Delay discounting and effort discounting among

primary insomnia under sleep restriction of China:

The evidence from EEG and time-frequency

Course：DEP Training Research Proposal

Date due：5.27.22
Focused Question: Does sleep restriction affect delay discounting and effort
discounting in patients with primary insomnia disorder of China?

Abstract：

Sleep is an essential component of human health that is necessary for optimal

functioning both mentally and physically. Insufficient sleep can affect decision-making
negatively by impairing our ability to integrate prior outcome information accurately
into later decisions. To explore the effect of sleep restriction on delay discounting and
effort discounting in patients with primary insomnia, we will measure the discount rates
of two types of reward in resting wakefulness (RW) and sleep deprivation (SD)
conditions. The first two experiments were conducted in a crossover design, one after
a night of normal sleep (RW) and the other after a night of no sleep (SD). The first
experiment evaluated only time discounting, while the second evaluated time and effort
discounting. A third experiment will assess effort discounting.

Introduction：

Primary insomnia (PI) is a chronic clinical symptom characterized by the subjective

experience of sleep loss and disturbed sleep. Patients with PI show heightened arousal
and find it difficult to sleep in bed (Roth et al., 2007). It is a very common sleep disorder
among the general population.
The first goal of this study is to determine if a shift in delay discounting occurs in sleep-
deprived volunteers and primary insomniac. Paragraph error

The second goal of this study is to characterize effort discounting in sleep deprivation
and to compare delay and effort discounting in the same subjects. Effort discounting
refers to the discounting of rewards according to the effort required to attain them. Most
persons are willing to perform effortful tasks only if the reward is sufficiently large.
Correspondingly, lower reward-related brain activity is elicited when rewards come by
way of greater effort rather than less effort. In turn, one's willingness to expend effort
is dependent on the availability of energy resources. When resources are less available
as is the case in sleep deprivation, greater effort discounting might be expected. This
possibility is supported by studies showing that sleep loss decreases the willingness of
participants to perform more difficult tasks (Engle-Friedman et al., 2010).
With the development of cognitive neuroscience and technology, many neuroimaging
and electrophysiological studies have begun to explore the characteristics of changes in
cerebral cortex function caused by lack of sleep. The results of the study seem to
indicated that there are differences in the susceptibility of different parts of the cerebral
cortex to sleep restriction. In contrast, the prefrontal cortex is more susceptible to
complete sleep deprivation than another cortex.

Literature review：

A number of previous EEG studies have demonstrated that these electrophysiological

correlates of feedback processing are modulated by the riskiness of decision making
(Chandrakumar et al., 2018). Delta oscillations have been implicated in the
motivational relevance of the task and the salience of the target stimulus (Knyazev,
2007, 2012) and appear to be associated with reward processing (Cavanagh, 2015;
Knyazev, 2007). In a dynamic reinforcement learning task, Cavanagh found that delta
activity at different times reflected reward prediction error (RPE) and state prediction
error separately (Cavanagh, 2015). More specifically, early delta activity, which
constitutes reward positivity, may correspond to a surprising reward signal, while later
delta activity, which contributed to the P300 component, appeared to associate with
behavioral adjustments. Although not being interpreted in terms of risk processing, both
theta and delta oscillatory activity are modulated by risk parameters such as outcome
magnitude (Bernat et al., 2015; HajiHosseini et al., 2012; Leicht et al., 2013) and
outcome probability (Cohen et al., 2007; Hajihosseini & Holroyd, 2013). Moreover,
theta oscillation appears to predict risk-taking behaviors during gambling tasks
(Kamarajan et al., 2012; Pedroni et al., 2017; Schmidt et al., 2018; Zhang et al., 2013) ,
whereas delta oscillation is associated with motivation and conflict processes during
risk decisions (Pornpattananangkul et al., 2019).

Methodology：

We're going to use wrist activity recorders to monitor the actual sleep habits of the
participants during the experiment and they will keep records of the onset and offset of
all sleep bouts using sleep diaries. The order of the two sessions will be counterbalanced
across all the participants and separate by 1 week to minimize any residual effects of
sleep loss in participants whose SD session precede the RW session. For the RW session,
testing commenced at approximately 08:00. For the SD session, testing took place at
approximately 06:00, after participants had remained awake in the laboratory from
20:00 onward the night before. Throughout the sleep deprivation night participants will
be monitored under the supervision of a research assistant and will be allowed to engage
in nonstrenuous activities such as reading and watching videos. During the first 10 min
of every hour from 20:00 until 06:00, participants need to completed the psychomotor
vigilance task.
l Behavioral Tasks
Ø Delay Discounting Task

Figure 1. Delay Discounting Task.

Participants chose between pairs of monetary offers at different delays20 (Figure 1A).
In one of a pair of options (larger later option, or LL), the participant was promised $20
after a delay (1, 2, 3, 4, or 5 months in experiment one, and 2, 3, 4, 5, or 6 months in
experiments two and three). The alternative option (smaller sooner option, or SS) was
always smaller and earlier (immediate for experiment one and in 2 months for
experiments two and three). The magnitude of the SS offer started randomly between
$7 and $12, and then was varied between $0 and $20 using a binary search algorithm
according to the participant's choices.
Ø Effort/Delay Calibration Task

Figure 2. Effort/Delay Calibration Task.

To facilitate the comparison between delay and effort tasks, the subjective value that
participants assigned to offers in the two tasks had to be normalized. To do this, we
need to calibrate before trying to discount the task to find no difference between the
number of words and the number of delayed months (Figure 2). Participants chose
between pairs of monetary offers associated with different degrees of effort and
different degrees of delay. On one option of each pair, the participant could choose to
win $20 with some delay (2-6 months). On the other option, the participant could
choose to win $20 at the end of the experiment by typing a number of words. The
number of words started randomly between 50 and 100 words, and then was varied
between 0 and 350 using a binary search algorithm according to the participant's choices.
Doing this for six successive choices provided the participant's indifference point: the
number of words to type that participant found neither better nor worse than the delayed
$20.
Ø Effort Discounting Task
Figure 3. Effort Discounting Task.

Participants chose between pairs of monetary offers associated with different degrees
of effort (Figure 3). Effort consisted of typing a number of words backward in a future
session (i.e., not right after the task). The number of words was calibrated for each
participant (see effort/delay calibration task). Prior to performing this task participants
were familiarized with typing 50 words backward. On one option of each pair (the
larger harder option, or LH), the participant could win $20 for typing a number of words.
To provide the participant's indifference point: the amount of money the participant
found neither better nor worse than the harder $20 (Libedinsky et al., 2013).

Discussion：

Because impulsivity is not a unitary construct, it remains unclear whether changes in

risk preferences during sleep deprivation are related to other forms of impulsivity such
as motor impulsivity (acting without thinking).14 It is also possible that longer periods
of sleep deprivation might affect delay discounting in a similar manner to how
extending sleep deprivation to 49 h elicited behavioral shifts in risky decision making
that had not been evident at a shorter duration of sleep deprivation.

Conclusion：

We hypothesized that sleep deprivation led to an increase in effort discounting for

insomniacs, but did not affect delay discounting.

Recommendations：
It would be interesting to examine the extent to which the optimality of decisions shifts
as more simplified decision strategies are adopted when decision makers are sleep
deprived.

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