| 1. |
- Almén, Niclas, 1971-
(författare)
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Intervening Stress Recovery Behaviors in Everyday Life
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background. High levels of perceived stress and stress-related ill health, such as burnout, are common in many countries. Several theories postulate that stress behaviors promote adaption to environmental changes and if sustained they are potentially harmful for the body. In accordance, impaired stress recovery behaviors, i.e., psychophysiological deactivation after periods of stress behaviors, have been suggested to be a critical factor in explaining stress-related ill health. Whereas research shows that interventions targeting stress reactivity can have beneficial effects on stress-related variables, studies on interventions targeting stress recovery are surprisingly few. Also, the number of validated instruments for measuring behaviors important for stress recovery are few, in particular easily used self-rating scales. Aims. The primary aim of the thesis was to evaluate stress and health-related effects of an intervention targeting stress recovery behaviors in everyday life among people perceiving high levels of stress in life. A secondary aim was to validate a self-report scale measuring behaviors important for stress recovery in everyday life. Method. Three empirical studies were conducted to evaluate effects of the behavioral stress recovery intervention “balance in everyday life”, which solely aims at strengthening stress recovery behaviors in everyday life. First, a brief version of the intervention was investigated through a small pilot study in which a single-subject experimental design was used (study 1). After that, the intervention was exploratively tested in a group format in which a quasi-experimental design was used (study 2). Due to the positive results of these two studies, a larger scale study using a randomized controlled design was conducted in order to further investigate the effects of the intervention when delivered in a group format (study 3). To fulfill the secondary aim of the thesis, the Recovery Experience Questionnaire was translated into Swedish and analyzed using exploratory factor analysis and confirmatory factor analysis (study 4). Results. In study 1, data demonstrated immediate reduction of stress symptoms as a function of the intervention. The improvements were maintained at 1-year and 5-year follow-up assessments. In study 2, in comparison with a waiting-list-control group, the intervention yielded statistically significant improvements between pre- and postintervention assessment on eleven out of twelve stress and health-related variables. Medium to large between-groups effect sizes were demonstrated for the primary outcome measures covering (potential) recovery behaviors, perceived stress and rest and experiences of being recovered. In the third study, statistically significant improvements for all outcome measures at postintervention assessment and at the 3-month follow-up were demonstrated. The between-groups effect sizes for the primary measures - perceived stress, tension, and burnout - were medium-to-high at postintervention assessment and at follow-up. In addition, in all studies the intervention was associated with beneficial changes in levels of anxiety and depression. In the last study, support was found for the proposed four-factor structure of the Swedish version of the Recovery Experience Questionnaire. Conclusions. The results clearly indicate that the intervention “balance in everyday life” improves stress and health-related factors in a relatively satisfactory way among people perceiving high levels of stress in life. The empirical support is strongest for the reduction in tension, perceived stress, burnout, anxiety and depression, and to deliver the intervention in a group format. The studies demonstrated results that warrant further investigation of the effects of “balance in everyday life”, for example in different contexts, and to study other behavioral recovery interventions. To test (potential) recovery facilitating behaviors as mediators of intervention effects, such as reduction in burnout, the Swedish version of the Recovery Experience Questionnaire could be used.
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| 2. |
- Ahlström, Christer, 1977-, et al.
(författare)
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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
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Ingår i: IEEE transactions on intelligent transportation systems (Print). - : IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC. - 1524-9050 .- 1558-0016. ; 23:5, s. 4758-4766
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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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| 3. |
- Albrecht, Sophie Charlotte, et al.
(författare)
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Association of work-time control with sickness absence due to musculoskeletal and mental disorders : An occupational cohort study
- 2020
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Ingår i: Journal of Occupational Health. - : Wiley. - 1341-9145 .- 1348-9585. ; 62:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Work-time control is associated with lower sickness absence rates, but it remains unclear whether this association differs by type of diagnosis and sub-dimension of work-time control (control over daily hours and control over time off) and whether certain vulnerable groups benefit more from higher levels of work-time control.Methods: Survey data from the Finnish 10-town study in 2004 were used to examine if baseline levels of work-time control were associated with register data on diagnose-specific sickness absence for 7 consecutive years (n = 22 599). Cox proportional hazard models were conducted, adjusted for age, sex, education, occupational status, shift work including nights, and physical/mental workload.Results: During follow-up, 2,818 individuals were on sick leave (>= 10 days) due to musculoskeletal disorders and 1724 due to mental disorders. Employees with high (HR = 0.80, 95% CI 0.74-0.87; HR = 0.76, 95% CI 0.70-0.82, respectively) and moderate (HR = 0.83, 95% CI 0.77-0.90; HR = 0.85, 95% CI 0.79-0.91, respectively) levels of control over daily hours/control over time off had a decreased risk of sickness absence due to musculoskeletal disorders. Sub-group analyses revealed that especially workers who were older benefitted the most from higher levels of work-time control. Neither sub-dimension of work-time control was related to sickness absence due to mental disorders.Conclusions: Over a 7-year period of follow-up, high and moderate levels of work-time control were related to lower rates of sickness absence due to musculoskeletal disorders, but not due to mental disorders.
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| 4. |
- Albrecht, Sophie C., 1988-, et al.
