Subjective sleepiness is a sensitive indicator of insufficient sleep and impaired waking function
Subjective sleepiness is a sensitive indicator of insufficient sleep and impaired waking function
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DOI：
10.1111/jsr.12158
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发表时间：
2014-06-01
影响因子：
4.4
通讯作者：
Kecklund, Goran
中科院分区：
文献类型：
--
作者：
Akerstedt, Torbjorn;Anund, Anna;Kecklund, Goran
睡眠不足的主要后果是困倦。虽然睡眠潜伏期的测量、连续脑电/眼电(EEG/EOG)记录和性能测试在实验室和临床上是衡量困倦程度的有用指标，但它们在大型、真实的现场研究中不易实施。昏昏欲睡的主观评分是一种替代方法，但它们是否敏感、可靠和有效地衡量困倦程度仍不确定。这篇综述汇集了与这些问题相关的研究。它的重点是卡罗林斯卡嗜睡量表(KSS)，这是一个9分的利克特类型的量表。嗜睡的日变化呈U型，早晚KSS值较高，且具有较大的年际稳定性。在急性完全和反复部分睡眠剥夺和夜间工作，包括夜间驾驶期间，KSS值敏感地增加。影响大小在1.5到3之间。驾驶表现或嗜睡的EEG/EOG指标之间的关系是非常显著的，强烈的曲线关系，在个体之间是一致的。高(>；6)KSS值尤其与EEG中的驾驶性能受损和睡眠干扰有关。在许多临床情况下，如睡眠呼吸暂停、抑郁和倦怠，KSS值也会增加。背景对KSS收视率有很大影响。因此，体力活动、社交活动和光照会使KSS值降低1-2个单位。相反，在单调环境中的任务时间将增加1-2个单位的KSS值。总而言之，本文描述的嗜睡主观评分与客观测量一样，是嗜睡的灵敏和有效的指标，尤其适用于实地研究。
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.