Variation in sleepiness during early morning shifts:: A mixed model approach to an experimental field study of train drivers
Variation in sleepiness during early morning shifts:: A mixed model approach to an experimental field study of train drivers
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DOI：
10.1081/cbi-200036895
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发表时间：
2004-01-01
影响因子：
2.8
通讯作者：
Kecklund, L
中科院分区：
文献类型：
--
作者：
Ingre, M;Kecklund, G;Kecklund, L
本研究旨在从实验上评估清晨轮班对火车司机在正常工作条件下的睡眠和嗜睡的影响。研究人员对17名有经验的火车司机进行了研究，他们在两个方向行驶了4.5小时，其间休息了2.5小时，分三个班次：早班从05：49开始(火车在06：18离开)，结束于17：41小时，白班(07：49-19：41小时)和晚班(09：49-21：41小时)。在驾驶过程中的每一站，回顾(自最后一站以来)平均困倦和高峰困倦(Karolinska嗜睡量表-KSS：1=非常警觉，9=非常困倦，难以保持清醒)进行评估。结果表明，与白班和晚班相比，早班分别减少了1小时和2小时的睡眠时间(p<；0.001)。严重嗜睡(KSS大于或等于7)的发生率很高，特别是在早期轮班期间，14名(82%)受试者报告了在驾驶过程中至少发生过一次事件。将广义线性混合模型(GLMM)应用于嗜睡数据，结果表明，早班期间重度嗜睡的风险增加(OR=4.9)，并且随着两站之间行驶时间的延长(OR=1.9，15分钟)而进一步增加，提示早班和单调之间存在交互作用。这些发现对风险评估具有实际意义。没有停车和其他单调情况的长途驾驶与6点前开始的班次相比，早开始2小时的班次严重困倦的风险等级应该更高。
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 greater than or equal to 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.