| 1. |
- Miley-Åkerstedt, Anna, et al.
(author)
-
Criteria for self-reported quantitative sleep characteristics of individuals who sought medical help for disturbed sleep - a survey of a representative sample of the Swedish population
- 2018
-
In: Nature and Science of Sleep. - 1179-1608. ; 10, s. 295-301
-
Journal article (peer-reviewed)abstract
- Background: The public often seeks rule-of-thumb criteria for good or poor sleep, with a particular emphasis on sleep duration, sleep latency, and the number of awakenings each night. However, very few criteria are available. Aim: The present study sought to identify such criteria. Methods: Whether or not a person has sought medical help for sleep problems was selected as an indicator of poor sleep. The group that was studied constituted a representative sample of the general Swedish population (N=1,128), with a response rate of 72.8%. Results: Logistic regression analysis, with an adjustment for age and gender, showed an increased OR for a weekday sleep duration of <= 6 hour, (OR >2, and for <5 hour: OR >6). For weekend sleep, the value was <= 6 hour (OR >2). For awakenings per night, the critical value was >= 2 (OR >2, and for awakenings: OR >9), and for a sleep latency the critical value was >= 30 minutes (OR >2, and for >= 45 minutes: OR >6). Adding difficulties falling asleep and early morning awakening (considered qualitative because of the reflected difficulty), led to the elimination of all the quantitative variables, except for the number of awakenings. The addition of negative effects on daytime functioning and sleep being a big problem resulted in the elimination of all the other predictors except age. Conclusion: It was concluded that weekday sleep <= 6 hour, >= 2 awakenings/night, and a sleep latency of >= 30 minutes, can function as criteria for poor sleep, but that qualitative sleep variables take over the role of quantitative ones, probably because they represent the integration of quantitative indicators of sleep.
|
|
| 2. |
- Barck-Holst, Peter, et al.
(author)
-
Reduced working hours and stress in the Swedish social services : A longitudinal study
- 2017
-
In: International Social Work. - : SAGE Publications. - 0020-8728 .- 1461-7234. ; 60:4, s. 897-913
-
Journal article (peer-reviewed)abstract
- Stress has been reported among Swedish social workers for over a decade. Survey data from a longitudinal quasi-experimental trial in the public sector of reduced working hours, with a proportional decrease in workload and retained full pay, were used to examine the effect on stress, symptoms of Exhaustion syndrome, psychosocial work characteristics and work-life balance in social workers. Reduced working hours had a positive effect on restorative sleep, stress, memory difficulties, negative emotion, sleepiness, fatigue and exhaustion both on workdays and weekends; on sleep quality on weekends; and on demands, instrumental manager support and work intrusion on private life.
|
|
| 3. |
- Di Milia, Lee, et al.
(author)
-
Sleepiness, long distance commuting and night work as predictors of driving performance
- 2012
-
In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 7:9, s. e45856-
-
Journal article (peer-reviewed)abstract
- Few studies have examined the effect of working night shift and long distance commuting. We examined the association between several sleep related and demographic variables, commuting distance, night work and use of mobile phones on driving performance. We used a prospective design to recruit participants and conducted a telephone survey (n = 649). The survey collected demographic and journey details, work and sleep history and driving performance concerning the day the participant was recruited. Participants also completed the Karolinska Sleepiness Scale and the Epworth Sleepiness Scale. Night workers reported significantly more sleepiness, shorter sleep duration and commuting longer distances. Seven variables were significant predictors of lane crossing. The strongest predictor was acute sleepiness (OR = 5.25, CI, 1.42-19.49, p < 0.01) followed by driving >= 150 kms (OR = 3.61, CI, 1.66-7.81, p < 0.001), obtaining less than 10 hours sleep in the previous 48 hours (OR = 2.58, CI, 1.03-6.46, p < 0.05), driving after night shift (OR = 2.19, CI, 1.24-3.88, p < 0.001), being <43 years old (OR = 1.95, CI, 1.11-3.41, p < 0.05) and using mobile phones during the journey (OR = 1.90, CI, 1.10-3.27, p < 0.05). Sleep related variables, long-distance commuting and night work have a major impact on lane crossing. Several interventions should be considered to reduce the level of sleepiness in night workers.
|
|
| 4. |
- Hedström, Anna Karin, et al.
