Short sleep recovery partially restores decision-making alterations induced by total sleep deprivation

Abstract The dynamics of recovery from impaired decision-making after total sleep deprivation (TSD) are not well understood. We investigated the impact of TSD and subsequent 3 h sleep recovery night period on decision-making. After one baseline night (8 h Time in Bed [TIB], 23:00–07:00), 40 study participants (50 per cent women) followed a sleep deprivation protocol including one night of TSD (40 h continuous awakening), followed by 3 h TIB sleep recovery period (23:00–02:00) and 8 h TIB sleep recovery period. Indices derived from reaction time (RT), Go/No-Go, and complex Go/No-Go tasks (involving perceptual components, motor responses, RT, and accuracy) were assessed daily during dual-choice decision-making tasks (MindPulse Digital Battery). Composite indices to describe executive speed, reaction to difficulty, speed/accuracy balance, and parameters from decision diffusion model analysis were recorded. Errors and RT increased after TSD and remained elevated after a 3-h sleep recovery night, particularly for Go/No-Go tasks. Anticipation and inhibition errors as well as speed/accuracy balance are not restored by 3 h sleep recovery night, whereas RT was restored. Lower decision diffusion model drift values (i.e. slower information accumulation) observed in the higher difficulty (complex Go/No-Go) after TSD, persisted after the 3-h recovery night. All parameters were restored after an 8-h TIB recovery night. No effect of sleep loss on executive speed and reaction to difficulty was observed. In conclusion, short sleep recovery partially restored decision-making alterations induced by TSD. Slower perceptual and motor processes that persist after a short recovery night may favor errors, with possible operational consequences for shift or on-call workers. Clinical trial: NCT05924737, https://clinicaltrials.gov/study/NCT05924737, 2023_RECOPS study, registered 2023-06-12 (Study start 2023-10-01). Clinical Trial Informations: Delta Waves and Cognitive Recovery (RECOPS), NCT05924737, https://clinicaltrials.gov/study/NCT05924737, study record: 2023-06-20, study start: 2023-10-01. Statement of Significance Sleep deprivation altered decision-making performance. In this work, we observed for the first time that a short sleep recovery (3 h Time in Bed) partially restored decision-making alterations induced by total sleep deprivation. The most complex tasks remained affected by sleep deprivation. The slowing down of perceptual and motor processes that persisted after a short night of recovery may have increased errors in decision-making, with possible operational consequences for shift workers or on-call workers.