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Summary: Bedtime is frequently delayed by many factors in life, and a homeostatic response to the delay may compensate partly for increased time awake and shortened sleep. Because sleep becomes shorter with age and women complain of disturbed sleep more often than men, age and sex differences in the homeostatic response to a delayed bedtime may modify the homeostatic response. The purpose of the present study was to investigate the effect of late‐night short‐sleep (3 h with awakening at about 07:00 hours) on in‐home recorded sleep in men and women in two age groups (20–30 and 65–75 years). Results (N = 59) showed that late‐night short‐sleep was associated with an increase in percentage of N3 sleep and a decrease in percentage of rapid eye movement sleep, as well as decreases in several measures of sleep discontinuity and rapid eye movement density. Men showed a smaller decrease in percentage of rapid eye movement sleep than women in response to late‐night short‐sleep, as did older individuals of both sexes compared with younger. Older men showed a weaker percentage of N3 sleep in response to late‐night short‐sleep than younger men. In general, men showed a greater percentage of rapid eye movement sleep and a lower percentage of N3 sleep than women, and older individuals showed a lower percentage of N3 sleep than younger. In particular, older men showed very low levels of percentage of N3 sleep. We conclude that older males show less of a homeostatic response to late‐night short‐sleep. This may be an indication of impaired capacity for recovery in older men. Future studies should investigate if this pattern can be linked to gender‐associated differences in morbidity and mortality. [ABSTRACT FROM AUTHOR]

Human fatigue continues to threaten safe transport. There are claims that employers of operators should do more to mitigate the risks, and several regulators are promoting fatigue-risk management in the context of safety management systems (SMS). The current paper reviews fatigue-related risk and exposure factors and control measures for operators of land- and sea-based transport forms. Our review identifies 13 types of measures for the monitoring or control of fatigue risks: optimal staffing; optimal schedule design; optimisation of breaks/naps; monitoring of actual hours worked; optimisation of work content; monitoring and feedback of actual sleep; health screening and treatment; promotion of recovery from work; fitness-for-duty testing; monitoring of fatigue symptoms while operating; control of fatigue while operating; performance monitoring and assistance; and fatigue-proofing. We also identify two systemic measures needed to anchor risk mitigation in SMS: organisational learning and training/other. By structuring monitoring and control measures along Dawson and McCulloch’s [Managing fatigue: It’s about sleep.Sleep Medicine Reviews, 9(5), 365–380] fatigue-risk trajectory, a framework is obtained that acts as a guide for fatigue-risk management by transport employers. To inform transport managers further, evaluations are needed of the effectiveness of individual control measures as well as whole fatigue-risk management interventions. [ABSTRACT FROM AUTHOR]

Objectives Prostate cancer is the most common cancer and the second leading cause of cancer-related deaths among men, but the contributing factors are unclear. One such may be night work because of the day/night alternation of work and the resulting disturbance of the circadian system. The purpose of the present study was to investigate the prospective relation between number of years with night work and prostate cancer in men. Design Cohort study comparing night and day working twins with respect to incident prostate cancer in 12 322 men. Setting Individuals in the Swedish Twin Registry. Participants 12 322 male twins. Outcome measures Prostate cancer diagnoses obtained from the Swedish Cancer Registry with a follow-up time of 12 years, with a total number of cases=454. Results Multiple Cox proportional hazard regression analysis, adjusted for a number of covariates, showed no association between ever night work and prostate cancer, nor for duration of night work and prostate cancer. Analysis of twin pairs discordant for prostate cancer (n=332) showed no significant association between night work and prostate cancer. Conclusions The results, together with previous studies, suggest that night work does not seem to constitute a risk factor for prostate cancer. [ABSTRACT FROM AUTHOR]

BACKGROUND: Shift work has been associated with poor health, sleep and fatigue problems and low satisfaction with working hours. However, one type of shift working, namely split shifts, have received little attention. OBJECTIVE: This study examined stress, health and psychosocial aspects of split-shift schedules among bus drivers in urban transport. METHODS: A questionnaire was distributed to drivers working more than 70% of full time which 235 drivers in total answered. RESULTS: In general, drivers working split-shift schedules (n = 146) did not differ from drivers not working such shifts (n = 83) as regards any of the outcome variables that were studied. However, when individual perceptions towards split-shift schedules were taken into account, a different picture appeared. Bus drivers who reported problems working split shifts (36%) reported poorer health, higher perceived stress, working hours interfering with social life, lower sleep quality, more persistent fatigue and lower general work satisfaction than those who did not view split shifts as a problem. Moreover, drivers who reported problems with split shifts also perceived lower possibilities to influence working hours, indicating lower work time control. CONCLUSIONS: This study indicates that split shifts were not associated with increased stress, poorer health and adverse psychosocial work factors for the entire study sample. However, the results showed that individual differences were important and approximately one third of the drivers reported problems with split shifts, which in turn was associated with stress, poor health and negative psychosocial work conditions. More research is needed to understand the individual and organizational determinants of tolerance to split shifts. [ABSTRACT FROM AUTHOR]

