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Sökning: WFRF:(Kecklund Göran) > Tidskriftsartikel

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1.
  • Ingre, Michael, et al. (författare)
  • Sleep length as a function of morning shift-start time in irregular shift schedules for train drivers : self-rated health and individual differences.
  • 2008
  • Ingår i: Chronobiol Int. - : Informa UK Limited. - 1525-6073 .- 0742-0528. ; 25:2, s. 349-58
  • Tidskriftsartikel (refereegranskat)abstract
    • Sleep length as a function of morning shift-start time in irregular shift schedules for train drivers: self-rated health and individual differences.Ingre M, Kecklund G, Akerstedt T, Söderström M, Kecklund L.Stress Research Institute, Stockholm University, Sweden. michael.ingre@stressforskning.su.seForty-six male train drivers (mean age = 46.5, SD = 5.1) were recruited to participate in a diary study for 14 consecutive days with questions about their sleep and working hours. A polynomial mixed-effect regression model showed a curvilinear relation ( p < .001) between shift-start time and sleep duration for shifts starting at 03:00-12:00 hand with a near linear increase for ones starting between 04:30 and 09:00 h of approximately 0.7 h for every 1 h the shift was delayed. The longest sleeps were estimated at approximately 8 h before shifts that started at approximately 10:00 h. The shortest sleeps were found for shifts that started before 04:30 h and were estimated at approximately 5 h. Individual differences were estimated with a random-effect standard deviation of 0.51 h, independent of shift start time ( p = .005). One-half of the between-subject variance was explained by subjective health. A one-step decrease in health was associated with a 26 min increase in sleep length. The results have practical implications for constructing shift schedules. Early morning shifts reduced sleep length substantially and should be mixed with later start hours to avoid the accumulation of sleep dept. Delaying the shift-start past 10:00 h had little effect on sleep opportunity; however, delaying shift-start to between 04:30 and 9:00 h had a strong impact on sleep length, with 70% of the extra time used for sleep, suggesting large positive effects for this range of shift-start times.
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2.
  • Santoft, Fredrik, et al. (författare)
  • Mediators of Change in Cognitive Behavior Therapy for Clinical Burnout
  • 2019
  • Ingår i: Behavior Therapy. - : Elsevier BV. - 0005-7894 .- 1878-1888. ; 50:3, s. 475-488
  • Tidskriftsartikel (refereegranskat)abstract
    • Evidence supporting the effectiveness of cognitive behavior therapy (CBT) for stress-related illness is growing, but little is known about its mechanisms of change. The aim of this study was to investigate potential mediators of CBT for severe stress in form of clinical burnout, using an active psychological treatment as comparator. We used linear mixed models to analyze data from patients (N = 82) with clinical burnout who received either CBT or another psychological treatment in a randomized controlled trial. Potential mediators (i.e., sleep quality, behavioral activation, perceived competence, and therapeutic alliance) and outcome (i.e., symptoms of burnout) were assessed weekly during treatment. The results showed that the positive treatment effects on symptoms of burnout favoring CBT (estimated between-group d = 0.93) were mediated by improvements in sleep quality, ab = -0.017,95% CIasymmetric [-0.037, -0.002], and increase in perceived competence, ab = -0.037, 95% CIasymmetric [-0.070, -0.010]. Behavioral activation, ab = -0.004 [-0.016, 0.007], and therapeutic alliance, ab = 0.002 [-0.006, 0.011], did not significantly mediate the difference in effects between the treatments. Improving sleep quality and increasing perceived competence may thus constitute important process goals in order to attain symptom reduction in CBT for clinical burnout.
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3.
