The Effect of Sleep Restriction on Cognitive Performance in Elite Cognitive Performers: A Systematic Review.

Study objectives To synthesise original articles exploring the effects of sleep restriction on cognitive performance specifically for Elite Cognitive Performers; i.e. those who engage in cognitively demanding tasks with critical or safety-critical outcomes in their occupation or area of expertise. Methods Backward snowballing techniques, grey literature searches, and traditional database searches (Embase, MEDLINE, Web of Science, Google Scholar, PSYCinfo, and SportDiscus) were used to obtain relevant articles. A quality assessment was performed, and risk of training effects was considered. Results were narratively synthesised. Fourteen articles fit the criteria. Cognitive outcomes were divided into three categories defined by whether cognitive demands were 'low-salience', 'high-salience stable', or 'high-salience flexible'. Results Low-salience tests (i.e., psychomotor vigilance tasks & serial reaction tests), mainly requiring vigilance and rudimentary attentional capacities, were sensitive to sleep restriction, however this did not necessarily translate to significant performance deficits on low-salience occupation-specific task performance. High-salience cognitive outcomes were typically unaffected unless when cognitive flexibility was required. Conclusions Sleep Restriction is of particular concern to occupations whereby individuals perform (a) simple, low-salience tasks or (b) high-salience tasks with demands on flexible allocation of attention and working memory, with critical or safety-critical outcomes.