Driver fatigue has received increased attention during recent years and is now considered to be a major contributor to approximately 15-30% of all crashes. However, little is known about fatigue in city bus drivers. It is hypothesized that city bus drivers suffer from sleepiness, which is due to a combination of working conditions, lack of health and reduced sleep quantity and quality. The overall aim with the current study is to investigate if severe driver sleepiness, as indicated by subjective reports of having to fight sleep while driving, is a problem for city based bus drivers in Sweden and if so, to identify the determinants related to working conditions, health and sleep which contribute towards this. The results indicate that driver sleepiness is a problem for city bus drivers, with 19% having to fight to stay awake while driving the bus 2-3 times each week or more and nearly half experiencing this at least 2-4 times per month. In conclusion, severe sleepiness, as indicated by having to fight sleep during driving, was common among the city bus drivers. Severe sleepiness correlated with fatigue related safety risks, such as near crashes. [ABSTRACT FROM AUTHOR]

We examined whether the beneficial impact of work time control (WTC) on sleep leads to lower accident risk, using data from a nationally representative survey conducted in Sweden. Logistic regressions examined WTC in 2010 and 2012 as predictors of accidents occurring in the subsequent 2 years (N= 4840 and 4337, respectively). Sleep disturbance and frequency of short sleeps in 2012 were examined as potential mediators of the associations between WTC in 2010 and subsequent accidents as reported in 2014 (N= 3636). All analyses adjusted for age, sex, education, occupational category, weekly work hours, shift work status, job control and perceived accident risk at work. In both waves, overall WTC was inversely associated with accidents (p= 0.048 andp= 0.038, respectively). Analyses of the sub-dimensions of WTC indicated that Control over Daily Hours (influence over start and finish times, and over length of shift) did not predict accidents in either wave, while Control over Time-off (CoT; influence over taking breaks, running private errands during work and taking paid leave) predicted fewer accidents in both waves (p= 0.013 andp= 0.010). Sleep disturbance in 2012 mediated associations between WTC/CoT in 2010 and accidents in 2014, although effects’ sizes were small (effectWTC= −0.006, 95% confidence interval [CI] = −0.018 to −0.001;effectCoT= −0.009, 95%CI = −0.022 to −0.001; unstandardized coefficients), with the indirect effects of sleep disturbance accounting for less than 5% of the total direct and indirect effects. Frequency of short sleeps was not a significant mediator. WTC reduces the risk of subsequently being involved in an accident, although sleep may not be a strong component of the mechanism underlying this association. [ABSTRACT FROM PUBLISHER]

BACKGROUND: Sickness presence (SP) is a complex phenomenon that has been shown to predict sickness absence, poor work performance, and suboptimal self-rated health. However, more research is needed to increase the understanding of how SP relates to occupational factors, demographic variables, and self-rated health. OBJECTIVE: The aims of this study were to investigate (1) the prevalence of SP among the Police employees in Sweden in 2007 and in 2010; (2) the association between demographics, seniority, occupational group (police officer vs civil servant), and self-reported health on the one hand and SP on the other hand for both years separately. METHODS: Survey data from Swedish Police employees from 2007 (n = 17,512) and 2010 (n = 18,415) were analyzed using logistic regression to assess odds ratios (OR) and 95% confidence intervals (CI). RESULTS: The prevalence of SP was stable between the years, but the proportion who stated that they had not been ill at all decreased from 2007 to 2010 (28.0% vs. 23.6%), while the proportion stating always having stayed at home when ill did not differ; 45.0% in 2007 to 45.8% in 2010. The ORs of SP were higher among those with suboptimal self-rated health compared to those with optimal self-rated health (4.38 (95% CI 4.02-4.78) and 4.31 (3.96-4.70) in 2007 and 2010, respectively) and among police officers compared with civilians (1.26 (1.17-1.36) and 1.19 (1.10-1.28)), whereas no clear patterns were found for age, gender, and seniority. CONCLUSIONS: The prevalences of SP were about the same in 2007 and 2010 and were slightly lower compared to in previous studies. The strong association between SP and suboptimal self-rated health suggests that high levels of SP may be an early marker of future illness and sickness absence. In future studies of SP it is important to account for having been ill, that is, at risk of SP. [ABSTRACT FROM AUTHOR]

Driving while sleepy is associated with increased crash risk. Rumble strips are designed to alert a sleepy or inattentive driver when they deviate outside their driving lane. The current study sought to examine the effects of repeated rumble strip hits on levels of physiological and subjective sleepiness as well as simulated driving performance. In total, 36 regular shift workers drove a high-fidelity moving base simulator on a simulated road with rumble strips installed at the shoulder and centre line after a working a full night shift. The results show that, on average, the first rumble strip occurred after 20 min of driving, with subsequent hits occurring 10 min later, with the last three occurring approximately every 5 min thereafter. Specifically, it was found that the first rumble strip hit reduced physiological sleepiness; however, subsequent hits did not increase alertness. Moreover, the results also demonstrate that increased subjective sleepiness levels, via the Karolinska Sleepiness Scale, were associated with a greater probability of hitting a rumble strip. The present results suggest that sleepiness is very resilient to even strongly arousing stimuli, with physiological and subjective sleepiness increasing over the duration of the drive, despite the interference caused by rumble strips. [ABSTRACT FROM AUTHOR]

