which, in itself, can be detrimental to the health of an adolescent. Figure 4 shows how people find they perform academic tasks when functioning on less than required sleep and the general trend shows that more people feel that they perform worse than better. Figure 5 shows that most people also find that in some way their physical abilities are slightly impaired due to sleep deprivation.

These results are hard to compare to those of other studies since other studies worked off total sleep deprivation i.e. Up to 36 hours of no sleep while this study aimed to find the long-term effects of not getting enough sleep per night over extended periods of time. In a specific study CITATION Adr10 l 7177 (Adrienne M Tucker, et al., 2010), the researchers focused on executive functions (functions performed by the frontal lobe) and found that less sleep caused some detrimental effects to certain functions but not only those performed by the frontal lobe while these results show mostly detrimental effects or no effects to functions performed mostly by the frontal lobe. These results may differ due to the sample group in this study being made of adolescents and the sample group in that study being made of adults. The tests were also very different as this study relied on how the participants felt they were affected through self- monitoring, which can be less accurate as personal opinions are subjective rather than objective which is preferable in scientific investigations, and the other experiment had scientists observe a control and experiment group performing the same task to notice any changes which was more accurate as the scientists were detached from the test subjects and so able to be objective.

As per a study by Peter Franzen and associates CITATION Pet11 l 7177 (Peter Franzen, et al., 2011), it was shown that sleep deprivation elevates levels of stress in individuals which was examined in this study. This study didn’t just investigate stress though while the aforementioned study focusing on adults did meaning the rest of the results on the emotional state of the participants cannot be compared to the results of the other study. The methods of performing these studies were different but yielded similar results in both adolescents (this study) and adults (the corresponding study). Therefore, proving that sleep deprivation can negatively affect the emotional functioning of individuals.

Findings in a study on sleep deprivation CITATION Jol10 l 7177 (Orzel-Gryglewska, 2010) showed that several physical attributes can be negatively affected by sleep deprivation which is conclusive with the findings in this study that many of the individuals found their reaction times slower, impaired vision and others. The results from this study aren’t very easy to interprets as no options were given so too many forms of physical aspects were presented to find accurate trends but the physical aspects affected as found in the other study correlate to some of the ones found in this study showing slightly similar results such as slower reaction times. This proves similarities between the physical effects of sleep deprivation in adults and adolescents.

The findings of this study expand the existing body of knowledge on this topic as most other investigations have been centred around adults while this one focused solely on adolescents between 15 and 19 years of age. This study also investigated mental, emotional and physical effects equally while other studies focused so much on the mental effects that the emotional and physical effects were not explored in as much detail as they could have been. This study needs further investigation though so as to obtain fair results from averages sine this study had a small focus group of only 35 participants. This study may also be seen as not too reliable as it was based of self-assessment rather than objective observation by an external professional and so more studies should be carried out to test the validity and reliability of this study.

ConclusionThis experiment found that sleep deprivation in adolescents causes many detrimental effects to the mental, emotional and physical working of individuals. This experiment focused on sleep deprivation in the sense of not the correct amount of sleep needed every night for extended periods of time and worked mainly on average results of how the participant felt affected by this sleep deprivation.

The result that the researcher obtained reflect the hypothesis and so the researcher has accepted their hypothesis to be true.

This study had limitations as It only focused on adolescents, but this is accounted for as all the results were obtained from adolescents, so no outliers can exist due to this reason. It was also taken into account that these results were obtained from adolescents when comparing these results to these of other studies involving adults. Some of the results yielded showed a positive effect from the sleep deprivation but there were so few of these instances that researcher has deemed them to be negligible outliers.

These results were based mainly on opinion which was catered for by offering a selection of answers from which to choose to try to limit the amount of results making trends easier to observe. Although having opinion-based results may slightly affect the results obtained and so in future should a similar experiment be conducted it would be advisable to have the participants monitored by a third party to give better results. The experiment focused on slight sleep deprivation over extended times and so is not a fully accurate representation of the effects of sleep deprivation causing this study to be not entirely accurate and in need of further studies to validate it. This worked fairly well but having given the option for the participants to fill in some of their own options created very large groups of data that could be easily compared to one another but did show very slight trends that cannot be the sole focus of the study but can be mentioned in passing.