(författare)
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Prospective effects of work-time control on overtime, work-life interference and exhaustion in female and male knowledge workers
- 2024
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 52:2, s. 205-215
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Employee-based flexible working hours are increasing, particularly among knowledge workers. Research indicates that women and men use work–time control (WTC; control over time off and daily hours) differently: while men work longer paid hours, women use WTC to counteract work–life interference. In a knowledge-worker sample, we examined associations between WTC and overtime, work–life interference and exhaustion and tested whether gender moderates the mediating role of overtime. Methods: The sample contained 2248 Swedish knowledge workers. Employing hierarchical regression modelling, we examined effects of control over time off/daily hours on subsequent overtime hours, work–life interference and exhaustion in general and in gender-stratified samples. Using conditional process analysis, we tested moderated mediation models. Results: Control over time off was related to less work–life interference (βmen= −0.117; 95% confidence interval (CI): −0.237 to 0.003; βwomen= −0.253; 95% CI: −0.386 to −0.120) and lower exhaustion (βmen= −0.199; 95% CI: −0.347 to −0.051; βwomen= −0.271; 95% CI: −0.443 to −0.100). For control over daily hours, estimates were close to zero. While men worked more overtime (42 min/week), we could not confirm gender moderating the indirect effect of control over time off/daily hours on work–life interference/exhaustion via overtime. Independent of gender, effects of control over time off on work–life interference were partly explained by working fewer overtime hours. Conclusions: Control over time off was related to lower exhaustion and better work–life balance (in particular for women). We found no evidence for men’s work–life interference increasing with higher WTC owing to working more overtime. Knowledge workers’ control over time off may help prevent work–life interference and burnout.
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| 5. |
- Albrecht, Sophie Charlotte, 1988-
(författare)
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The Highs and Lows of Work-Time Control : Exploring the role of control over working hours for health
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Flexible work-time arrangements are thought to create ways of aligning work and private life and facilitate recovery. While temporal flexibility is found to generally bolster work–life balance, its effects on health outcomes are less well known. The present thesis seeks to examine if and how perceived control over working hours benefits workers’ health. Utilising a large Swedish cohort study, four empirical studies explored the association of work-time control (WTC) with subsequent mental and physical health as well as the underlying mechanisms and moderating influences.Study I assessed the factorial structure of an instrument to measure WTC and found two sub-dimensions: control over daily hours (the length, starting and ending times of a workday) and control over time off (the taking of breaks/time/days off, paid and unpaid). Levels of control per sub-dimension were described by demographic and work-related factors for a large sample of Swedish workers. In particular, shift, public sector and female workers reported low levels of WTC.Study II examined effects of control over daily hours and time off on depressive symptoms. Increasing control over time off was related to decreasing depressive symptoms over time, whereas only initial level of control over daily hours was associated with lower levels of depressive symptoms. For both sub-dimensions of WTC, the direction of this effect was predominantly from perceived control to subsequent depressive symptoms; reversed processes were of less importance.Study III focused on work–life interference as one step on the causal chain between WTC and depressive symptoms and musculoskeletal complaints, respectively. For both sub-dimensions of WTC, part of the effect on depressive symptoms went through work–life interference. Reversed processes played a role between depressive symptoms and work–life interference only. Control over time off was found to mitigate work–life interference and subsequent depressive symptoms more than control over daily hours, albeit with generally small effects. Regarding musculoskeletal complaints, effects were even smaller and work–life interference appeared to be less important.Study IV assessed gender differences in the impact of WTC on work–life interference and exhaustion regarding the mediating role of overtime hours. In a sample of knowledge workers, higher control over time off was associated with lower subsequent work–life interference and exhaustion, while control over daily hours was unrelated to both outcomes. Although men worked more overtime hours than women on average, no evidence was found for men with high control over time off/daily hours to perceive more work–life interference/exhaustion due to increased overtime compared to women.This thesis found that higher levels of WTC were beneficial for a range of health outcomes, which was partly explained by fewer work–life conflicts. While these effects were generally small, control over time off in particular was consistently associated with favourable outcomes in health, work-life balance and working hours. Given that the level of workers’ discretion over working hours varies starkly by work and demographic factors, enhancing the availability of flexible work-time arrangements is in the interest of public health. WTC, with a particular focus on employees’ ability to take time off from work, may improve the daily work–life interface and support a sustainable working life.
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| 6. |
- Albrecht, Sophie C., et al.
(författare)
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The mediating effect of work-life interference on the relationship between work-time control and depressive and musculoskeletal symptoms
- 2020
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 46:5, s. 469-479
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Evidence shows that work-time control (WTC) affects health but underlying mechanisms are still unclear. Work-life interference (WLI) might be a step on the causal pathway. The present study examined whether WLI mediates effects on mental and physical health and contrasted these to other causal pathways.Methods Four biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH, N=26 804) were used. Cross-lagged analyses were conducted to estimate if WLI mediated effects from WTC (differentiating between control over daily hours and time off) to subsequent depressive and musculoskeletal symptoms. Other causal directions (reversed mediation, direct and reversed direct effects) and robustness of mediation (by including covariates) were examined.Results WLI partially mediated the relationship of WTC (control over daily hours/time off) with both health outcomes. Indirect effect estimates were small for depressive symptoms (-0.053 for control over time off and -0.018 for control over daily hours) and very small for musculoskeletal symptoms (-0.007 and -0.003, respectively). While other causal directions were generally weaker than causal mediational pathways, they played a larger role for musculoskeletal compared to depressive symptoms. Estimates relating to control over time off were in general larger than for control over daily hours.Conclusions Our results suggest that WLI mediates part of the effect from WTC to mental/musculoskeletal symptoms, but small estimates suggest that (i) WTC plays a small but consistent role in effects on health and (ii) particularly regarding musculoskeletal disorders, other causal directions and mediators need to be further examined.
