Psychologic and Psychiatric Assessment

Sleep disorders have a significant adverse impact on alertness, vigilance/sustained attention, and higher cognitive functions (e.g., executive functioning and visual memory) as well as mood/affect. Neuropsychological evaluation can be helpful to evaluate the extent and severity of adverse effects of sleep disruption on cognitive functioning. Neuropsychological assessment of deficits should target the assessment of vigilance/sustained attention (frequently using a continuous performance task), executive functions (sequencing, problem solving, disinhibition, and problem solving), mood/affective functioning, and, sometimes, visual memory. Neuropsychological evaluations can have implications for identifying the extent and severity of cognitive impairments. Treatment for insomnia can improve neuropsychological function. Patients with acute sleep deprivation show improved neuropsychological functioning with a variety of stimulant medications (e.g., dextroamphetamine, modafinil, ritalin, etc.). Patients with obstructive sleep apnea show improved neuropsychological functioning following initiation of continuous positive airway pressure or bilevel positive airway pressure. Neuropsychological evaluation is also a method to document the effectiveness of treatment for sleep disorders.