Sleepiness and driving events in shift workers: the impact of circadian and homeostatic factors
Sleepiness and driving events in shift workers: the impact of circadian and homeostatic factors
复制标题
DOI：
10.1093/sleep/zsz074
复制
发表时间：
2019-06-01
期刊：
影响因子：
5.6
通讯作者：
Rajaratnam, Shantha M. W.
中科院分区：
文献类型：
--
作者：
Mulhall, Megan D.;Sletten, Tracey L.;Rajaratnam, Shantha M. W.
我们的目的是表征短期工作通勤期间的客观和主观嗜睡和驾驶事件，并检查昼夜节律和体内平衡因素对轮班工人人群中不同轮班类型的影响。对33名护士进行为期2周的白班（07:00-15:30）、晚班（13:00-21:30）和夜班（21:00-07:30）监测。通过每日睡眠记录和手腕活动记录仪来测量睡眠。每次上下班都要完成驾驶日志，报告驾驶事件和驾驶前卡罗林斯卡嗜睡量表（KSS）。来自一部分参与者（n = 11）的眼部数据在通勤期间使用红外眼图评估客观嗜睡。在24-48小时内通过收集尿6-硫氧褪黑激素（aMT6s）在三个时间点评估昼夜节律。主客观嗜睡、睡眠相关危险驾驶事件与倒班前比较，夜班后显著增加。与白班和晚班相比，KSS、睡眠相关和注意力不集中相关事件在夜班上下班期间最高。与睡眠相关的事件在第一次上夜班后最高，而与注意力不集中相关的事件在连续上夜班后最常见。在>= 16小时清醒后的驾驶中，KSS、睡眠相关事件和危险事件增加。在aMT6s峰期+/- 3小时内，KSS和睡眠相关事件增加。观察到体内平衡和昼夜节律过程之间的相互作用，KSS和睡眠相关事件在顶相+/- 3小时内最高，此时清醒时间为>= 16小时。在自然条件下，夜班后主观和客观的嗜睡和驾驶事件增加，即使是在短时间（类似于30分钟）的通勤中，昼夜节律阶段和清醒时间之间的相互作用加剧了嗜睡和驾驶事件。
We aimed to characterize objective and subjective sleepiness and driving events during short work commutes and examine the impact of circadian and homeostatic factors across different shift types in a shift worker population. Thirty-three nurses were monitored for 2 weeks over day (07:00-15:30), evening (13:00-21:30), and night shifts (21:00-07:30). Sleep was measured via daily sleep logs and wrist actigraphy. Driving logs were completed for each work commute, reporting driving events and a predrive Karolinska Sleepiness Scale (KSS). Ocular data from a subset of participants (n = 11) assessed objective sleepiness using infrared oculography during commutes. Circadian phase was assessed at three time points via urinary 6-sulphatoxymelatonin (aMT6s) collected over 24-48 hours. Subjective and objective sleepiness and sleep-related and hazardous driving events significantly increased following night shift compared with preshift. There were significant shift differences with KSS, sleep-related and inattention-related events highest during the postnight shift commute, compared with day and evening shifts. Sleep-related events were highest following the first night shift, while inattention-related events were most frequent after consecutive night shifts. KSS, sleep-related and hazardous events were increased during drives following >= 16 hours of wakefulness. KSS and sleep-related events increased during drives within +/- 3 hours of aMT6s acrophase. An interaction between homeostatic and circadian processes was observed, with KSS and sleep-related events highest within +/- 3 hours of acrophase, when wakefulness was >= 16 hours. In naturalistic conditions, subjective and objective sleepiness and driving events are increased following night shifts, even during short (similar to 30 minutes) commutes and exacerbated by an interaction between circadian phase and duration of wakefulness.