This study aimed to examine the association between polysomnographic sleep and subjective habitual sleep quality and restoration from sleep. Thirty-one normal sleepers completed the Karolinska Sleep Questionnaire and multiple home polysomnography recordings (n= 2–5). Using linear regression, sleep quality and restoration were separately analyzed as functions of standard polysomnography parameters: sleep efficiency, total sleep time, sleep latency, stage 1 and 2 sleep, slow-wave sleep, rapid eye movement sleep, wake time after sleep onset, and awakenings (n), averaged across recordings. Stage 2 and slow-wave sleep predicted worse and better sleep quality, respectively. Also, slow-wave sleep predicted less subjective restoration, although adjustment for age attenuated this relation. Our findings lend some physiological validity to ratings of habitual sleep quality in normal sleepers. Data were less supportive of a physiological correlate of ratings of restoration from sleep. [ABSTRACT FROM PUBLISHER]

Objectives: Recent research has suggested a moderate link between night work and breast cancer in women, mainly through case-control studies, but non-significant studies are also common and cohort studies are few. The purpose of the present study was to provide new information from cohort data through investigating the association between the number of years with night work and breast cancer among women. Design: Cohort study of individuals exposed to night shift work in relation to incidence of breast cancer in women. Setting: Individuals in the Swedish Twin registry, with follow-up in the Swedish Cancer Registry. Participants: 13 656 women from the Swedish Twin Registry, with 3404 exposed to night work. Outcome measures: Breast cancer from the Swedish Cancer Registry (463 cases) during a follow-up time of 12 years. Results: A Cox proportional hazards regression analysis with control for a large number of confounders showed that the HR was HR=1.68 (95% CI 0.98 to 2.88) for the group with >20 years of night work. When the follow-up time was limited to ages below 60 years, those exposed >20 years showed a HR=1.77 (95% CI 1.03 to 3.04). Shorter exposure to night work showed no significant effects. Conclusions: The present results, together with previous work, suggest that night work is associated with an increased risk of breast cancer in women, but only after relatively long-term exposure. [ABSTRACT FROM AUTHOR]

Profound changes are taking place within working life, where established boundaries between work and personal life are challenged by increased global competition, ever-faster changing markets, and rapid development of boundary transcending information and communication technologies (CT). The aim of this study was to investigate boundary management preferences in terms of keeping work and personal life domains separated or integrated, that is, segmenting or blending of domains, the perception of being in control of one's preferred boundaries, and work-life balance among employees at a Swedish telecom company (N = 1,238, response rate 65%, men 73%, mean age 42 years). Psychosocial work factors, individual characteristics, sociodemographic factors, and work-life balance were investigated in relation to boundary management preferences and perceived boundary control. For high boundary control among segmenters, nearly all the studied psychosocial work factors were significant. Among integrators, this was the case only for clear expectations in work. For both groups, the individual capacity for self-regulation was associated with high boundary control. Regarding sociodemographic factors, cohabiting women with children who preferred segmentation had low boundary control. Finally, there was a main effect of boundary control on work-life balance. In particular, male segmenters perceiving high boundary control had better work-life balance than all others. Conclusions of the study are that segmenters need external boundaries in work for succesful boundary management. Moreover, self-regulation seems a crucial boundary competence in knowledge- intensive, flexible work. Results are of value for health promotion in modern work organizations in supporting employees achieving successful boundary control and subsequent work-life balance. [ABSTRACT FROM AUTHOR]

Sleepiness and fatigue are important risk factors in the transport sector and bio-mathematical sleepiness, sleep and fatigue modeling is increasingly becoming a valuable tool for assessing safety of work schedules and rosters in Fatigue Risk Management Systems (FRMS). The present study sought to validate the inner workings of one such model, Three Process Model (TPM), on aircrews and extend the model with functions to model jetlag and to directly assess the risk of any sleepiness level in any shift schedule or roster with and without knowledge of sleep timings. We collected sleep and sleepiness data from 136 aircrews in a real life situation by means of an application running on a handheld touch screen computer device (iPhone, iPod or iPad) and used the TPM to predict sleepiness with varying level of complexity of model equations and data. The results based on multilevel linear and non-linear mixed effects models showed that the TPM predictions correlated with observed ratings of sleepiness, but explorative analyses suggest that the default model can be improved and reduced to include only two-processes (S+C), with adjusted phases of the circadian process based on a single question of circadian type. We also extended the model with a function to model jetlag acclimatization and with estimates of individual differences including reference limits accounting for 50%, 75% and 90% of the population as well as functions for predicting the probability of any level of sleepiness for ecological assessment of absolute and relative risk of sleepiness in shift systems for safety applications. [ABSTRACT FROM AUTHOR]

The article focuses on a study conducted on 46 subjects to investigate the impact of stress on sleep. It reveals that polysomnographic data of 33 individuals were collected whereas 13 did not completed the full protocol because of minor disease and work schedules. It mentions that all participants were given a self-administered questionnaire based on their social and demographic background such as smoking, alcohol consumption and physical activity.

