{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T20:22:48Z","timestamp":1793996568478,"version":"4.8.0"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Sleep is vital for physical and mental health, yet sleep deprivation is a widespread issue that may impair cognitive flexibility, leading to rigid thinking and slower decision-making. This scoping review synthesizes evidence on the impact of sleep deprivation or sleep loss on cognitive flexibility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To provide a comprehensive understanding of the complex and multifaceted effects of sleep deprivation on cognitive flexibility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched PubMed, Web of Science, ClinicalKey, Cochrane, Scopus, SinoMed, and CNKI for studies evaluating the effects of sleep deprivation on cognitive flexibility. Two researchers independently screened and extracted data, assessing study quality using the Mixed Method Appraisal Tool (MMAT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 410 retrieved articles, 6 randomized controlled trials and 11 non-randomized studies were included, focusing on the impact of sleep deprivation on cognitive flexibility across children, adolescents, college students, clinicians, athletes, and other adults. Eight studies found that sleep deprivation reduces cognitive flexibility, six reported no significant impact, and two noted temporary improvements due to physical stress. One study highlighted that being overweight exacerbates the negative effects of sleep deprivation on cognitive flexibility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sleep deprivation may predominantly impair accuracy rather than reaction time. Total sleep deprivation consistently reduces task-switching accuracy and cognitive flexibility, whereas partial sleep deprivation's effects remain unclear. The primary biological mechanisms involve decreased cerebral oxygen supply, impaired cerebrovascular reactivity, and alterations in gene expression and hormone levels. Rigorous randomized trials with objective measures are needed to assess long-term impacts across populations and age groups.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnins.2025.1626309","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T05:31:28Z","timestamp":1753162288000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["The effects of sleep deprivation on cognitive flexibility: a scoping review of outcomes and biological mechanisms"],"prefix":"10.3389","volume":"19","author":[{"given":"Xuefeng","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihan","family":"Qu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaotu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinye","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haifeng","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongshi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1080\/11101849.2020.1768630","article-title":"Effects of partial sleep deprivation following night shift on cognitive functions of Egyptian anesthesiologists: prospective observational study","volume":"36","author":"Abdelhamid","year":"2020","journal-title":"Egypt. J. Anaesth."},{"key":"B2","doi-asserted-by":"publisher","first-page":"335","DOI":"10.5665\/sleep.1690","article-title":"The BDNF Val66Met polymorphism modulates sleep intensity: EEG frequency- and state-specificity","volume":"35","author":"Bachmann","year":"2012","journal-title":"Sleep"},{"key":"B3","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.jbtep.2018.02.002","article-title":"The effects of one night of partial sleep deprivation on executive functions in individuals reporting chronic insomnia and good sleepers","volume":"60","author":"Ballesio","year":"2018","journal-title":"J. Behav. Ther. Exp. Psychiatry"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e487","DOI":"10.1371\/journal.pmed.0030487","article-title":"Impact of extended-duration shifts on medical errors, adverse events, and attentional failures","volume":"3","author":"Barger","year":"2006","journal-title":"PLoS Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e93298","DOI":"10.1371\/journal.pone.0093298","article-title":"Psychological and behavioral changes during confinement in a 520-day simulated interplanetary mission to Mars","volume":"9","author":"Basner","year":"2014","journal-title":"PLoS ONE"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1073\/pnas.1710323115","article-title":"Laminar recordings in frontal cortex suggest distinct layers for maintenance and control of working memory","volume":"115","author":"Bastos","year":"2018","journal-title":"Proc. Natl. Acad. Sci. USA."},{"key":"B7","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1093\/sleep\/22.3.328","article-title":"Short-term total sleep deprivation does not selectively impair higher cortical functioning","volume":"22","author":"Binks","year":"1999","journal-title":"Sleep"},{"key":"B8","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1016\/j.sleep.2024.11.005","article-title":"The impact of sleep restriction on cerebrovascular reactivity and cognitive outcomes in healthy adolescents: a pilot crossover trial","volume":"124","author":"Chan","year":"2024","journal-title":"Sleep Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1111\/medu.14296","article-title":"Acute and chronic sleep deprivation in residents: cognition and stress biomarkers","volume":"55","author":"Choshen-Hillel","year":"2021","journal-title":"Med. Educ."