  • Santoft, Fredrik, et al. (författare)
  • Processes in cognitive behavior therapy for social anxiety disorder : Predicting subsequent symptom change
  • 2019
  • Ingår i: Journal of Anxiety Disorders. - : Elsevier BV. - 0887-6185 .- 1873-7897. ; 67
  • Tidskriftsartikel (refereegranskat)abstract
    • Although cognitive behavior therapy (CBT) is an effective treatment for social anxiety disorder, little is known about the processes during treatment that bring about change. The aim of this study was to investigate whether the proposed processes of change according to the cognitive model of social anxiety disorder predicted subsequent symptom reduction in CBT delivered as therapist-guided bibliotherapy. We analyzed data from patients with social anxiety disorder (N = 61) who participated in an effectiveness trial of CBT in primary care. Seven putative processes and outcome (i.e., social anxiety) were assessed on a weekly basis throughout treatment. We used linear mixed models to analyze within-person relations between processes and outcome. The results showed a unidirectional effect of reduced avoidance on subsequent decrease in social anxiety. Further, we found support for reciprocal influences between four of the proposed processes (i.e., estimated probability and cost of adverse outcome, self-focused attention, and safety behaviors) and social anxiety. The remaining two processes, (i.e., anticipatory and post-event processing) did not predict subsequent social anxiety, but were predicted by prior symptom reduction. The findings support that several of the change processes according to the cognitive model of social anxiety disorder are involved in symptom improvement.
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4.
  • Ahlström, Christer, et al. (författare)
  • Fit-for-duty test for estimation of drivers sleepiness level: Eye movements improve the sleep/wake predictor
  • 2013
  • Ingår i: Transportation Research Part C. - : Elsevier. - 0968-090X .- 1879-2359. ; 26, s. 20-32
  • Tidskriftsartikel (refereegranskat)abstract
    • Driver sleepiness contributes to a considerable proportion of road accidents, and a fit-for-duty test able to measure a drivers sleepiness level might improve traffic safety. The aim of this study was to develop a fit-for-duty test based on eye movement measurements and on the sleep/wake predictor model (SWP, which predicts the sleepiness level) and evaluate the ability to predict severe sleepiness during real road driving. Twenty-four drivers participated in an experimental study which took place partly in the laboratory, where the fit-for-duty data were acquired, and partly on the road, where the drivers sleepiness was assessed. A series of four measurements were conducted over a 24-h period during different stages of sleepiness. Two separate analyses were performed; a variance analysis and a feature selection followed by classification analysis. In the first analysis it was found that the SWP and several eye movement features involving anti-saccades, pro-saccades, smooth pursuit, pupillometry and fixation stability varied significantly with different stages of sleep deprivation. In the second analysis, a feature set was determined based on floating forward selection. The correlation coefficient between a linear combination of the acquired features and subjective sleepiness (Karolinska sleepiness scale, KSS) was found to be R = 0.73 and the correct classification rate of drivers who reached high levels of sleepiness (KSS andgt;= 8) in the subsequent driving session was 82.4% (sensitivity = 80.0%, specificity = 84.2% and AUC = 0.86). Future improvements of a fit-for-duty test should focus on how to account for individual differences and situational/contextual factors in the test, and whether it is possible to maintain high sensitive/specificity with a shorter test that can be used in a real-life environment, e.g. on professional drivers.
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5.
  • Ahlström, Christer, 1977-, et al. (författare)
  • Real-Time Adaptation of Driving Time and Rest Periods in Automated Long-Haul Trucking : Development of a System Based on Biomathematical Modelling, Fatigue and Relaxation Monitoring
  • 2022
  • Ingår i: IEEE transactions on intelligent transportation systems (Print). - : IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC. - 1524-9050 .- 1558-0016. ; 23:5, s. 4758-4766
  • Tidskriftsartikel (refereegranskat)abstract
    • Hours of service regulations govern the working hours of commercial motor vehicle drivers, but these regulations may become more flexible as highly automated vehicles have the potential to afford periods of in-cab rest or even sleep while the vehicle is moving. A prerequisite is robust continuous monitoring of when the driver is resting (to account for reduced time on task) or sleeping (to account for the reduced physiological drive to sleep). The overall aims of this paper are to raise a discussion of whether it is possible to obtain successful rest during automated driving, and to present initial work on a hypothetical data driven algorithm aimed to estimate if it is possible to gain driving time after resting under fully automated driving. The presented algorithm consists of four central components, a heart rate-based relaxation detection algorithm, a camera-based sleep detection algorithm, a fatigue modelling component taking time awake, time of day and time on task into account, and a component that estimates gained driving time. Real-time assessment of driver fitness is complicated, especially when it comes to the recuperative value of in-cab sleep and rest, as it depends on sleep quality, time of day, homeostatic sleep pressure and on the activities that are carried out while resting. The monotony that characterizes for long-haul truck driving is clearly interrupted for a while, but the long-term consequences of extended driving times, including user acceptance of the key stakeholders, requires further research.