Seafarer sleepiness jeopardizes safety at sea and has been documented as a direct or contributing factor in many maritime accidents. This study investigates sleep, sleepiness, and neurobehavioral performance in a simulated 4 h on/8 h off watch system as well as the effects of a single free watch disturbance, simulating a condition of overtime work, resulting in 16 h of work in a row and a missed sleep opportunity. Thirty bridge officers (age 30 ± 6 yrs; 29 men) participated in bridge simulator trials on an identical 1-wk voyage in the North Sea and English Channel. The three watch teams started respectively with the 00-04, the 04-08, and the 08-12 watches. Participants rated their sleepiness every hour (Karolinska Sleepiness Scale [KSS]) and carried out a 5-min psychomotor vigilance test (PVT) test at the start and end of every watch. Polysomnography (PSG) was recorded during 6 watches in the first and the second half of the week. KSS was higher during the first (mean ± SD: 4.0 ± 0.2) compared with the second (3.3 ± 0.2) watch of the day ( p < 0.001). In addition, it increased with hours on watch ( p < 0.001), peaking at the end of watch (4.1 ± 0.2). The free watch disturbance increased KSS profoundly ( p < 0.001): from 4.2 ± 0.2 to 6.5 ± 0.3. PVT reaction times were slower during the first (290 ± 6 ms) compared with the second (280 ± 6 ms) watch of the day ( p < 0.001) as well as at the end of the watch (289 ± 6 ms) compared with the start (281 ± 6 ms; p = 0.001). The free watch disturbance increased reaction times ( p < 0.001) from 283 ± 5 to 306 ± 7 ms. Similar effects were observed for PVT lapses. One third of all participants slept during at least one of the PSG watches. Sleep on watch was most abundant in the team working 00-04 and it increased following the free watch disturbance. This study reveals that-within a 4 h on/8 h off shift system-subjective and objective sleepiness peak during the night and early morning watches, coinciding with a time frame in which relatively many maritime accidents occur. In addition, we showed that overtime work strongly increases sleepiness. Finally, a striking amount of participants fell asleep while on duty. [ABSTRACT FROM AUTHOR]

The aim of the present study was to explore if observer rated sleepiness (ORS) is a feasible method for quantification of driver sleepiness in field studies. Two measures of ORS were used: (1) one for behavioural signs based on facial expression, body gestures and body movements labelled B-ORS, and (2) one based on driving performance e.g. if swerving and other indicators of impaired driving occurs, labelled D-ORS. A limited number of observers sitting in the back of an experimental vehicle on a motorway about 2 hours repeatedly 3 times per day (before lunch, after lunch, at night) observed 24 participant’s sleepiness level with help of the two observer scales. At the same time the participant reported subjective sleepiness (KSS), EOG was recorded (for calculation of blink duration) and several driving measure were taken and synchronized with the reporting. Based on mixed model Anova and correlation analysis the result showed that observer ratings of sleepiness based on drivers’ impaired performance and behavioural signs are sensitive to extend the general pattern of time awake, circadian phase and time of driving. The detailed analysis of the subjective sleepiness and ORS showed weak correspondence on an individual level. Only 16% of the changes in KSS were predicted by the observer. The correlation between the observer ratings based on performance (D-ORS) and behavioural signs (B-ORS) are high (r = .588), and the B-ORS shows a moderately strong association (r = .360) with blink duration. Both ORS measures show an association (r>0.45) with KSS, whereas the association with driving performance is weak. The results show that the ORS-method detects the expected general variations in sleepy driving in field studies, however, sudden changes in driver sleepiness on a detailed level as 5 minutes is usually not detected; this holds true both when taking into account driving behaviour or driver behavioural signs. [ABSTRACT FROM AUTHOR]

This dedicated issue of Chronobiology International is devoted to the selected proceedings of the 20th International Symposium on Shift Work and Working Time held in Stockholm, Sweden, 28 June to 1 July 2011. It constitutes the fifth such issue of the journal since 2004 dedicated to the selected proceedings to the meetings of the Working Time Society. The key theme of the 20th Symposium was 'Biological Mechanisms, Recovery, and Risk Management in the 24-h Society.' The collection of papers of this dedicated issue represents the best of contemporary research on the effects of night and rotating shift schedules on worker health and safety. The contents cover such topics as sleep restriction, injuries, health, and performance of night work and rotating shiftwork, plus light treatment as a countermeasure against the circadian disruption of shiftwork. The majority of the papers are observational field studies, including some of large sample size, and three studies are well-designed laboratory experiments. (Author correspondence: ) [ABSTRACT FROM AUTHOR]

The article discusses a study conducted to know the effects of sleep loss on driving behaviour and subjective sleepiness ratings when driving on a road with a milled rumble strip in the centre of the lane. While comparing the alert condition with the sleep deprived condition, the study results found both the Standard Deviation of Lateral Position (SDLP) and the Karolinska Sleepiness Scale (KSS) increased for drivers with sleep deprivation.

