0223 Hormonal Contraceptive Use and Cognitive Flexibility During a Sleep-Deprivation Go/No-Go Reversal Task

Abstract Introduction Cognitive flexibility permits an individual to adapt behavioral responses following a change in circumstance. Although hormonal contraceptives (HCs) have been shown to influence several cognitive processes, their impact on cognitive flexibility during sleep loss is largely unexplored. Sleep deprivation is known to impair executive functioning broadly, including processes involved in adaptive behavior and cognitive flexibility. Through the alteration of endogenous hormone levels, HCs may contribute to differences in cognitive flexibility, as compared to naturally cycling females. This study examined whether HCs were associated with differences in cognitive flexibility following rule reversal during sleep deprivation. Methods Forty-eight participants (ages 18-30) undergoing 28-hours of total sleep deprivation were organized into three groups: males (n = 25), naturally cycling (NC) females (n = 12), and HC females (n = 10). Participants completed cognitive assessments between 12pm and 2pm on Days 1 and 2, separated by a night of total sleep deprivation. D-prime scores were calculated for pre-reversal and post-reversal phases of a Go/No-Go task. The reversal phase required participants to inhibit a learned prepotent response and adjust to a new stimulus-response rule. General linear models were used to evaluate within-subject effects of Day (rested vs. sleep-deprived), between-subject effects of Group, and Day × Group interactions Results There were no significant effects of Day or Day × Group interactions in either task phase (all p > .05), indicating that sleep deprivation did not produce consequential changes in reversal performance. However, a significant between-group effect was identified for post-reversal (F(2,44) = 5.81, p = .006), with HC females displaying significantly lower sensitivity than males and NC females. No group differences were noted in the pre-reversal phase (p = .376). Conclusion Females using HCs demonstrated reduced cognitive flexibility when compared to naturally cycling females and males, as exemplified by lower post-reversal d′ scores, independent of sleep deprivation effects. These findings suggest that altered hormonal status induced by contraceptives may negatively impact adaptive decision-making, but this effect is not influenced by sleep deprivation. Further research is necessary to clarify the cognitive implications of hormonal contraceptives on executive functioning in larger samples and in real-world sleep-loss applications. Support (if any)