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| 7. |
- Amid Hägg, Shadi, 1982-
(författare)
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Sleep disturbances : Consequences and comorbidities
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Sleep disorders are common in the general population, with insomnia and sleep-related breathing disorders being the most common disorders. Since sleep has many important functions, such as a role in consolidation of memories and learning, energy conservation, cardiovascular and immune system regulation, it is not surprising that the disruption of normal sleep may lead to negative health effects and various comorbidities. Aim: The overall aim of this thesis was to investigate the impact of disturbed sleep on various consequences and comorbidities. Methods and results: Papers I and II were based on the Sleep and Health in Women (SHE), a population-based prospective study of women, where a questionnaire was sent to women in 2000 and 2010. In paper I, the study cohort comprised 4,320 women <67 years of age who answered both questionnaires and had worked during the follow-up period. In women, having a long history of insomnia symptoms was associated with an increased risk of self-reported occupational accidents.In paper II, the 4,882 participants who answered the questions regarding nocturnal gastroesophageal reflux and snoring in both questionnaires were included in the study cohort. Women with nocturnal gastroesophageal reflux and snoring were at an increased risk of developing daytime sleepiness and to involuntarily fall asleep during the day. Paper III was based on the RHINE-cohort with participants from seven Northern European centers. The study cohort in paper III comprised the 2,568 smokers in the baseline study that also reported being smokers or former smokers in the follow-up study. It was found that having insomnia symptoms or excessive daytime sleepiness decreases the chance of long-term smoking cessation, and that smoking increases the risk of incident difficulties inducing sleep. Paper IV was the population-based, cross-sectional GA2LEN-survey which was conducted in four major Swedish cities. Paper IV included the 25,901 participants who answered questions regarding both snoring and insomnia symptoms. The combination of snoring and insomnia symptoms was associated with an increased risk of hypertension, asthma, chronic obstructive pulmonary disease, and daytime sleepiness. Conclusions: Disturbed sleep, due to varying causes, influences the risk of occupational accidents, on the chance of successful smoking cessation, on the risk of daytime sleepiness, hypertension, and obstructive lung disease. In clinical consultation, it is important to always inquire about disturbed sleep as it can have an impact on many aspects of health.
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| 8. |
- Axelsson, John, et al.
(författare)
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Sleepiness as motivation : a potential mechanism for how sleep deprivation affects behavior
- 2020
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Ingår i: Sleep. - : Oxford University Press (OUP). - 0161-8105 .- 1550-9109. ; 43:6
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Tidskriftsartikel (refereegranskat)abstract
- STUDY OBJECTIVES: To determine how sleepiness and sleep deprivation drive the motivation to engage in different behaviors.METHODS: We studied the sleepiness of 123 participants who had been randomized to sleep deprivation or normal sleep, and their willingness to engage in a range of everyday behaviors.RESULTS: Self-reported sleepiness was a strong predictor of the motivation to engage in sleep-preparatory behaviors such as shutting one's eyes (OR=2.78, 95%CI: 2.19-3.52 for each step up on the Karolinska Sleepiness Scale) and resting (OR=3.20, CI: 2.46-4.16). Sleepiness was also related to the desire to be cared for by a loved one (OR=1.49, CI: 1.22-1.82), and preparedness to utilize monetary and energy resources to get to sleep. Conversely, increased sleepiness was associated with a decreased motivation for social and physical activities (e.g., be with friends OR=0.71, CI: 0.61-0.82; exercise OR=0.65, CI: 0.56-0.76). Sleep deprivation had similar effects as sleepiness on these behaviors. Neither sleepiness nor sleep deprivation had strong associations with hunger, thirst, or food preferences.CONCLUSIONS: Our findings indicate that sleepiness is a dynamic motivational drive that promotes sleep-preparatory behaviors and competes with other drives and desired outcomes. Consequently, sleepiness may be a central mechanism by which impaired alertness, e.g., due to insufficient sleep, contributes to poor quality of life and adverse health. We propose that sleepiness helps organize behaviors toward the specific goal of assuring sufficient sleep, in competition with other needs and incentives. A theoretical framework on sleepiness and its behavioral consequences are likely to improve our understanding of several disease mechanisms.
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| 9. |
- Deter, Hans-Christian, et al.