},{"key":"B10","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/bs.pbr.2019.01.007","article-title":"The impact of sleep deprivation on declarative memory","volume":"246","author":"Cousins","year":"2019","journal-title":"Prog. Brain Res."},{"key":"B11","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1016\/j.tins.2015.07.003","article-title":"Demystifying cognitive flexibility: implications for clinical and developmental neuroscience","volume":"38","author":"Dajani","year":"2015","journal-title":"Trends Neurosci."},{"key":"B12","doi-asserted-by":"publisher","first-page":"3745","DOI":"10.1097\/00001756-199912160-00004","article-title":"Sleep deprivation-induced reduction in cortical functional response to serial subtraction","volume":"10","author":"Drummond","year":"1999","journal-title":"Neuroreport"},{"key":"B13","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1038\/s41386-021-01132-0","article-title":"The role of prefrontal cortex in cognitive control and executive function","volume":"47","author":"Friedman","year":"2022","journal-title":"Neuropsychopharmacology"},{"key":"B14","doi-asserted-by":"publisher","first-page":"107","DOI":"10.5935\/1984-0063.20200049","article-title":"Sleep deprivation effects on basic cognitive processes: which components of attention, working memory, and executive functions are more susceptible to the lack of sleep?","volume":"14","author":"Garc\u00eda","year":"2021","journal-title":"Sleep Sci."},{"key":"B15","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.bbr.2017.09.025","article-title":"Impaired cognitive flexibility during sleep deprivation among carriers of the brain derived neurotrophic factor (BDNF) Val66Met allele","volume":"338","author":"Grant","year":"2018","journal-title":"Behav. Brain Res."},{"key":"B16","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.maturitas.2019.04.214","article-title":"Sleep disorders and cognitive alterations in women","volume":"126","author":"Guarnieri","year":"2019","journal-title":"Maturitas"},{"key":"B17","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1016\/j.cell.2024.11.027","article-title":"Norepinephrine-mediated slow vasomotion drives glymphatic clearance during sleep","volume":"188","author":"Hauglund","year":"2025","journal-title":"Cell"},{"key":"B18","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.sleh.2014.12.010","article-title":"National Sleep Foundation's sleep time duration recommendations: methodology and results summary","volume":"1","author":"Hirshkowitz","year":"2015","journal-title":"Sleep Health"},{"key":"B19","doi-asserted-by":"publisher","first-page":"285","DOI":"10.3233\/EFI-180221","article-title":"The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers","volume":"34","author":"Hong","year":"2018","journal-title":"Educ. Inf."},{"key":"B20","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.aap.2018.02.013","article-title":"Cognitive flexibility: a distinct element of performance impairment due to sleep deprivation","volume":"126","author":"Honn","year":"2019","journal-title":"Accid. Anal. Prev."},{"key":"B21","doi-asserted-by":"publisher","first-page":"727959","DOI":"10.3389\/fimmu.2021.727959","article-title":"Sleep deprivation disturbs immune surveillance and promotes the progression of hepatocellular carcinoma","volume":"12","author":"Huang","year":"2021","journal-title":"Front. Immunol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1038\/s41386-019-0432-6","article-title":"Sleep deprivation, vigilant attention, and brain function: a review","volume":"45","author":"Hudson","year":"2020","journal-title":"Neuropsychopharmacology"},{"key":"B23","doi-asserted-by":"publisher","first-page":"58","DOI":"10.4062\/biomolther.2019.192","article-title":"Impact of sleep disorder as a risk factor for dementia in men and women","volume":"28","author":"Jee","year":"2020","journal-title":"Biomol. Ther."},{"key":"B24","doi-asserted-by":"publisher","first-page":"65","DOI":"10.2147\/JEP.S11143","article-title":"Pharmacological modulation of brain levels of glutamate and GABA in rats exposed to total sleep deprivation","volume":"2","author":"Kamal","year":"2010","journal-title":"J. Exp. Pharmacol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"91","DOI":"10.17712\/nsj.2023.2.20220108","article-title":"The consequences of sleep deprivation on cognitive performance","volume":"28","author":"Khan","year":"2023","journal-title":"Neurosciences"},{"key":"B26","doi-asserted-by":"publisher","first-page":"z105","DOI":"10.1093\/sleep\/zsz105","article-title":"The National Center on Sleep Disorders Research: progress and promise","volume":"42","author":"Kiley","year":"2019","journal-title":"Sleep"},{"key":"B27","doi-asserted-by":"publisher","first-page":"127","DOI":"10.3109\/00207450108986529","article-title":"The effect of total sleep deprivation on cognitive functions in normal adult male subjects","volume":"109","author":"Kim","year":"2001","journal-title":"Int. J. Neurosci."