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- Akerstedt, Torbjörn, et al.
(författare)
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Accounting for partial sleep deprivation and cumulative sleepiness in the Three-Process Model of alertness regulation.
- 2008
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Ingår i: Chronobiol Int. - : Informa UK Limited. - 1525-6073 .- 0742-0528. ; 25:2, s. 309-19
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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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| 2. |
- Akerstedt, Torbjörn, et al.
(författare)
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Disturbed sleep in shift workers, day workers, and insomniacs.
- 2008
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Ingår i: Chronobiol Int. - : Informa UK Limited. - 1525-6073 .- 0742-0528. ; 25:2, s. 333-48
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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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| 3. |
- Akerstedt, Torbjörn, et al.
(författare)
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Effects of context on sleepiness self-ratings during repeated partial sleep deprivation.
- 2008
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Ingår i: Chronobiol Int. - : Informa UK Limited. - 1525-6073 .- 0742-0528. ; 25:2, s. 271-8
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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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| 4. |
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| 5. |
- Axelsson, John, et al.
(författare)
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Sleepiness and performance in response to repeated sleep restriction and subsequent recovery during semi-laboratory conditions.
- 2008
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Ingår i: Chronobiol Int. - : Informa UK Limited. - 1525-6073 .- 0742-0528. ; 25:2, s. 297-308
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Tidskriftsartikel (refereegranskat)abstract
- Sleepiness and performance in response to repeated sleep restriction and subsequent recovery during semi-laboratory conditions.Axelsson J, Kecklund G, Akerstedt T, Donofrio P, Lekander M, Ingre M.Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. john.axelsson@ki.seThere is an ongoing debate of how best to measure the effects of sleep loss in a reliable and feasible way, partly because well controlled laboratory studies and field studies have come to different conclusions. The aims of the present study were to investigate both sleepiness and performance in response to long-term sleep restriction and recovery in a semi-laboratory environment, investigate order effects (i.e., whether levels return to baseline) in a study with seven days of recovery, and characterize individual differences in tolerance to restricted sleep. Nine healthy men (age 23-28 yrs) participated in the protocol, which included one habituation day (sleep 23:00-07:00 h), two baseline days (23:00-07:00 h), five days with restricted sleep (03:00-07:00 h), and seven recovery days (23:00-07:00 h). Participants went outdoors at least twice each day. Reaction-time tests were performed at 08:00, 14:00, and 20:00 h each day in the laboratory. Sleepiness was self-rated by the Karolinska Sleepiness Scale (KSS)after each test. The mixed-effect regression models showed that each day of restricted sleep resulted in an increase of sleepiness by 0.64+/- .05 KSS units (a nine-step scale, p < .001), increase of median reaction times of 6.6+/- 1.6 ms ( p = .003), and increase of lapses/test of 0.69 +/- .16 ms ( p < .001). Seven days of recovery allowed participants to return to the baseline for sleepiness and median reaction time, but not for lapses.The individual differences were larger for performance measures than for sleepiness; the between-subject standard deviation for the random intercept was in the magnitude of the effects of 1.1 days of restricted sleep for sleepiness, 6.6 days of restricted sleep for median reaction time, and 3.2 days for lapses. In conclusion, the present study shows that sleepiness is closely related to sleep pressure, while performance measures, to a larger extent, appear determined by specific individual traits. Moreover, it is suggested to measure sleepiness in a standardized situation so as to minimize the influences of contextual factors.
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| 9. |
- Eriksen, Claire A., et al.
(författare)
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Sleepiness and sleep in a simulated ''six hours on/six hours off'' sea watch system
- 2006
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Ingår i: Chronobiology International. - : Informa UK Limited. - 0742-0528 .- 1525-6073. ; 23:6, s. 1193-1202
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Tidskriftsartikel (refereegranskat)abstract
- Ships are operated around the clock using rapidly rotating shift schedules called sea watch systems. Sea watch systems may cause fatigue, in the same way as other irregular working time arrangements. The present study investigated subjective sleepiness and sleep duration in connection with a 6 h on/6 h off duty system. The study was performed in a bridge simulator, very similar to those found on ships. Twelve officers divided into two groups participated in the study that lasted 66 h. Half of the subjects started with the 06:00-12:00 h watch and the other half with the 12:00-18:00 h watch. The subjects alternated between off-duty and on-duty for the remainder of the experimental period. Approximately halfway through the experiment, the 12:00-18: 00 h watch was divided into two 3 h watches/off-duty periods. The effect of this was to reverse the on-duty/off-duty pattern between the two groups. This enabled all subjects to work the four possible watches (00:00-06:00 h, 06:00-12:00 h, 12:00-18:00 h, and 18:00-24:00 h) in an order that was essentially counterbalanced between groups. Ratings of sleepiness (Karolinska Sleepiness Scale; KSS) were obtained every 30 min during on-duty periods and if subjects were awake during off-duty periods. The subjectively rated duration of sleep was recorded after each off-duty period that preceded watch periods when KSS was rated. The results showed that the average level of sleepiness was significantly higher during the 00:00-06:00 h watch compared to the 12:00-18:00 h and 18:00-24:00 h watches, but not to the 06:00-12:00 h watch. Sleepiness also progressed significantly from the start toward the end of each watch, with the exception of the 06:00-12:00 h watch, when levels remained approximately stable. There were no differences between groups (i.e., the order between watches). Sleep duration during the 06:00-12:00 h off-duty period (3 h 29 min) was significantly longer than during the 12:00-18:00 h period (1 h 47 min) and the 18:00-24:00 h period (2 h 7 min). Sleep during the 00:00-06:00 h period (4 h 23 min) was longer than all sleep periods except the 06:00-12:00 h period. There were no differences between groups. In spite of sufficient opportunities for sleep, sleep was on the average around 1-1 h 30 min shorter than the 7-7 h 30 min that is considered "normal" during a 24 h period. This is probably a consequence of the difficulty to sleep during daytime due to the alerting effects of the circadian rhythm. Also, sleepiness during the night and early mornings reached high levels, which may be explained by a combination of working close to or during the circadian trough of alertness and the relatively short sleep periods obtained. An initial suppression of sleepiness was observed during all watches, except for the 06:00-12:00 h watch. This suppression may be explained by the "masking effect" exerted by the relative high levels of activity required when taking over the responsibility of the ship. Toward the end of watches, the levels of sleepiness progressively increased to relatively high levels, at least during the 00:00-06:00 h watch. Presumably, initially high levels of activity are replaced by routine and even boredom.
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