(author)
-
Short- and long-term mortality following hypnotic use
- 2020
-
In: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 29:4
-
Journal article (peer-reviewed)abstract
- Potential long-term consequences of hypnotics remain controversial. We used the prospective Swedish National March Cohort, a study based on 41,695 participants with a mean follow-up duration of 18.9 years. Logistic regression models and Cox proportional hazards models with attained age as timescale were used to assess associations of hypnotic use with short- and long-term mortality. The proportion of subjects who initiated or discontinued hypnotic use during follow-up was substantial. All groups of hypnotics were associated with increased mortality within 2 years after a first prescription, with an overall OR of 2.38 (95% CI, 2.13-2.66). The association was more pronounced among subjects younger than 60 years (OR, 6.16; 95% CI, 3.98-9.52). There was no association between hypnotic use and long-term mortality. The association between hypnotic use and increased mortality was thus restricted to a relatively short period after treatment initiation, and may be explained in terms of confounding by indication.
|
|
| 5. |
- Lekander, Mats, et al.
(author)
-
Subjective health perception in healthy young men changes in response to experimentally restricted sleep and subsequent recovery sleep
- 2013
-
In: Brain Behavior and Immunity. - : Elsevier BV. - 0889-1591 .- 1090-2139. ; 34, s. 43-46
-
Journal article (peer-reviewed)abstract
- Sleep and subjective health are both prospectively related to objective indices of health and health care use. Here, we tested whether five days with restricted sleep and subsequent recovery days affect subjective health and is related to increased levels of circulating IL-6 and TNF-alpha and fatigue. Nine healthy men (23-28 years) went through a 6-week sleep protocol with subjects as their own controls in a repeated measures design with a total of 11 nights in a sleep laboratory. The experimental part of the protocol included three baseline days (sleep 23-07 h), five days with sleep restriction (03-07 h) and three recovery days (23-07 h) in the sleep laboratory. Subjective health and fatigue was recorded daily. Eight blood samples were drawn each day (every third hour) on 8 days of the protocol and analyzed with respect to IL-6 and TNF-alpha. Subjective health deteriorated gradually during restricted sleep (p = .002) and returned to baseline levels after three days of recovery. IL-6 and TNF-alpha did not change significantly. Fatigue increased gradually during sleep restriction (p = .001), which significantly contributed to the association between restricted sleep and subjective health. The study is the first to show that subjective health is directly responsive to changes in sleep length and related to increased fatigue. Thus, subjective health is differently appraised after manipulation of one of its presumed determinants. Larger experimental studies would be beneficial to further distinguish causation from association regarding the underpinnings of subjective health. (C) 2013 Published by Elsevier Inc.
|
|
| 6. |
- Lindsäter, Elin, et al.
(author)
-
Internet-Based Cognitive Behavioral Therapy for Chronic Stress : A Randomized Controlled Trial
- 2018
-
In: Psychotherapy and Psychosomatics. - : S. Karger AG. - 0033-3190 .- 1423-0348. ; 87:5, s. 296-305
-
Journal article (peer-reviewed)abstract
- Background: Prolonged exposure to stress can lead to substantial suffering, impairment and societal costs. However, access to psychological treatment is limited. Internet-based cognitive behavioral therapy (ICBT) can be effective in reducing symptoms of stress, but little is known of its effects in clinical samples. The aim of this study was to investigate the efficacy of ICBT for patients suffering from chronic stress, operationalized as adjustment disorder (AD) and exhaustion disorder (ED). Methods: A total of 100 adults diagnosed with AD or ED were randomly assigned to a 12-week ICBT (n = 50) or waitlist control condition (n = 50). Primary outcome was the level of perceived stress (PSS). Secondary outcomes included several mental health symptom domains as well as functional impairment and work ability. All outcomes were assessed at baseline, after treatment and at the 6-month follow-up. The study was preregistered at Clinicaltrials.gov: NCT02540317. Results: Compared to the control condition, patients in the ICBT group made large and significant improvements on the PSS (d = 1.09) and moderate to large improvements in secondary symptom domains. Effects were maintained at the 6-month follow-up. There was no significant between-group effect on functional impairment or work ability. Conclusions: A relatively short ICBT is indicated to be effective in reducing stress-related symptoms in a clinical sample of patients with AD and ED, and has the potential to substantially increase treatment accessibility. Results must be replicated, and further research is needed to understand the relationship between symptom reduction, functional impairment and work ability.
|
|
| 7. |
|
|
| 8. |
- Nordin, Maria, et al.