},{"key":"B28","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1007\/s41105-022-00396-3","article-title":"Effects of partial sleep deprivation on prefrontal cognitive functions in adolescents","volume":"20","author":"Kiri\u015f","year":"2022","journal-title":"Sleep Biol. Rhythm."},{"key":"B29","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1037\/a0018883","article-title":"A meta-analysis of the impact of short-term sleep deprivation on cognitive variables","volume":"136","author":"Lim","year":"2010","journal-title":"Psychol. Bull."},{"key":"B30","doi-asserted-by":"publisher","first-page":"687","DOI":"10.5665\/sleep.5552","article-title":"Cognitive performance, sleepiness, and mood in partially sleep deprived adolescents: the need for sleep study","volume":"39","author":"Lo","year":"2016","journal-title":"Sleep"},{"key":"B31","doi-asserted-by":"publisher","first-page":"100057","DOI":"10.1016\/j.nbas.2022.100057","article-title":"The prevalence of sleep loss and sleep disorders in young and old adults","volume":"3","author":"Madan Jha","year":"2022","journal-title":"Aging Brain"},{"key":"B32","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1007\/s00134-015-4115-4","article-title":"Night shift decreases cognitive performance of ICU physicians","volume":"42","author":"Maltese","year":"2016","journal-title":"Intensive Care Med."},{"key":"B33","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/S0301-0082(00)00014-9","article-title":"Brain-derived neurotrophic factor in the control human brain, and in Alzheimer's disease and Parkinson's disease","volume":"63","author":"Murer","year":"2001","journal-title":"Prog. Neurobiol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/j.bandc.2009.03.005","article-title":"The Wisconsin Card Sorting Test and the cognitive assessment of prefrontal executive functions: a critical update","volume":"71","author":"Nyhus","year":"2009","journal-title":"Brain Cogn."},{"key":"B35","doi-asserted-by":"publisher","first-page":"609","DOI":"10.3357\/AMHP.5056.2018","article-title":"A pilot study exploring the effects of sleep deprivation on analogue measures of pilot competencies","volume":"89","author":"O'Hagan","year":"2018","journal-title":"Aerosp. Med. Hum. Perform."},{"key":"B36","doi-asserted-by":"publisher","first-page":"n160","DOI":"10.1136\/bmj.n160","article-title":"PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"B37","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.annemergmed.2017.10.005","article-title":"Influence of shift duration on cognitive performance of emergency physicians: a prospective cross-sectional study","volume":"72","author":"Persico","year":"2018","journal-title":"Ann. Emerg. Med."},{"key":"B38","doi-asserted-by":"publisher","first-page":"872761","DOI":"10.3389\/fneur.2022.872761","article-title":"Cognitive function in soccer athletes determined by sleep disruption and self-reported health, yet not by decision-reinvestment","volume":"13","author":"Pourhassan","year":"2023","journal-title":"Front. Neurol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1842","DOI":"10.1016\/j.freeradbiomed.2011.08.016","article-title":"Sleep deprivation under sustained hypoxia protects against oxidative stress","volume":"51","author":"Ramanathan","year":"2011","journal-title":"Free Radic. Biol. Med."},{"key":"B40","first-page":"861","article-title":"Cognitive function following acute sleep restriction in children ages 10\u201314","volume":"21","author":"Randazzo","year":"1998","journal-title":"Sleep"},{"key":"B41","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.smrv.2017.05.002","article-title":"The role of sleep in regulating structural plasticity and synaptic strength: implications for memory and cognitive function","volume":"39","author":"Raven","year":"2018","journal-title":"Sleep Med. Rev."},{"key":"B42","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1037\/0894-4105.20.6.675","article-title":"Costs of a predictable switch between simple cognitive tasks following severe closed-head injury","volume":"20","author":"Schmitter-Edgecombe","year":"2006","journal-title":"Neuropsychology"},{"key":"B43","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.ijpsycho.2023.08.011","article-title":"The effect of 24-hour sleep deprivation on subjective time perception","volume":"192","author":"Sen","year":"2023","journal-title":"Int. J. Psychophysiol."},{"key":"B44","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1016\/j.sleep.2015.03.007","article-title":"Sleep deprivation leads to mood deficits in healthy adolescents","volume":"16","author":"Short","year":"2015","journal-title":"Sleep Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"zsx200","DOI":"10.1093\/sleep\/zsx200","article-title":"Sleep deprivation triggers cognitive control impairments in task-goal switching","volume":"41","author":"Slama","year":"2018","journal-title":"Sleep"},{"key":"B46","doi-asserted-by":"publisher","first-page":"2473","DOI":"10.1519\/JSC.0b013e31827f4792","article-title":"Effects of time-of-day and partial sleep deprivation on short-term maximal performances of judo competitors","volume":"27","author":"Souissi","year":"2013","journal-title":"J. Strength Cond. Res."