Should this study be repeated the researcher would suggest including a group of tests designed to investigate the mental, emotional and physical abilities of individuals to ensure that the data is all following one person’s perspective rather than the opinions of many different individuals. A larger sample group could also be advised so that the researcher can ensure that outliers do not have any major effects on the results. Better results might also be yielded should this study be completed in circumstances involving complete sleep deprivation over a short period.

References BIBLIOGRAPHY Adrienne M Tucker, P. et al., 2010. Oxford Academic. Online Available at: 21 03 2018.

Adrienne M Tucker, P. et al., 2010. Oxford Academic. Online Available at: 21 03 2018.

Alessandro Couyoumdjian, S. S. D. T. G. C. E. R. L. D. G. M. F., 2010. Wiley Online Library. Online Available at: 21 03 2018.

Alessandro Couyoumdjian, S. S. D. T. G. C. E. R. L. D. G. M. F., 2010. Wiley Online Library. Online Available at: 21 03 2018.

Anon., 2007. PubMed. Online Available at: 2018.

Anon., 2010. International Journal of Occupational Medicine and Environmental Health, Volume 23, pp. 95-114.

Banks S, D. D., 2007. Behavioral and physiological consequences of sleep restriction. J Clin Sleep Med.

Bjorvatn B, S. I. O. N. W. S. F. A. P. S. e. a., 2007. The association between sleep duration, body mass index and metabolic measures in the Hordaland Health Study. J Sleep Res, pp. 66-76.

Bódizs R, K. T. L. A., 2005. PubMed. Online Available at: 2018.

Bonnet MH, A. D., 2001. Clinical effects of sleep fragmentation versus sleep deprivation.. Sleep Med. Rev., pp. 297-310.

Breslau N, R. T. R. L. A. P., 1996. PubMed. Online Available at: 2018.

Carroll D, S. G. S. M. S. A. B. E. M. M., 2001. Blood pressure reactions to acute psychological stress and future blood pressure status: a 10-year follow-up of men in the Whitehall II study.. Psychosom Med, pp. 737-743.

Cirelli C, T. G., 2008. PubMed. Online Available at: 2018.

DB, R., 2004. PubMed. Online Available at: 2018.

Diekelmann S, B. J., 2010. PubMed. Online Available at: 2018.

Drummond, S. P. B. G. G. G. J. C. S. J. L. W. E. C. a. B. R. B., 2000. Altered brain response to verbal learning following sleep deprivation. Nature, p. 655–667.

Drummond, S. P. B. G. G. S. J. L. B. R. B. W. E. C. a. G. J. C., 1999. Sleep deprivation?induced reduction in cortical functional response to serial subtraction.. Neuroreport, p. 3745–3748.

Golan N, S. E. R. S. P. G., 2004. PubMed. Online Available at: 2018.

Gotlib IH, J. J., 2010. PubMed. Online Available at: 2018.

Harrison Y, H. J., 1997. Sleep deprivation affects speech. Sleep, pp. 871-877.

Harrison, Y. a. H. J. A., 1998. Sleep loss impairs short and novel language tasks having a prefrontal focus. Sleep Res, pp. 95-100.

Harrison, Y. a. H. J. A., 1999. One night of sleep loss impairs innovative thinking and flexible decision making.. Organ. Behav. Hum. Decis. Process., pp. 128-154.

Harrison, Y. a. H. J. A., 2000. The impact of sleep deprivation on decision making: a review. J. Exp. Psychol. Appl., pp. 236-249.

Harrison, Y. a. H. J. A., 2001. Sleep deprivation affects speech. Sleep, pp. 871-877.

Hatzinger M, H. U. B. S. I. M. H.-T. E., 2004. PubMed. Online Available at: 2018.

Jones K, H. Y., 2001. Frontal lobe function, sleep loss and fragmented sleep. Sleep Med Review, p. 5.

Kim KR, J. Y. S. M. N. K. K. J. L. J., 2010. PubMed. Online Available at: 2018.

Kirov R, K. J. H. S., 2004. PubMed. Online Available at: 2018.

Kirov R, U. H. A. B. B. T. R. A., 2011. Two faces of REM sleep in normal and psychopathological development.. Eur Psychiatry, pp. 26,422-423.

Kirov, S. B. a. R., 2011. Dove Medical Press. Online Available at: 21 03 2018.

Kobayashi T, G. C. M. K. S. R. G.-R. E., 2004. PubMed. Online Available at: Kobayashi T, Good C, Mamiya K, Skinner RD, Garcia-Rill EAccessed 2018.