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6.
  • Akerstedt, Torbjörn, et al. (författare)
  • Accounting for partial sleep deprivation and cumulative sleepiness in the Three-Process Model of alertness regulation.
  • 2008
  • Ingår i: Chronobiol Int. - : Informa UK Limited. - 1525-6073 .- 0742-0528. ; 25:2, s. 309-19
  • Tidskriftsartikel (refereegranskat)abstract
    • Accounting for partial sleep deprivation and cumulative sleepiness in the Three-Process Model of alertness regulation.Akerstedt T, Ingre M, Kecklund G, Folkard S, Axelsson J.Stress Research Institute, University of Stockholm, Stockholm, Sweden. torbjorn.akerstedt@ki.seMathematical models designed to predict alertness or performance have been developed primarily as tools for evaluating work and/or sleep-wake schedules that deviate from the traditional daytime orientation. In general, these models cope well with the acute changes resulting from an abnormal sleep but have difficulties handling sleep restriction across longer periods. The reason is that the function representing recovery is too steep--usually exponentially so--and with increasing sleep loss, the steepness increases, resulting in too rapid recovery. The present study focused on refining the Three-Process Model of alertness regulation. We used an experiment with 4 h of sleep/night (nine participants) that included subjective self-ratings of sleepiness every hour. To evaluate the model at the individual subject level, a set of mixed-effect regression analyses were performed using subjective sleepiness as the dependent variable. These mixed models estimate a fixed effect (group mean) and a random effect that accounts for heterogeneity between participants in the overall level of sleepiness (i.e., a random intercept). Using this technique, a point was sought on the exponential recovery function that would explain maximum variance in subjective sleepiness by switching to a linear function. The resulting point explaining the highest amount of variance was 12.2 on the 1-21 unit scale. It was concluded that the accumulation of sleep loss effects on subjective sleepiness may be accounted for by making the recovery function linear below a certain point on the otherwise exponential function.
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7.
  • Akerstedt, Torbjörn, et al. (författare)
  • Disturbed sleep in shift workers, day workers, and insomniacs.
  • 2008
  • Ingår i: Chronobiol Int. - : Informa UK Limited. - 1525-6073 .- 0742-0528. ; 25:2, s. 333-48
  • Tidskriftsartikel (refereegranskat)abstract
    • Disturbed sleep in shift workers, day workers, and insomniacs.Akerstedt T, Ingre M, Broman JE, Kecklund G.Stress Research Institute, University of Stockholm, Karolinska Institutet, Stockholm, Sweden. torbjorn.akerstedt@ki.seVery little is known about differences in sleep between day and shift workers in representative samples of the population. This study compared a national representative sample (N=3400) of shift (with night shifts) and day workers regarding the different types of sleep disturbances and also the level of sleep symptoms with that of insomnia patients. The results showed very few differences between shift and day workers; only "too little sleep" and "nodding off at work" were marginally higher among shift workers. The results also showed that the complaints of insomnia patients for most sleep disturbances corresponded to the 2nd-16th percentile of the shift workers' levels of complaints. The results suggest, at least with the present questionnaire methodology, that shift work does not appear to be a major source of sleep disturbances and that their complaint levels bear no resemblance to those seen in insomniac patients.
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8.
  • Akerstedt, Torbjörn, et al. (författare)
  • Effects of context on sleepiness self-ratings during repeated partial sleep deprivation.
