Subjective sleepiness is a sensitive indicator of insufficient sleep and impaired waking function

Publisher's full text
Torbjorn Åkerstedt
John Axelsson
Goran Kecklund

The main consequence of insufficient sleep is sleepiness. While measures of sleep latency, continuous encephalographical/electro-oculographical (EEG/EOG) recording and performance tests are useful indicators of sleepiness in the laboratory and clinic, they are not easily implemented in large, real-life field studies. Subjective ratings of sleepiness, which are easily applied and unobtrusive, are an alternative, but whether they measure sleepiness sensitively, reliably and validly remains uncertain. This review brings together research relevant to these issues. It is focused on the Karolinska Sleepiness Scale (KSS), which is a nine-point Likert-type scale.

The diurnal pattern of sleepiness is U-shaped, with high KSS values in the morning and late evening, and with great stability across years. KSS values increase sensitively during acute total and repeated partial sleep deprivation and night work, including night driving. The effect sizes range between 1.5 and 3. The relation to driving performance or EEG/EOG indicators of sleepiness is highly significant, strongly curvilinear and consistent across individuals. High (>6) KSS values are associated particularly with impaired driving performance and sleep intrusions in the EEG. KSS values are also increased in many clinical conditions such as sleep apnea, depression and burnout. The context has a strong influence on KSS ratings. Thus, physical activity, social interaction and light exposure will reduce KSS values by 1–2 units. In contrast, time-on-task in a monotonous context will increase KSS values by 1–2 units. In summary, subjective ratings of sleepiness as described here is as sensitive and valid an indicator of sleepiness as objective measures, and particularly suitable for field studies.

LATEST NEWS


2018-06-13

International Conference on Electric Road Systems starts today

Electric Road Systems (ERS) is a relatively new concept with many initiatives on the way. To learn from each other and stimulate new collaborations the Swedish Research and Innovation Platform for Electric Roads arranged the first international conference...


2018-05-18

Same survey of road users’ attitudes in 50 countries

At the Road Safety on Five Continents Conference, RS5C, one entire session presented a large survey of road users' attitudes in 38 countries. Results show large differences between countries in many areas, both regarding behavior and attitudes. A new survey...


2018-05-17

Good results with alcohol interlock program according to Swedish study

An alcohol interlock program makes it possible for drink driving offenders to continue their everyday lives. In a Swedish study most of the participants were satisfied with the program and experienced improved health. They also reported drinking alcohol more...


2018-05-16

Traffic safety in the spotlight

Today the Conference Road Safety on Five Continents (RS5C) opened in Jeju Island, South Korea. More than 220 participators have come from all over the world to present findings and learn about traffic safety. Dr. Young Tae Kim, Secretary-General of the...


2018-04-17

VTI will develop simulators for ambulance staff

VTI has initiated a pilot study for paramedics with the Centre for Teaching & Research in Disaster Medicine and Traumatology and Linköping University. The aim is to give ambulance staff the opportunity to practice critical medical tasks in a moving vehicle in...


2018-04-12

Unique electrified road opens in Sweden

The world’s first electrified road recharging the batteries of cars and trucks while driving opened in Sweden. The Swedish Minister for Infrastructure, Tomas Eneroth, was at the formal inauguration of the electrified road on April 11, 2018. VTI is one of 22...