The article focuses on a survey to find the role of night work, fatigue and sleepiness in traffic accidents. As mentioned, the survey was conducted on traffic and local police officers as well as prosecutors. It informs that the aim of survey was to understand the law which is applicable to prohibit fatigued driving. It also mentions that shift workers including police officers break the law while driving home after a night shift.

The article offers information on a study conducted to find the impact of organizational changes on work stress, sleep, recovery and health. It was speculated that less or disturbed sleep and incomplete recovery initiate the adverse health conditions and consequences of organizational changes which increases the work stress. The study was conducted on Swedish police force using cross sectional questionnaire.

This paper addresses the problem of detecting sleepiness in car drivers. First, a variety of sleepiness indicators (based on driving behavior) proposed in the literature were evaluated. These indicators were then subjected to parametric optimization using stochastic optimization methods. To improve performance, the functional form of some of the indicators was generalized before optimization. Next, using a neural network, the best performing sleepiness indicators were combined with a mathematical model of sleepiness, i.e., the sleep/wake predictor (SWP). The analyses were based on data obtained from a study that involved 12 test subjects at the moving-base driving simulator at the Swedish National Road and Transportation Research Institute (VTI), Linköping, Sweden. The data were derived from 12 1-h driving sessions for each test subject, with varying degrees of sleepiness. The performance measure (range [0,1]) for indicators was taken as the average of sensitivity and specificity. Starting with indicators proposed in the literature, the best such indicator, i.e., the standard deviation of the yaw angle, reached a performance score of 0.72 on previously unseen test data. It was found that indicators based on a given signal gave essentially equal performance after parametric optimization, but in no case was it better than 0.72. The best generalized indicator (the generic variability indicator) obtained a performance score of 0.74. SWP achieved a score of 0.78. However, by nonlinearly combining SWP with the generic variability indicator, a score of 0.83 was obtained. Thus, the results imply that a nonlinear combination of a measure based on driving behavior with a model of sleepiness significantly improves driver sleepiness detection. [ABSTRACT FROM PUBLISHER]

Very little is known about the prevalence of morning work and its relationship with sleep and fatigue. The present study obtained data from a representative sample of the Swedish population (N = 5489) to address this limitation in the literature. The results show that 15% of the population commenced work, at least occasionally, before 05:30 h and ∼2% did so most of the time. With the increasing phase advance of the start time, the time of rising also advanced, but bedtime changed very little. Thus, early start times were not compensated with earlier bedtimes. Total sleep time decreased as the work start time was advanced; sleep duration was <5 h for work start times between 03:00 and 04:30 h. The results also indicated that advanced start times were linked with increased fatigue, feelings of not being well rested, and reports of early start times as a rather large or very large problem. However, difficulties in waking and disturbed sleep did not change with advanced start times. It was concluded that early start times are common and are associated with sleep problems and fatigue. (Author correspondence: ) [ABSTRACT FROM AUTHOR]

Very little is known about the effects on sleep and sleepiness of entering or exiting shiftwork. The present study used a longitudinal database (n = 3637). Participants completed a questionnaire on work hours, sleep, and work environment at the start and end of a 5-yr period. Changes in shift/day work status were related to change in a number of subjective sleep variables using logistic regression analysis. The analyses were adjusted for age, sex, and differences in socioeconomic status, work demands, work control, physical workload, marriage status, and number of children. In comparison with constant day work, entering shiftwork (with or without night shifts) from day work increased the risk of difficulties in falling asleep, and leaving shiftwork reduced this risk (odds ratio [OR] = 2.8 [confidence interval, CI = 1.8–4.5]). Also falling asleep at work showed a consistent pattern; an increased risk of falling asleep for those with shiftwork on both occasions, and for those with night work on both occasions. Also entering night work was associated with a strongly increased risk of falling asleep at work (OR = 2.9 [CI = 1.3–6.7]). These results suggest that entering and leaving shiftwork has a considerable impact on sleep and alertness. However, there is a need for large and more extended longitudinal studies to support our findings. (Author correspondence: ) [ABSTRACT FROM AUTHOR]

The article examines the relationship between long-term sickness absence and disturbed sleep or fatigue among the workers of Sweden. It talks about poor sleep being prospectively related to mortality, cardiovascular disease and diabetes. It presents the study which was conducted using logistic regression analysis for different work environment variables such as disturbed sleep and fatigue.

The article presents information on a study conducted to determine the rate of road crashes due to the sleepiness while driving cars on roads. It mentions that sleep and fatigue while driving are considered as the contributing factors of road accidents as declared by the U.S. National Transportation and Safety Board.