Kollar EJ, N. N. P. R. N. P., 1968. Neurological findings during prolonged sleep deprivation. Neurology.

Konofal E, L. M. C. S., 2010. PubMed. Online Available at: 2018.

Krueger, J. M. R. D. M. R. S. V. D. H. P. B. G. a. P. J., 2008. Sleep as a fundamental property of neuronal assemblies.. Nat. Rev. Neurosci., pp. 910-919.

Lim J, D. D., 2008. Sleep deprivation and vigilant attention.. s.l.:s.n.

Lusardi P, M. A. P. P. Z. A. D. G. F. R., 1996. Effects of a restricted sleep regimen on ambulatory blood pressure monitoring in normotensive subjects. Am J Hypertens, pp. 503-505.

Mander BA, S. S. S. J. W. M., 2011. PubMed. Online Available at: 2018.

Matthews KA, K. C. M. H. W. M. W. D. Z. S. M. J., 2004. Blood pressure reactivity to psychological stress predicts hypertension in the CARDIA study. Circulation, pp. 74-78.

Meiran, 1996. s.l.:s.n.

Monti JM, M. D., 2007. PubMed. Online Available at: 2018.

Onen SH, A. A. G. A. E. A. D. C., 2001. The effects of total sleep deprivation, selective sleep interruption and sleep recovery on pain tolerance thresholds in healthy subjects.. J Sleep Res, pp. 35-42.

Orzel-Gryglewska, J., 2010. Online Available at: Accessed 21 03 2018.

Orzel-Gryglewska, J., 2010. APAPsycNet. Online Available at: 21 03 2018.

Pagani M, P. P. T. A. F. C. B. S. B. M. C.-S. M. B. S. B. O. L. D. P. P., 2009. Hemodynamic, autonomic and baroreflex changes after one night sleep deprivation in healthy volunteers. Auton Neurosci, pp. 76-80.

Patrick GT, G. J., 1896. Studies from the psychological laboratory of the University of Iowa: On the effects of loss of sleep. Psychol Rev.

Peter Franzen, P. et al., 2011. HHS Public Access. Online Available at: 21 03 2018.

Peter Franzen, P. et al., 2011. HHS Public Access. Online Available at: 21 03 2018.

Robillard R, L. P. P. F. F. D. C. J., 2011. Sleep deprivation increases blood pressure in healthy normotensive elderly and attenuates the blood pressure response to orthostatic challenge. Sleep, pp. 335-339.

RT, W., 1962. Muscle tension during mental work under sleep deprivation. Muscle tension during mental work under sleep deprivation, pp. 565-571.

Schabus M, H. K. G. G., 2006. PubMed. Online Available at: 2018.

Schabus M, H. K. P. T., 2008. PubMed. Online Available at: 2018.

T, A., 2006. Psychosocial stress and impaired sleep. Scand J Work Environ Health, pp. 493-501.

Tochikubo O, I. A. M. E. I. M., 1996. Effects of insufficient sleep on blood pressure monitored by a new multibiomedical recorder.. Hypertension, pp. 1318-1324.

Treiber FA, K. T. S. N. S. D. K. G. T. T., 2003. Cardiovascular reactivity and development of preclinical and clinical disease states.. Cardiovascular reactivity and development of preclinical and clinical disease states., pp. 46-62.

Van Dongen HPA, D. D., 2005. Circadian rhythms in fatigue, alertness and performance.. Kryger MH, Roth T, Dement WC, eds. Principles and practice of sleep medicine, Volume 4, pp. 43-435.

Van Dongen HPA, D. D., 2005. Sleep, circadian rhythms, and psychomotor vigilance.. s.l.:s.n.

Van Dongen HPA, M. G. M. J. D. D., 2003. The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation.. s.l.:s.n.

Whitney P, J. T. H. J., 2004. Impulsiveness and executive control of working memory.. s.l.:s.n.

Wimmer, F. H. R. F. B. R. A. a. M. A. R., 1992. The effects of sleep deprivation on divergent thinking and attention processes.. J. Sleep Res., pp. 223-230.

Winkelman JW, J. E. R. L., 2011. Sleep-related Eating Disorder. In: C. S. Montagna P, ed. Sleep Disorders, Part 1. Handbook of Clinical Neurology Series. s.l.:s.n., p. 98.