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Conclusions: Since chronic restriction of sleep to 6 h or less per night

produced cognitive performance deficits equivalent to up to 2 nights of
total sleep deprivation, it appears that even relatively moderate sleep
restriction can seriously impair waking neurobehavioral functions in
healthy adults. Sleepiness ratings suggest that subjects were largely
unaware of these increasing cognitive deficits, which may explain why the
impact of chronic sleep restriction on waking cognitive functions is often
assumed to be benign. Physiological sleep responses to chronic restric-
tion did not mirror waking neurobehavioral responses, but cumulative
wakefulness in excess of a 15.84 h predicted performance lapses across
all four experimental conditions. This suggests that sleep debt is perhaps
best understood as resulting in additional wakefulness that has a neuro-
biological “cost” which accumulates over time.