(author)
-
Psychometric evaluation and normative data for the Karolinska Sleep Questionnaire
- 2013
-
In: Sleep and Biological Rhythms. - Hoboken : Springer Science and Business Media LLC. - 1446-9235 .- 1479-8425. ; 11:4, s. 216-226
-
Journal article (peer-reviewed)abstract
- The study objective was to validate the Karolinska Sleep Questionnaire with regard to dimensionality, internal consistency, and construct and criterion validity. Another objective was to provide normative data. Data from the cross-sectional Vasterbotten Environmental Health Study in Sweden were used. The 3406 participants in this study, 18 to 79 years old, constituted a random sample stratified for age and sex. Along with the Karolinska Sleep Questionnaire, the participants responded to the Hospital Anxiety and Depression Scale, the Perceived Stress Scale, and the Shirom Melamed Burnout Questionnaire for assessing construct validity. Factor analyses of the questions in the Karolinska Sleep Questionnaire that relate to nocturnal sleep revealed the dimensions sleep quality, non-restorative sleep, and sleep apnea. A separate factor analysis on the questions regarding day time sleepiness revealed a sleepiness dimension. The sleep quality, non-restorative sleep, and sleepiness dimensions showed approximate normal distributions, whereas the distribution for sleep apnea was positively skewed. All dimensions showed good internal consistency. Satisfactory construct validity was found for all dimensions. Using the DSM-IV criteria of insomnia, relevant questions in the Karolinska Sleep Questionnaire were combined into an index of nocturnal symptoms of insomnia as were questions of sleep apnea. Prevalences of insomnia and sleep apnea correspond well to those of other studies, indicating good criterion validity. The favorable psychometric properties of the dimensions and indexes from the Karolinska Sleep Questionnaire suggest their use for assessing sleep quality, non-restorative sleep, sleep apnea, sleepiness and nocturnal symptoms of insomnia.
|
|
| 9. |
- Westerlund, Anna, et al.
(author)
-
Using the Karolinska Sleep Questionnaire to identify obstructive sleep apnea syndrome in a sleep clinic population
- 2014
-
In: Clinical Respiratory Journal. - : Wiley. - 1752-6981 .- 1752-699X. ; 8:4, s. 444-454
-
Journal article (peer-reviewed)abstract
- Introduction: In Scandinavia, portable monitoring has virtually replaced standard polysomnography for diagnosis of obstructive sleep apnea syndrome (OSAS). Because waiting times for specialized OSAS care remain long, an accurate screening tool to exclude low-risk patients from diagnostic testing would be valuable. Objectives: To examine the diagnostic accuracy of the Karolinska Sleep Questionnaire (KSQ) for OSAS. Methods: Consecutive patients, 30-66 years old, attending a large sleep clinic in Sweden for OSAS evaluation completed the KSQ and underwent in-home portable monitoring and medical history evaluation. OSAS was defined as apnea-hypopnea index >= 5 with symptoms of disease. We calculated sensitivity and specificity of apnea/snoring and sleepiness indices of the KSQ. Retrospectively, we combined six KSQ items (snoring, breathing cessations, disturbed sleep, etc.) and four clinical variables (age, sex, body mass index, smoking status) predictive of OSAS into a new instrument, which we also evaluated. Instrument score ranged between 0 and 21; a higher score indicated more severe symptoms. Results: Of 103 patients, 62 were diagnosed with OSAS. Sensitivity and specificity of the indices were 0.56 and 0.68 (apnea/snoring), and 0.37 and 0.71 (sleepiness). The new instrument performed optimally at a score of 9. Sensitivity was 0.76 (95% confidence interval 0.63-0.86) and specificity 0.88 (0.74-0.96). Between 19.4% and 50.5% of patients were unaware of having apnea/snoring symptoms. Conclusions: Diagnostic accuracy of the apnea/snoring and sleepiness indices for OSAS was poor but could be improved by combining clinical and KSQ items. The usefulness of the apnea/snoring index and the combined instrument was questionable because of extensive symptom unawareness.
|
|
| 10. |
- Åkerstedt, Torbjorn, et al.
(author)
-
Night work, mortality, and the link to occupational group and sex
- 2020
-
In: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 46:5, s. 508-515
-
Journal article (peer-reviewed)abstract
- Objective Night shifts are associated with several major diseases. Mortality has been studied only to a limited extent, and the association with night shifts remains unclear. The purpose of the present study was to investigate the association between duration of night shift exposure and mortality in a large sample from the Swedish Twin Registry (the SALT cohort).Methods Cox proportional hazards regression models were used to analyze the data (N=42 731) over a followup period of 18 years, with years of night shift work as the exposure variable and adjustment for lifestyle factors and age, and stratification on gender and occupational group.Results The hazard ratio (HR) for “ever” night shifts for total mortality was 1.07 [95% confidence interval (CI) 1.01–1.15] but 1.15 (95% CI 1.07–1.25) for longer exposure (>5 years). Also, HR for cause-specific mortality due to cardiovascular disease was significant, with higher HR for longer night shift exposure. Mortality due to cancer was significant for longer exposure only. White-collar workers showed significant HR for longer exposure. In particular, male white-collar workers showed a significant HR, with a highest value for longer exposure [HR 1.28 (95% CI 1.09–1.49)]. Heredity did not influence the results significantly.Conclusions Long duration of exposure to night shift work is associated with increased mortality, particularly in male white-collar workers. The lack of effects of accumulated exposure suggests that the results should be interpreted with caution.
|
|