Forty-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 between shift-start time and sleep duration for shifts starting at 03:00-12:00 h and 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 ∼8 h before shifts that started at ∼10:00 h. The shortest sleeps were found for shifts that started before 04:30 h and were estimated at ∼5 h. Individual differences were estimated with a random-effect standard deviation of 0.51 h, independent of shift-start time . 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. [ABSTRACT FROM AUTHOR]

Ratings 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. [ABSTRACT FROM AUTHOR]

There 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, increase of median reaction times of and increase of lapses/test of 0.69±.16 ms . 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. [ABSTRACT FROM AUTHOR]

Mathematical 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. [ABSTRACT FROM AUTHOR]

Very 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. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the predictability of subjective and physiological indicators of sleepiness during a vigilance task. Correlation analysis of the electrophysiological and performance data obtained from 13 healthy male volunteers reveals that sleepiness indicators and standard deviation of heart rate were significantly correlated with succeeding performance on the vigilance test.

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The article focuses on a study addressing the effects of flexible shift system based on self-determined work hours with respect to sleep/wake complaints and subjective health in police officers. The secondary aim was to analyze the relation between work hour characteristics indicating compressed or difficult rosters and subjective sleep and sleepiness within the flexible shift system group. Results showed that the group did not differ with respect to sleep/wake complaints and subjective health.

Shift work increases the risk for developing cardiovascular disease. There is, however, little knowledge of what aspects of shift scheduling that are detrimental and what characteristics promote good health. The aim of the present study was to evaluate whether coronary risk factors deteriorate after a hard work period and whether recovery, in the form of a week off, was sufficient to improve them. A total of 19 women worked an extremely rapidly rotating and clockwise shift schedule at a paper and pulp factory. They underwent two health examinations, one at the end of the work period and one after the week off. In addition, the women were divided into a tolerant and a vulnerable group, depending on their satisfaction with their work hours. Most risk factors did not change, but total cholesterol and low‐density lipoprotein (LDL)‐cholesterol were lower after the working period than after the week‐off. In addition, vulnerable women had higher levels of total cholesterol and a higher ratio of total cholesterol/high‐density lipoprotein (HDL) than tolerant ones. In conclusion, the finding that a week‐off worsens cholesterol levels was against our hypothesis and suggests further studies on how activities/responsibilities outside the workplace affect shift‐working women. It was also shown that susceptible shift workers had worse lipid profiles. [ABSTRACT FROM AUTHOR]

The present study aimed to experimentally evaluate the effect of early morning shifts on sleep and sleepiness of train drivers during normal working conditions. A total of 17 experienced train drivers were studied during a 4.5 h drive in two directions with a 2.5 h break in between on three different shifts: an early shift that started at 05:49 h (train left at 06:18 h) and ended at 17:41 h, a day shift (07:49–19:41 h), and an evening shift (09:49–21:41 h). Retrospective (since the last stop) ratings of mean sleepiness and peak sleepiness (Karolinska Sleepiness Scale—KSS: 1 = very alert, 9 = very sleepy, fighting sleep, difficulty staying awake) were assessed at each stop during the drive. The results showed that sleep length was reduced (p < 0.001) by 1 h and 2 h, respectively, by the early shift compared to the day and evening shifts. The prevalence of severe sleepiness (KSS ≥ 7) was high, especially during the early shift when 14 (82%) subjects reported at least one event during the drive. Application of the Generalized Linear Mixed Models (GLMM) to the sleepiness data showed that there was an increased risk for severe sleepiness during the early shift (OR = 4.9) that increased further with the length of the drive between stops (OR = 1.9, 15 min), suggesting an interaction between early morning shift and monotony. The findings have practical implications in risk assessment. Long drives without stops and other monotonous situations should have a higher risk rating for severe sleepiness in shifts with an early start before 06:00 h, compared to shifts that begin 2 h later. [ABSTRACT FROM AUTHOR]

Despite results linking shift work with ill health, only a few studies have addressed its relation with mortality. The purpose of the present study was to examine the hypothesis that shift work is a predictor of mortality. The study involved a sample of 22,411 individuals of the Swedish population. Data were obtained through annual phone interviews done between 1979 and 2000. Cox regression analysis was used to assess the association between shift work/day work as the independent variable and death/survival during the subsequent years as the dependent variable. Separate analyses were carried out for female and male white- and blue-collar workers, respectively. The results were adjusted for age, stress, physical work load, disease at the outset of the study, and smoking. Mortality was significantly increased for female white-collar workers, with a Hazard Ratio of 2.61 and a 95% confidence interval of 1.26–5.41. No other significant effects were found. It is concluded that blue-collar shift work is not related to mortality, but that risk of death is increased for women white-collar shift workers compared to women white-collar day workers. [ABSTRACT FROM AUTHOR]