},{"key":"B47","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1001\/jamaneurol.2024.1332","article-title":"Effect of sleep restriction on adolescent cognition by adiposity: a randomized crossover trial","volume":"81","author":"Stager","year":"2024","journal-title":"JAMA Neurol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"e13744","DOI":"10.1111\/jsr.13744","article-title":"Effects of total sleep deprivation on components of top-down attentional control using a flexible attentional control task","volume":"32","author":"Stenson","year":"2023","journal-title":"J. Sleep Res."},{"key":"B49","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.sleep.2007.03.011","article-title":"Sleep-dependent memory consolidation and reconsolidation","volume":"8","author":"Stickgold","year":"2007","journal-title":"Sleep Med."},{"key":"B50","doi-asserted-by":"publisher","first-page":"zsaa177","DOI":"10.1093\/sleep\/zsaa177","article-title":"Sleep deprivation and compensatory cognitive effort on a visual information processing task","volume":"44","author":"Sullan","year":"2021","journal-title":"Sleep"},{"key":"B51","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1016\/S0140-6736(98)00034-8","article-title":"Effect of sleep deprivation on surgeons' dexterity on laparoscopy simulator","volume":"352","author":"Taffinder","year":"1998","journal-title":"Lancet"},{"key":"B52","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/j.neubiorev.2016.07.004","article-title":"Sleep, sleep deprivation, autonomic nervous system and cardiovascular diseases","volume":"74","author":"Tobaldini","year":"2017","journal-title":"Neurosci. Biobehav. Rev."},{"key":"B53","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1126\/science.342.6156.301","article-title":"Neuroscience. Sleep: the brain's housekeeper?","volume":"342","author":"Underwood","year":"2013","journal-title":"Science"},{"key":"B54","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1093\/sleep\/26.2.117","article-title":"The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation","volume":"26","author":"Van Dongen","year":"2003","journal-title":"Sleep"},{"key":"B55","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/1471-2202-15-88","article-title":"Sleep deprivation leads to a loss of functional connectivity in frontal brain regions","volume":"15","author":"Verweij","year":"2014","journal-title":"BMC Neurosci."},{"key":"B56","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1001\/jama.287.8.955","article-title":"Sleep deprivation and clinical performance","volume":"287","author":"Weinger","year":"2002","journal-title":"JAMA"},{"key":"B57","doi-asserted-by":"publisher","first-page":"745","DOI":"10.5665\/sleep.4668","article-title":"Feedback blunting: total sleep deprivation impairs decision making that requires updating based on feedback","volume":"38","author":"Whitney","year":"2015","journal-title":"Sleep"},{"key":"B58","doi-asserted-by":"publisher","first-page":"16020","DOI":"10.1038\/s41598-017-16165-z","article-title":"Sleep deprivation diminishes attentional control effectiveness and impairs flexible adaptation to changing conditions","volume":"7","author":"Whitney","year":"2017","journal-title":"Sci. Rep."},{"key":"B59","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1126\/science.1241224","article-title":"Sleep drives metabolite clearance from the adult brain","volume":"342","author":"Xie","year":"2013","journal-title":"Science"},{"key":"B60","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1016\/S2352-4642(22)00188-2","article-title":"Effects of sleep duration on neurocognitive development in early adolescents in the USA: a propensity score matched, longitudinal, observational study","volume":"6","author":"Yang","year":"2022","journal-title":"Lancet Child Adolesc. Health"},{"key":"B61","doi-asserted-by":"publisher","first-page":"103734","DOI":"10.1016\/j.concog.2024.103734","article-title":"Neuroelectrophysiological alteration associated with cognitive flexibility after 24 h sleep deprivation in adolescents","volume":"124","author":"Zhang","year":"2024","journal-title":"Conscious. Cogn."},{"key":"B62","doi-asserted-by":"publisher","first-page":"5436","DOI":"10.1093\/cercor\/bhac431","article-title":"Cognitive flexibility: neurobehavioral correlates of changing one's mind","volume":"33","author":"Z\u00fchlsdorff","year":"2023","journal-title":"Cereb. Cortex"}],"container-title":["Frontiers in Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnins.2025.1626309\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T05:31:29Z","timestamp":1753162289000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnins.2025.1626309\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,22]]},"references-count":62,"alternative-id":["10.3389\/fnins.2025.1626309"],"URL":"https:\/\/doi.org\/10.3389\/fnins.2025.1626309","relation":{},"ISSN":["1662-453X"],"issn-type":[{"value":"1662-453X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,22]]},"article-number":"1626309"}}