  • 2008
  • Ingår i: Chronobiol Int. - : Informa UK Limited. - 1525-6073 .- 0742-0528. ; 25:2, s. 271-8
  • Tidskriftsartikel (refereegranskat)abstract
    • Effects of context on sleepiness self-ratings during repeated partial sleep deprivation.Akerstedt T, Kecklund G, Axelsson J.Stress Research Institute, Stockholm University, Stockholm, Sweden. torbjorn.akerstedt@ki.seRatings of subjective sleepiness are often used in laboratory and field studies of sleep loss and shifted sleep hours. Some studies suggest that such ratings might fail to reflect sleepiness as shown in physiology or performance. One reason for this may be the influence of the context of the rating. Social interaction or physical activity may mask latent sleepiness. The present study attempted to approach this question. Nine subjects participated in a partial sleep-deprivation experiment (five days of 4 h of time in bed [TIB]), preceded by two baseline days (8 h TIB) and followed by three recovery days (8 h TIB). Sleepiness was self-rated on the Karolinska Sleepiness Scale (KSS; scores of 1-9) after a period of relaxation, after a reaction-time test, and after 30 min of free activities. The results showed a strong increase in subjective sleepiness during sleep restriction and a significant difference between conditions. Free activity reduced the self-rated subjective sleepiness by 1.1 KSS units compared to the level of sleepiness self-rated at the end of the reaction-time test. Thus, the results of this study indicate that the context of a sleepiness rating affects the outcome of the rating.
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9.
  • Akerstedt, Torbjörn, et al. (författare)
  • Predicting road crashes from a mathematical model of alertness regulation--The Sleep/Wake Predictor.
  • 2008
  • Ingår i: Accid Anal Prev. - : Elsevier BV. - 0001-4575. ; 40:4, s. 1480-5
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Predicting road crashes from a mathematical model of alertness regulation--The Sleep/Wake Predictor.Akerstedt T, Connor J, Gray A, Kecklund G.Stress Research Institute, Stockholm University and Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. torbjorn.akerstedt@ki.seSleepiness is related to factors such as the time of day, the time since awakening and the duration of prior sleep. The present study investigated whether actual road crashes could be predicted from a mathematical model based on these three factors (the Sleep/Wake Predictor-SWP). Data were derived from a population-based case-control study of serious injury crashes. Data on accident time (or control sampling time) and start and end of prior sleep were entered into the model (blind). The predicted sleepiness values were used in logistic regressions. The results showed a highly significant odds ratio (OR)=1.72 (confidence interval=1.41-2.09) for each incremental step of sleepiness on the output sleepiness scale (nine steps). There was also a significant interaction with blood alcohol level, showing high OR values for high sleepiness levels and alcohol levels above 50 mg% (0.05 g/dl). It was concluded that the model is a good predictor of road crashes beyond that of alcohol level, and that interaction between the two carries a very high risk.
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10.
  • Akerstedt, Torbjörn, et al. (författare)
  • Sleep and sleepiness in relation to stress and displaced work hours.
  • 2007
  • Ingår i: Physiol Behav. - : Elsevier BV. - 0031-9384. ; 92:1-2, s. 250-5
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Sleep and sleepiness in relation to stress and displaced work hours.Akerstedt T, Kecklund G, Gillberg M.Karolinska Institutet, Institute for Psychosocial Medicine Box 230, S-171 77 Stockholm, Sweden. torbjorn.akerstedt@ipm.ki.seSleep is an important factor in relation to accidents, long-term health and mortality. Our group has had a long-term commitment to research on sleep regulation and its consequences. Over the years we have demonstrated pronounced effects of night work on sleep and alertness, including electroencephalographically determined sleep during work. We have also demonstrated that experimental displacement of sleep will result in short sleep at daytime and increased physiological sleepiness at night and developed mathematical models for prediction of sleep duration, as well as of sleepiness and risk of sleep-related accidents. We have also looked at the concept of sleep quality and found it dependent on sleep duration, sleep continuity and content of sleep stages 3 and 4. Sleep is also clearly disturbed in patients on long-term sick leave for burnout or in non-patients with high burnout scores, in particular sleep fragmentation is increased and sleep efficiency and sleep stages 3 and 4 (SWS--deep sleep) decreased. The fragmentation in turn seems related to endocrine changes. Present work is focused on bringing this work together, connecting the links from stress to sleep to metabolic changes to disease and long-term sickness absence.PMID: 17585960 [PubMed - indexed for MEDLINE]
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