The objectives of this study were to explore individual differences associated with diverse reactions in cortisol secretion under different stress levels. This study was part of a larger project concerning working hours and health. Thirty-four white-collar workers participated under two different conditions; one work week with a high stress level (H) and one with a lower stress level (L) as measured through self-rated stress during workdays. Based on the morning cortisol concentration during a workday subjects were divided into two groups. One group consisted of subjects whose morning level of cortisol increased in response to the high-stress week, compared to their morning levels in the low-stress condition (Group 1). The other group consisted of subjects whose morning cortisol response was the opposite, with a lower level under the high stress condition (Group 2). Subjects wore actiwatches, completed a sleep diary, and rated their sleepiness and stress for one work week in each condition, i.e., high and low stress. Saliva samples for measures of cortisol were collected on a Wednesday. Group 2 reported higher workload, fatigue, and exhaustion during both weeks. Since there were no differences in perceived stress, neither within nor between groups, the data indicate that there are other factors influencing morning cortisol. The results suggest that one component modulating the cortisol response might be the level of exhaustion, probably related to work overload. Higher levels of stress in exhausted individuals might suppress morning cortisol levels. [ABSTRACT FROM AUTHOR]

Compares satisfied and dissatisfied shift workers with respect to major anabolic and catabolic hormones. Lower morning testosterone levels of dissatisfied shift workers than satisfied ones; Association of low testosterone levels with greater sleep need, distirbed sleep and increased need for recovery after the work period.

Ships typically operate on a 24/7 basis giving rise to a wide variety of working time arrangements and watch keeping schedules. Typically, these can be divided into 2-watch systems (where two watch keepers/teams share the 24-h period) and 3-watch systems (where three watch keepers/teams share the 24-h period). The current study uses the three-process model of alertness regulation to compare these systems in terms of the amount of severe sleepiness that is predicted to take place on watch and the amount of sleep that is predicted to occur while off watch. Separate predictions are calculated for individuals characterised as morning and evening chronotypes. Comparing 2-watch systems, highest levels of severe sleepiness were seen for evening types working 0000–1200 within the 12on12off system. The longest sleep per 24 h day was also found for evening types, but for those working the 1200–0000 watch within the 12on12off system. Total daily sleep duration ranged between 268 and 445 min. However, the picture is complex and the lowest risk of severe sleepiness while on watch is not necessarily correlated with the maximal time available for rest and recuperation when off watch. For 3-watch systems, the "five-and-dime" system (changeover times: 02-07-12-17-22) stands out having the lowest prevalence of severe sleepiness on watch and the longest amount of predicted daily sleep off watch. Considerable differences exist between morning and evening types offering the opportunity for considerable improvement in sleep amount for fixed (but not rotating) systems when individual chronotype is considered in watch scheduling. It is concluded that 3-watch systems, although economically costlier, have clear advantages over 2-watch systems, but that a perfect system that fits all does not exist due to the considerable impact of individual differences related to sleep/wake regulation. • Two-watch systems are worse in terms of sleep of fatigue than three-watch systems. • Diurnal preference considerably affects fatigue levels and the possibilities for sleep. • Rotating schedules are not necessarily worse than fixed schedules. [ABSTRACT FROM AUTHOR]

SummaryNight workers complain of sleepiness, reduced performance and disturbed sleep due to lack of adjustment of the circadian rhythm. In simulated night-work experiments scheduled exposure to bright light has been shown to reduce these complaints. Here we studied the effects of bright light treatment on the adaptation to 14 days of consecutive night work at an oil platform in the North Sea, and the subsequent re-adaptation to day life at home, using the Karolinska sleep/wake diary. Bright light treatment of 30 min per exposure was applied during the first 4 nights of the night-shift period and the first 4 days at home following the shift period. The bright light exposure was scheduled individually to phase delay the circadian rhythm. Bright light treatment modestly facilitated the subjective adaptation to night work, but the positive effect of bright light was especially pronounced during the re-adaptation back to day life following the return home. Sleepiness was reduced and the quality of day was rated better after exposure to bright light. The modest effect of bright light at the platform was, possibly, related to the finding that the workers seemed to adapt to night work within a few days even without bright light. These results suggest that short-term bright light treatment may help the adaptation to an extended night-work period, and especially the subsequent re-adaptation to day life. [ABSTRACT FROM AUTHOR]

Eighteen truck drivers had their EEG recorded continuously during a night or evening drive between southern Sweden and Stockholm (500 km). They also carried out self ratings of sleepiness and performance every hour. The EEG was subjected to spectral analysis. The drivers were divided into two groups with a night group (n = 7) who drove between 20:30 to 07:20, and an evening group (n = 11) who drove between 18:20 and 04:00. The night group showed higher subjective sleepiness and lower subjective performance, and increased alpha and theta burst activity during the last three hours of the drive. The groups did not differ for the first 2-3 h of the drive. For the night group, a significant intraindividual correlation was found between subjective sleepiness and EEG alpha burst activity. End-of-the-drive subjective sleepiness and alpha burst activity were significantly correlated with total work hours and arrival time but not with age, diurnal type, prior (rated) sleep length, total break time, drive time or prior time awake. A regression analysis showed that total work hours and total break time predicted 66% of the variance of alpha burst activity during the end of the drive. [ABSTRACT FROM PUBLISHER]

