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. 2018 Aug 1;41(8):zsy098.
doi: 10.1093/sleep/zsy098.

Increased vulnerability to attentional failure during acute sleep deprivation in women depends on menstrual phase

Parisa Vidafar  1 , Joshua J Gooley  2   3   4 , Angus C Burns  1 , Shantha M W Rajaratnam  1   2   3 , Melanie Rueger  2   3 , Eliza Van Reen  5 , Charles A Czeisler  2   3 , Steven W Lockley  1   2   3 , Sean W Cain  1   2   3
Affiliations

Increased vulnerability to attentional failure during acute sleep deprivation in women depends on menstrual phase

Parisa Vidafar et al. Sleep. .

Abstract

Study objectives: To investigate sex differences in the effect of sleep deprivation on performance, accounting for menstrual phase in women.

Methods: We examined alertness data from 124 healthy women and men (40 women, 84 men; aged 18-30 years) who maintained wakefulness for at least 30 hr in a laboratory setting using a constant routine protocol. Objective alertness was assessed every 2 hr using a 10 min psychomotor vigilance task. Subjective alertness was assessed every hour via the Karolinska Sleepiness Scale.

Results: Women in the follicular phase of the menstrual cycle demonstrated the poorest level of performance. This poor performance was most pronounced at times corresponding to the typical sleep episode, demonstrating a window of vulnerability at night during this menstrual phase. At 24 hr awake, over 60 per cent of their responses were lapses of >500 ms and over one-third of their responses were longer lapses of at least 3 s in duration. Women in the luteal phase, however, were relatively protected from alertness failure, performing similar or better than both follicular-phase women and men.

Conclusions: These results have important implications for education and intervention programs for shift workers, specifically during times of vulnerability to attentional failure that increase risk of injury.

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Figures

Figure 1.
Figure 1.
Representative Raster plot of the study protocol. Black bars represent 8 hr self-selected scheduled sleep episodes. White areas represent scheduled wake on baseline days. Gray bars represent the 30–50 hr constant routine in dim light (30 hr CR pictured). Baseline sleep periods were timed based on typical sleep time for the week preceding admit to the study.
Figure 2.
Figure 2.
PVT performance by group. Line graphs (A, C, E, and G) depict least-square means and standard error of the means (SEMs) of PVT performance as a function of time awake for men (gray circles), follicular (red), and luteal (blue) phase women. Dotted-line bars represent typical sleep periods (16–24 hr). Bar graphs (B, D, F, and H) adjacent to each line graph depict the least-square means and SEMs for the change (Δ) in each performance index from PVTs during typical wake to those during typical sleep, within-groups. *p < 0.05, **p < 0.01, ***p < 0.001 for independent sample t-tests.
Figure 3.
Figure 3.
Log reaction time distributions for men (gray) and women in either the luteal (blue) or follicular (red) phase of the menstrual cycle during the day (A) and night (B). Group means and standard error of the means (SEMs) at each percentile are presented. Pairwise comparisons were performed at the 5th, 25th, 75th, and 95th percentiles. Asterisks to the left of the curves indicate comparisons of men with luteal-phase women. Asterisks on the right-hand side of the curves indicate comparisons of follicular-phase women with both men (gray asterisks) and luteal-phase women (blue asterisks). *p < 0.05, **p < 0.01, ***p < 0.001 for independent sample t-tests.
Figure 4.
Figure 4.
Core body temperature in women in the luteal or follicular phases of the menstrual cycle. (A) CBT profiles for follicular (red) and luteal (blue) women. Data were aligned with CBT minimum for every individual as 0°. Asterisks indicate significant comparisons (p < 0.05). (B) Box-plots of CBT amplitude in follicular and luteal women. Whiskers show the minimum and maximum values.
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