Weakened Sustained Attention and Increased Cognitive Effort after Total Sleep Deprivation: A Virtual Reality Ecological Study

Total sleep deprivation (TSD) has a major impact on sustained attention as reported by previous studies that have investigated effects of TSD, however by using classical neuropsychological tests that lack ecological validity. To study the effects of TSD on daily-life activities, we carried out an ecological evaluation of sustained attention using a virtual reality task requiring driving along an unpredictable path. We enrolled 30 volunteers who underwent two experimental sessions: baseline (after normal sleep night) and after 36 h of total TSD. We assessed changes in sustained attentional performance by analysing the series of visuomotor adjustments while driving. After TSD, we found greater inaccuracy and longer attentional lapses. Furthermore, the visuomotor adjustments series exhibited higher long-range correlations (self-similarity) which has been associated with greater cognitive efforts. Sustained attention assessed by the ecological task requiring visuomotor coordination gets worse after 36 h of total TSD together with greater cognitive effort.