Objective: Shift work is associated with impaired health and safety but there is a lack of systematic knowledge of shift workers attitude to their shift systems. This may be important for the ability to retain valuable personnel in the company/organization, and to attract new employees. The purpose of the present study was to investigate: the prevalence of shift characteristics (nights, long shifts, short rest, etc.) in traditional shift systems, the workers' attitude to their shift systems, if combinations of problematic shift characteristics are associated with the workers' attitude, and if work stress and poor sleep, fatigue, or social difficulties are associated with attitudes to shift systems. Methods: A representative sample of 3,500 individuals with non-day work in the general population of Sweden were asked to participate in the study. A total of 1965 workers remained after drop-outs. The material was analyzed by Chi2 analysis and hierarchical multiple regression. Results: The results showed that traditional shift systems included many more shift characteristics than those constituting the core of the systems. All included day work, for example. 90.2% of those with roster work had shifts > 10 h at least once a month. 66.9% of those with roster work without nights had < 11 h rest between shifts at least once a month. Less than 25% of the respondents had a rather or very negative attitude to their shift system, with the lowest level for those who work either fixed days or nights (7.6 and 5.7%, respectively) and highest for three-shift work (21.2%) and roster work without night work (24.4%). Shiftwork or roster work with nights had highest levels (> 50%) of sleep problems and fatigue. The difference across shift systems was significant at p <.001 in all cases. Combinations of the most problematic shift characteristics were associated with some increase in negative attitude to the shift schedule. Among schedule characteristics, only long weeks turned out significant in the multivariable regression. The strongest predictor of negative attitude to work hours were social difficulties due to work schedule [ß = 4.98 (95% Confidence interval (Ci) = 3.41, 7.27; p <.001], fatigue caused by schedule (ß = 3.20 Ci = 2.03, 5.05; p <.001), sleep problems caused by schedule (ß = 2.10 Ci = 1.46, 3.01; p =.01), and stressful work (ß = 1.52 Ci = 1.10, 2.11; p <.05). Conclusion: It was concluded that shift systems often included many different shift characteristics, that night shift systems had a large proportion of long shifts, and that split shifts mainly occurred in roster day work. Furthermore, it was concluded that the attitude to the worker's present shift systems seems to be positive for the majority, with the highest level for those who work either fixed days or nights, compared to those who work alternating shifts (including night shifts). Negative attitude to shift systems was more linked to social difficulties, fatigue or sleep problems due to the shift schedule, than to schedule characteristics per se. [ABSTRACT FROM AUTHOR]

Sleep deprivation commonly impairs affective regulation and causes worse mood. However, the majority of previous research concerns young adults. Because susceptibility to sleep deprivation and emotion regulation change distinctively across adult age, we tested here the hypothesis that the effect of sleep deprivation on mood is stronger in young than in older adults. In an experimental design, young (18–30 years) and older adults (60–72 years) participated in either a sleep control (young, n = 63; older, n = 47) or a total sleep deprivation condition (young, n = 61; older, n = 47). Sleepiness, mood and common symptoms of sleep deprivation were measured using established questionnaires and ratings. Sleep‐deprived participants felt more sleepy, stressed and cold, and reported lower vigour and positive affect, regardless of age. All the other outcome measures (negative affect, depression, confusion, tension, anger, fatigue, total mood disturbance, hunger, cognitive attenuation, irritability) showed a weaker response to sleep deprivation in the older group, as indicated by age*sleep deprivation interactions (ps < 0.05). The results show that older adults are emotionally less affected by sleep deprivation than young adults. This tolerance was mainly related to an attenuated increase in negative mood. This could possibly be related to the well‐known positivity effect, which suggests that older adults prioritize regulating their emotions to optimize well‐being. The results also highlight that caution is warranted when generalizing results from sleep deprivation studies across the adult lifespan. [ABSTRACT FROM AUTHOR]

The author discusses the risks of sleepiness in shift work. He mentions that accident risk is increased due to sleepiness and fatigue. Author has also discussed a scale Karolin's Sleepiness Scale (KSS)2) calculated by electroencephalogram (EEG) and electrooculogram (EOG) for seeing effects of sleepiness during morning, day and night shifts. It is suggested by the author that night shifts have shown rise in sleepiness level.

By using scenarios based on moral dilemmas, Gill (2020) found that when consumers are riding in an autonomous vehicle (AV), they are more willing to harm a pedestrian than when they, themselves, are driving a regular car. By taking a first-person perspective, in contrast to most prior research that has taken a third-person perspective, the problem is framed in a personal way that allows identification of a mechanism of responsibility attribution. In this commentary, a generalized framework is developed in which we can locate the work of Gill (2020) , as well as prior research that uses moral dilemmas, to understand how consumers believe that AVs should respond when faced with competing life-and-death alternatives. The framework shows the distinct positions that research to date has adopted, points out gaps in research, and suggests a family of four research agendas that can be pursued going forward, driven in large part by the perspective taken to the moral dilemma. Research employing these different perspectives, including the unresearched problem of taking the perspective of the object, holds promise for using moral dilemmas for enabling our understanding of consumer experience and consumer–object relationships with AVs. [ABSTRACT FROM AUTHOR]