(författare)
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Behavioral factors predict all-cause mortality in female coronary patients and healthy controls over 26 years – a prospective secondary analysis of the Stockholm Female Coronary Risk Study
- 2022
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:12
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThe prognosis of coronary artery disease (CAD) is related to its severity and cardiovascular risk factors in both sexes. In women, social isolation, marital stress, sedentary lifestyle and depression predicted CAD progression and outcome within 3 to 5 years. We hypothesised that these behavioral factors would still be associated with all-cause mortality in female patients after 26 years.MethodsWe examined 292 patients with CAD and 300 healthy controls (mean age of 56 ± 7 y) within the Fem-Cor-Risk-Study at baseline. Their cardiac, behavioral, and psychosocial risk profiles, exercise, smoking, and dietary habits were assessed using standardized procedures. Physiological characteristics included a full lipid profile, the coagulation cascade and autonomic dysfunction (heart rate variability, HRV). A new exploratory analysis using machine-learning algorithms compared the effects of social and behavioral mechanisms with standard risk factors. Results: All-cause mortality records were completed in 286 (97.9%) patients and 299 (99.7%) healthy women. During a median follow-up of 26 years, 158 (55.2%) patients and 101 (33.9%) matched healthy controls died. The annualized mortality rate was 2.1% and 1.3%, respectively. After controlling for all available confounders, behavioral predictors of survival in patients were social integration (HR 0.99, 95% CI 0.99–1.0) and physical activity (HR 0.54, 95% CI 0.37–0.79). Smoking acted as a predictor of all-cause mortality (HR 1.56, 95% CI 1.03–2.36). Among healthy women, moderate physical activity (HR 0.42, 95% CI 0.24–0.74) and complete HRV recordings (≥50%) were found to be significant predictors of survival.ConclusionsCAD patients with adequate social integration, who do not smoke and are physically active, have a favorable long-term prognosis. The exact survival times confirm that behavioral risk factors are associated with all-cause mortality in female CAD patients and healthy controls.
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| 10. |
- Garde, Anne Helene, et al.
(författare)
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How to schedule night shift work in order to reduce health and safety risks
- 2020
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 46:6, s. 557-569
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This discussion paper aims to provide scientifically based recommendations on night shift schedules, including consecutive shifts, shift intervals and duration of shifts, which may reduce health and safety risks. Short-term physiological effects in terms of circadian disruption, inadequate sleep duration and quality, and fatigue were considered as possible links between night shift work and selected health and safety risks, namely, cancer, cardio-metabolic disease, injuries, and pregnancy-related outcomes.Method In early 2020, 15 experienced shift work researchers participated in a workshop where they identified relevant scientific literature within their main research area.Results Knowledge gaps and possible recommendations were discussed based on the current evidence. The consensus was that schedules which reduce circadian disruption may reduce cancer risk, particularly for breast cancer, and schedules that optimize sleep and reduce fatigue may reduce the occurrence of injuries. This is generally achieved with fewer consecutive night shifts, sufficient shift intervals, and shorter night shift duration.Conclusions Based on the limited, existing literature, we recommend that in order to reduce the risk of injuries and possibly breast cancer, night shift schedules have: (i) ≤3 consecutive night shifts; (ii) shift intervals of ≥11 hours; and (iii) ≤9 hours shift duration. In special cases – eg, oil rigs and other isolated workplaces with better possibilities to adapt to daytime sleep – additional or other recommendations may apply. Finally, to reduce risk of miscarriage, pregnant women should not work more than one night shift in a week.
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| 11. |
- Garefelt, Johnna, et al.
(författare)
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How does cessation of work affect sleep? Prospective analyses of sleep duration, timing and efficiency from the Swedish Retirement Study
- 2021
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Ingår i: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 30:3
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Tidskriftsartikel (refereegranskat)abstract
- Several strands of research indicate that work competes for time with sleep, but to what extent the timing and duration of sleep is affected by work is not known. Retirement offers a quasi-experimental life transition to study this in a within-individual study design. The few existing studies report that people sleep longer and later after retirement but mainly rely on self-reported data or between-individual analyses. We recruited 100 participants aged 61–72 years who were in paid work but would soon retire and measured them in a baseline week with accelerometers, diaries and questionnaires. After 1 and 2 years, the measurements were repeated for the now retired participants. Changes in sleep duration, timing, efficiency, chronotype and social jetlag were analysed using multilevel modelling. Gender, chronotype at baseline and partner's working status were analysed as potential effect modifiers. Sleep duration increased by 21 min, whereas sleep efficiency remained similar. Time of sleep onset and final awakening were postponed by 26 and 52 min, respectively, pushing midsleep forward from 03:17 to 03:37 hours. Changes in duration and timing of sleep were driven by weekday sleep, whereas weekend sleep stayed about the same. Social jetlag decreased but still occurred after retirement. Changes at retirement in sleep duration and timing were smaller for participants with a later chronotype and who had full-time working partners. These findings indicate that paid work generates sleep loss and hinders people from sleeping in line with their biological time.
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| 12. |
- Garefelt, Johanna, et al.
(författare)
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How does work impact daily sleep quality? A within-individual study using actigraphy and self-reports over the retirement transition
- 2022
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Ingår i: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 31:3
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Tidskriftsartikel (refereegranskat)abstract
- This study examined how the cessation of work at retirement affects daily measures of actigraphy-measured and self-rated sleep quality. Time in bed or asleep and stress at bedtime were examined as potential mechanisms. In total 117 employed participants who were aged 60-72 years and planned to retire soon were recruited to the Swedish Retirement Study. Sleep quality was measured in a baseline week using accelerometers, diaries, and questionnaires. Subjective sleep measures were sleep quality, restless sleep, restorative sleep, getting enough sleep, estimated wake after sleep onset, difficulties falling asleep, too early final awakening, and difficulties waking up. Actigraphy measures were sleep efficiency, wake after sleep onset, and average awakening length. After 1 and 2 years, the measurements were repeated for the now retired participants. Daily variations in sleep quality before and after retirement were analysed using multilevel modelling, with time in bed or asleep and stress at bedtime as potential mediators. We found that several self-reports of sleep improved (e.g., +0.2 standard deviations for sleep quality and +0.5 standard deviations for restorative sleep) while objective sleep quality remained unchanged or decreased slightly with retirement (e.g., -0.8% for sleep efficiency). Increased time in bed or asleep and stress at bedtime accounted partially for the improvements in self-rated sleep quality at retirement. In conclusion, actigraph-measured and self-reported sleep quality do not change in concert at retirement, highlighting the interest of studying both outcomes. The main effects of retirement from work concern subjective experiences of recovery more than sleep quality per se.
