Voxel-based morphometric gray matter correlates of daytime sleepiness

Sleep disorders such as narcolepsy, obstructive sleep apnea, and chronic insomnia have been associated with reduced gray matter volume of the ventromedial prefrontal cortex (VMPFC). Functional neuroimaging and behavioral data also implicate this region as important in sleep-related problems and the ability to resist the impairing effects of sleep loss on cognition. However, no study has linked gray matter volume within this region to normal self-reported levels of daytime sleepiness. We therefore hypothesized that reduced gray matter volume within the VMPFC would be related to greater self-reported levels of general daytime sleepiness, as assessed by the Epworth Sleepiness Scale (ESS) in a sample of 36 healthy non-clinical participants. Using voxel-based morphometry, scores of the ESS were correlated with gray matter volume, after controlling for age, gender, and whole brain volume. Daytime sleepiness correlated negatively with gray matter volume in a cluster of voxels within the left gyrus rectus and medial orbitofrontal cortex. Findings converge with prior evidence to suggest that the VMPFC and medial orbitofrontal cortex may play a particularly important role in sleep-wake related phenomena including sleep disorders and trait-like individual differences in vulnerability to the impairing effects of sleep deprivation on neurobehavioral performance, and also in normal variations in self-reported daytime sleepiness.