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| 13. |
- Garefelt, Johanna, 1986-
(författare)
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Work and sleep - what's stress got to do with it?
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Work may affect sleep by reducing the time available for recovery and, via work stress, by reducing sleep quality. Further, people experiencing sleep disturbance may be less resistant to work stress. These processes may lead to the development of a vicious cycle between work and sleep, in which stress has a central role.Knowledge of the prospective relations between work, stress and sleep is limited, particularly from studies examining relationships from sleep to work stress and large-scale studies using objective measures of sleep.Consequently, this thesis aims to analyse the prospective relations, including directions of effects, between work-related factors, in particular work stress, and self-rated and objective measures of sleep.The first two studies used the Swedish Longitudinal Occupational Survey of Health, with biennial self-rated measures of work-related factors (demands, control, support, stress, physical factors, scheduling) and sleep. We used structural equation models to analyse the direction of effects between work-related factors and sleep. The next two studies used the Swedish Retirement Study, a prospective study using self-reports and actigraphy, which followed people into retirement. We used multilevel modelling to analyse within-individual changes in sleep duration, timing and quality over three waves across retirement.We observed prospective reciprocal relations between work stressors (demands, control and support), perceived stress and self-rated sleep quality. Work was associated with earlier timing of sleep and sleep deprivation of 30 minutes per night. Improvements in self-rated sleep quality after retirement were not accompanied by improvements in actigraph-measured sleep quality.In conclusion, this thesis has demonstrated that work, stress and sleep form a vicious cycle. Interventions targeting sleep disturbance could improve people’s experience of their work environments. Likewise, interventions aiming to lower stress and increase the flexibility of work could reduce the impact of work on sleep, and thereby on health, contributing to a decent and sustainable working life.
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| 14. |
- Harma, Mikko, et al.
(författare)
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Working hours and health - key research topics in the past and future
- 2024
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Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 50:4, s. 233-243
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This paper discusses the past and present highlights of working hours and health research and identifies key research needs for the future. Method: We analyzed over 220 original articles and reviews on working hours and health in the Scandinavian Journal of Work, Environment & Health published during the last 50 years. Key publications from other journals were also included. Results: The majority of identified articles focussed on the effects of shift and night work, with fewer studying long and reduced working hours and work time control. We observed a transition from small-scale experimental and intensive field studies to large-scale epidemiological studies utilizing precise exposure assessment, reflecting the recent emergence of register -based datasets and the development of analytic methods and alternative study designs for randomized controlled designs. The cumulative findings provide convincing evidence that shift work and long working hours, which are often associated with night work and insufficient recovery, increase the risk of poor sleep and fatigue, sickness absence, occupational injuries, and several chronic health conditions such as cardiovascular diseases and cancer. The observed risks are strongly modified by individual and work -related factors. Conclusions: Although the observed health risks of shift work and long working hours are mostly low or moderate, the widespread prevalence of exposure and the hazardousness of the many associated potential outcomes makes such working time arrangements major occupational health risks. Further research is needed to identify exposure-response associations, especially in relation to the chronic health effects, and to elucidate underlying pathways and effective personalized intervention strategies.
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| 15. |
- Holding, Benjamin C., et al.
(författare)
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Sleepiness, sleep duration, and human social activity : An investigation into bidirectionality using longitudinal time-use data
- 2020
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 117:35, s. 21209-21217
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Tidskriftsartikel (refereegranskat)abstract
- Daytime sleepiness impairs cognitive ability, but recent evidence suggests it is also an important driver of human motivation and behavior. We aimed to investigate the relationship between sleepiness and a behavior strongly associated with better health: social activity. We additionally aimed to investigate whether a key driver of sleepiness, sleep duration, had a similar relationship with social activity. For these questions, we considered bidirectionality, time of day, and differences between workdays and days off. Over 3 wk, 641 working adults logged their behavior every 30 min, completed a sleepiness scale every 3 h, and filled a sleep diary every morning (rendering >292,000 activity and >70,000 sleepiness datapoints). Using generalized additive mixed-effect models, we analyzed potential nonlinear relationships between sleepiness/sleep duration and social activity. Greater sleepiness predicted a substantial decrease in the probability of social activity (odds ratio 95% CI = 0.34 to 0.35 for days off), as well as a decreased duration of such activity when it did occur. These associations appear especially robust on days off and in the evenings. Social duration moderated the typical time-of-day pattern of sleepiness, with, for example, extended evening socializing associated with lower sleepiness. Sleep duration did not robustly predict next-day social activity. However, extensive social activity (>5 h) predicted up to 30 min shorter subsequent sleep duration. These results indicate that sleepiness is a strong predictor of voluntary decreases in social contact. It is possible that bouts of sleepiness lead to social withdrawal and loneliness, both risk factors for mental and physical ill health.
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| 16. |
- Johansson, Peter, 1975-, et al.
(författare)
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Development and performance of a sleep estimation algorithm using a single accelerometer placed on the thigh : an evaluation against polysomnography
- 2023
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Ingår i: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869. ; 32:2
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Tidskriftsartikel (refereegranskat)abstract
- Accelerometers placed on the thigh provide accurate measures of daily physical activity types, postures and sedentary behaviours, over 24 h and across consecutive days. However, the ability to estimate sleep duration or quality from thigh-worn accelerometers is uncertain and has not been evaluated in comparison with the 'gold-standard' measurement of sleep polysomnography. This study aimed to develop an algorithm for sleep estimation using the raw data from a thigh-worn accelerometer and to evaluate it in comparison with polysomnography. The algorithm was developed and optimised on a dataset consisting of 23 single-night polysomnography recordings, collected in a laboratory, from 15 asymptomatic adults. This optimised algorithm was then applied to a separate evaluation dataset, in which, 71 adult males (mean [SD] age 57 [11] years, height 181 [6] cm, weight 82 [13] kg) wore ambulatory polysomnography equipment and a thigh-worn accelerometer, simultaneously, whilst sleeping at home. Compared with polysomnography, the algorithm had a sensitivity of 0.84 and a specificity of 0.55 when estimating sleep periods. Sleep intervals were underestimated by 21 min (130 min, Limits of Agreement Range [LoAR]). Total sleep time was underestimated by 32 min (233 min LoAR). Our results evaluate the performance of a new algorithm for estimating sleep and outline the limitations. Based on these results, we conclude that a single device can provide estimates of the sleep interval and total sleep time with sufficient accuracy for the measurement of daily physical activity, sedentary behaviour, and sleep, on a group level in free-living settings.
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| 17. |
- Kecklund, Göran, et al.
(författare)
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Fysisk aktivitet vid insomni
- 2021. - 4
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Ingår i: FYSS 2021. - Stockholm : Läkartidningens Förlag AB. - 9789198509823 ; , s. 363-368
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 18. |
- Kecklund, Göran, et al.
(författare)
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Må bra i skiftarbete : Hur ser de goda lösningarna ut?
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Projektet ”Må bra i skiftarbete” handlar om sambandet mellan skiftschemats utformning och förekomst av sömn och hälsobesvär. Projektet består av fyra delstudier:1) en enkätstudie med syfte att undersöka samband mellan objektiva arbetstider och sömn, trötthet, hälsa och välbefinnande bland sjukvårdspersonal, exklusive läkare2) i samma population undersöka skillnader i hälsa och välbefinnande mellan tre olika arbetstidsmodeller – fast schema, reducerad arbetstid (med bibehållen lön) samt individuell schemaplanering (ISP)3) en klusterrandomiserad interventionsstudie där personalen vid tre avdelningar erbjöds utbildning om skiftarbete, sömn och hälsa. Dessa avdelningar jämfördes med tre avdelningar där personalen förutom utbildning även fick individuell schemaåterkoppling. Samtliga avdelningar hade ISP.4) en pilotstudie på läkare som använder ISP. Pilotstudien omfattade en enkät samt objektiva arbetstidsdata bland ett litet urval läkare.Undersökningen är baserad på enkäter och objektiva arbetstider. De viktigaste resultaten var:(1) De besvärligaste arbetstidskomponenterna var kort dygnsvila, roterande treskift, och helgarbete. Kort dygnsvila innebar otillräcklig sömn och ungefär 2,5 timmes sömnbrist.(2) Det fanns inga samband mellan förekomst av kort dygnsvila respektive nattarbete (baserade på objektiva arbetstidsdata) och psykisk ohälsa, otillräcklig återhämtning, att arbetet stör privatlivet och uppfattning om att inte orka arbeta fram till pension.(3) Däremot fanns det tydliga samband mellan att uppleva stora besvär med kort dygnsvila och nattarbete, och psykisk ohälsa, otillräcklig återhämtning, att arbetet stör privatlivet och att inte orka arbeta fram till pension (under rådande arbetsförhållanden).(4) Även hög arbetsbelastning, att uppleva att arbetet är emotionellt krävande, samt att inte få tillräckliga raster, visade samband med psykisk ohälsa och att inte orka arbeta fram till pension.(5) Jämförelsen av arbetstidsmodellerna – fast schema, reducerad arbetstid och ISP – visade marginella skillnader när det gäller hälsa, återhämtning och arbetsrelaterade störningar av privatlivet.(6) Interventionen, särskilt utbildning, var uppskattad av deltagarna men hade ingen effekt på hälsa, återhämtning och störningar i privatlivet. Interventionen innebar en ökning av mindre personalkonflikter relaterade till de valda arbetstiderna.(7) Pilotstudien om ISP för läkare visade att många uppskattade att kunna påverka sitt arbetstidsschema och rekommenderade andra avdelningar att pröva ISP. Däremot påverkade inte ISP förekomsten av hälso- och sömnbesvär.
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| 19. |
- Lowden, Arne, et al.
(författare)
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Considerations on how to light the night-shift
- 2021
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Ingår i: Lighting Research and Technology. - : SAGE Publications. - 1477-1535 .- 1477-0938. ; 53:5, s. 437-452
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Tidskriftsartikel (refereegranskat)abstract
- Electric lighting has decreased dependence on natural light to illuminate the workplace. Humans are genetically predisposed to be day-oriented (diurnal) and depend on daylight to regulate circadian rhythms. Shift work will force workers to sleep and work at non-biological times, inducing circadian disruption with implications for workers' safety and health. The scientific literature may be used in practice in shift work settings to improve safety, performance and health in the workplace by reducing circadian misalignment. Alertness profiles at work and degree of melatonin suppression may indicate degree of circadian disruption among workers. However, when considering lighting solutions at night, there are several factors that need consideration. Light measures based on biological effectiveness should be used rather than room illuminance giving better predictions of performance and long-term health among workers. Also, large individual differences in light sensitivity and preferences suggest not only to rely on common lighting alone but also to implement complementary individual lighting solutions at work. Lighting advice should consider shift scheduling characteristics such as speed of turnover and shift timing to guide decisions of preferred circadian phase influence. Lighting should also include the flexibility to be fit for morning, afternoon and evening work.
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| 20. |
- Nyberg, Anna, et al.
(författare)
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Workplace violence and health in human service industries : a systematic review of prospective and longitudinal studies
- 2021
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 78:2, s. 69-81
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Forskningsöversikt (refereegranskat)abstract
- Objectives To provide systematically evaluated evidence of prospective associations between exposure to physical, psychological and gender-based violence and health among healthcare, social care and education workers.Methods The guidelines on Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. Medline, Cinahl, Web of Science and PsycInfo were searched for population: human service workers; exposure: workplace violence; and study type:prospective or longitudinal in articles published 1990–August 2019. Quality assessment was performed based on a modified version of the Cochrane’s ‘Tool to Assess Risk of Bias in Cohort Studies’.Results After deduplication, 3566 studies remained, of which 132 articles were selected for full-text screening and 28 were included in the systematic review. A majority of the studies focused on healthcare personnel, were from the Nordic countries and were assessed to have medium quality. Nine of 11 associations between physical violence and poor mental health were statistically significant, and 3 of 4 associations between physical violence and sickness absence. Ten of 13 associations between psychological violence and poor mental health were statistically significant and 6 of 6 associations between psychological violence and sickness absence. The only study on gender-based violence and health reported a statistically non-significant association.Conclusion There is consistent evidence mainly in medium quality studies of prospective associations between psychological violence and poor mental health and sickness absence, and between physical violence and poor mental health in human service workers. More research using objective outcomes, improved exposure assessment and that focus on gender-based violence is needed.
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| 21. |
- Persson Asplund, Robert, 1977-
(författare)
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Learning how to recover from stress-related disorders via internet-based interventions
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Stress has become one of the major challenges of modern society, especially within the working population, causing significant costs and personal problems. However, the range of prevention and treatment is not at all proportionate to the needs of the public. Internet provides new options for broad dissemination and a growing body of evidence suggest that internet-based interventions for stress could be effective. However, few studies have examined the efficacy in clinical samples or how participants experience these new treatment delivery formats. Further, only a limited number of studies have evaluated the efficacy of work-focused stress interventions on work-related outcomes (e.g., absenteeism), and if recovery has the potential in stress-prevention.In the present thesis, internet-based cognitive behavioural stress interventions (iCBT), designed to reduce symptoms of stress and increase recovery and workparticipation among 117 managers and 260 employees, were evaluated in three randomized controlled trials (Study I, III and IV) and a qualitative study (Study II). Results of Study I and III indicate that the iCBT for managers and employees with stress-related disorders was effective in reducing symptoms of chronic stress. In Study III effects on work-related outcomes, e.g., work ability and absenteeism, were only seen in the work-focused iCBT. In Study II, participants found the work-focused iCBT to be accessible and feasible and reported positive experiences on stress and well-being in both life and at work. Finally, preliminary results in Study IV suggest that recovery experiences, an important protective factor against chronic stress, could be improved by a brief internet-based recovery intervention.In conclusion, if implemented, these relatively brief and accessible interventions could be a feasible way to increase access to treatment and learning distressed employees and others how to prevent and recover from stress-related disorders.
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| 22. |
- Petersen, Helena, et al.
(författare)
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Disturbed sleep and its attribution to stress and other causes : A population-based survey
- 2023
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Ingår i: Scandinavian Journal of Psychology. - : John Wiley & Sons. - 0036-5564 .- 1467-9450. ; 64:2, s. 99-104
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Tidskriftsartikel (refereegranskat)abstract
- This study explores the prevalence of attributed causes of disturbed sleep and the association between stress-disturbed sleep and age, sex, and sleep duration on weekdays as well as weekends in a representative sample. A nationally representative sample (n = 1,128, response rate 72.8%), stratified for sex and age, completed a computer-assisted phone survey that included questions about sleep disturbances and attributed causes. Stress was the main attributed cause of sleep disturbance (35.1%), most frequently attributed by younger women (χ2 = 26.5, p < 0.001). Prevalence of stress-disturbed sleep was higher with lower age (B = −0.05, odds ratio (OR) = 0.94, CI = 0.91, 0.98). There was a trend, however, toward a significant interaction between age and sex, with women in the older age-groups more frequently reporting stress-disturbed sleep than older men (B = −0.02, OR = 1.022, CI = 1.003, 1.042). Weekday sleep duration decreased with increased stress-disturbed sleep, with an inverse relationship on weekends except for those reporting stress-disturbed sleep more than 5 days per week (F = 10.5, p < 0.001), who also had the shortest weekend sleep duration. Sleep disturbances were commonly attributed to stress, and more strongly so in women younger than 46 years. Stress-disturbed sleep during weekdays seems to be potentially compensated for with extended sleep on weekends, except for those with continuous stress-disturbed sleep.
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| 23. |
- Radun, Igor, et al.
(författare)
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Sleepy drivers on a slippery road : A pilot study using a driving simulator
- 2022
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Ingår i: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869. ; 31:2
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Tidskriftsartikel (refereegranskat)abstract
- Sleepy drivers have problems with keeping the vehicle within the lines, and might often need to apply a sudden or hard corrective steering wheel movement. Such movements, if they occur while driving on a slippery road, might increase the risk of ending off road due to the unforgiving nature of slippery roads. We tested this hypothesis. Twelve young men participated in a driving simulator experiment with two counterbalanced conditions; dry versus slippery road x day (alert) versus night (sleepy) driving. The participants drove 52.5 km on a monotonous two-lane highway and rated their sleepiness seven times using the Karolinska Sleepiness Scale. Blink durations were extracted from an electrooculogram. The standard deviation of lateral position and the smoothness of steering events were measures of driving performance. Each outcome variable was analysed with mixed-effect models with road condition, time-of-day and time-on-task as predictors. The Karolinska Sleepiness Scale increased with time-on-task (p < 0.001) and was higher during night drives (p < 0.001), with a three-way interaction suggesting a small increased sleepiness with driving time at night with slippery road conditions (p = 0.012). Blink durations increased with time-on-task (p < 0.01) with an interaction between time-of-day and road condition (p = 0.040) such that physiological sleepiness was lower for sleep-deprived participants in demanding road conditions. The standard deviation of lateral position increased with time-on-task (p = 0.026); however, during night driving it was lower on a slippery road (p = 0.025). The results indicate that driving in demanding road condition (i.e. slippery road) might further exhaust already sleepy drivers, although this is not clearly reflected in driving performance.
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| 24. |
- Radun, Igor, et al.
(författare)
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Suicide by crashing into a heavy vehicle : A one-year follow-up study of professional drivers
- 2020
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Ingår i: Transportation Research Part F. - : Elsevier BV. - 1369-8478 .- 1873-5517. ; 73, s. 318-324
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Tidskriftsartikel (refereegranskat)abstract
- Train and heavy vehicle drivers can experience a traumatic event caused by people attempting suicide by crashing into their vehicles or jumping in front of them. While there are a number of studies on train drivers showing the negative consequences these events can have on their well-being, there are no studies on heavy vehicle drivers involved in these types of crashes. In the current study, we surveyed Finnish heavy vehicle drivers (N = 15) involved in a suicide crash in the year 2017 regarding their experiences and coping approximately one month (T1) and one year (T2) after the crash. Ten of these drivers reported one or various combinations of measurable consequences such as minor physical injuries, shorter or longer sickness absences, significant posttraumatic stress symptoms (measured using the Impact of Events Scale-Revised) and requiring psychological help. Posttraumatic stress symptoms decreased over time; however, three out of the four drivers who had a high IES-R score at T1 were still around the IES-R cut-off score at T2. This research raises questions whether and what kind of support heavy vehicle drivers who have been involved in a suicide crash should be given.
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| 25. |
- Rocha, Felipe Pereira, et al.
(författare)
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Evaluation of truck driver rest locations and sleep quality
- 2022
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Ingår i: Sleep Science. - : Georg Thieme Verlag KG. - 1984-0659 .- 1984-0063. ; 15:1, s. 55-61
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Truck drivers’ work organization requires that rest and sleep be taken in various locations, where sleep quality might be affected by the discomfort of these environments. The purpose of this study was to evaluate truck drivers’ rest locations and their association with sleep quality utilizing an ergonomic approach. MATERIAL AND METHODS: The sleep quality of 81 truck drivers was assessed using the Pittsburgh sleep quality index (PSQI). An adapted version of the ergonomics workplace analysis (EWA) instrument was used to evaluate 44 rest locations. RESULTS: Half of the workers preferred sleeper berths (51.2%) as a rest place. Sleep was classified as poor by 71.6% of the drivers. Dorms were rated more positively (p<0.001) by truck drivers (2.0±1.1) than by the analyst (2.6±0.6). Sleeper berths and dorms were rated statistically different by truck drivers (p=0.002), as well as by the analyst (p=0.003). No correlation was found between EWA evaluations and total score for sleep quality. Separate analyses of dorms and truck berths showed very few correlations. The higher the noise of roommates in dorms, the worse the sleep quality. Conversely, noise in corridors or outside the room positively impacted sleep quality. CONCLUSION: Noise in the rest place may affect sleep in both directions, negatively or positively. Sleep was classified as poor regardless of resting place. The quality of resting places seemed to have little effect on sleep quality of truck drivers. Factors other than rest place, such as work scheduling, are probably more important for promoting good sleep quality.
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