The relationship between subjective and objective sleepiness and performance during a simulated night-shift with a nap countermeasure

The aim of the present study was to investigate the relationship between perceived and actual sleepiness and performance during a simulated night-shift that included a 30-min night-nap as an on-duty sleepiness countermeasure. Twenty-four healthy young adults (nine males, fifteen females) participated in a repeated measures design comprising two experimental conditions: no night-nap and 30-min night-nap. Both groups were given a 2-h prophylactic afternoon sleep opportunity (1500-1700 h). Measures of subjective sleepiness (Stanford Sleepiness Scale, Karolinska Sleepiness Scale and Visual Analogue Scale), objective sleepiness (sleep latency tests), objective performance (Symbol-Digit Substitution Task) and reaction time (Psychomotor Vigilance Task) were taken before the night-nap (0230 h) and at several intervals post-nap. Time-series correlation analyses indicated that subjective sleepiness was less correlated with objective sleepiness and objective performance when participants were given a 30-min night-nap. However subjective sleepiness and reaction time performance was strongly correlated in both conditions, and there was no significant difference between the nap and no-nap conditions. Consistent with previous research, results of the present study indicate that subjective and objective indicators of sleepiness and performance may not always correspond, and this relationship may be reduced by the inclusion of a night-nap.     

Who is sleepier on the night shift? The influence of bio-psycho-social factors on subjective sleepiness of female nurses during the night shift

Sleepiness is a common complaint during the night shift and may impair performance. The current study aims to identify bio-psycho-social factors associated with subjective sleepiness during the night shift. Ninety-two female nurses working rotating shifts completed a sociodemographic questionnaire, the Munich ChronoType Questionaire for shift workers, the Pittsburg Sleep Quality Index, and the Pre-sleep Arousal Scale. Subjective sleepiness was measured hourly during two night shifts using the Karolinska Sleepiness Scale, and activity monitors assessed sleep duration 24-h before each shift. Findings showed that increased sleepiness was associated with increased age in nurses with early chronotypes and with more children. High cognitive pre-sleep arousal, but not sleep, was associated with increased sleepiness, especially in late chronotypes. The impact of bio-psycho-social factors on night shift sleepiness is complex, and depends on mutual interactions between these factors. Nurses most prone to increased sleepiness must develop personal strategies for maintaining vigilance on the night shift.

Practitioner Summary: This study aims to identify bio-psycho-social factors associated with subjective sleepiness of female nurses during the night shift. Increasing sleepiness was associated with increased age in nurses with early chronotypes and with more children. Increased cognitive pre-sleep arousal, but not sleep, was associated with increased sleepiness, especially in late chronotypes.     

Sleepiness,alertness and performance during a laboratory simulation of an acute shift of the wake-sleep cycle

Monitoring the presence of sleepiness on the job and its effects on performance is of primary importance for improving schedule systems of shiftworkers. Shiftworkers, often involved in night-time operations and irregular work schedules, frequently complain of nocturnal sleepiness especially in conditions of abrupt shift of the wakesleep cycle. In this study, the authors evaluated the effects of a laboratory simulation of acute night-shift changes on sleepiness, vigilance and performance, using Maintenance of Wakefulness Test,Multiple Sleep Latency Test and three pencil and paper tests: Digit Symbol Substitition Test, ‘Deux Barrages’ Test and a 3-Letter Cancellation Task. All of the tests were administered four times at 2-hourly intervals during the night after daytime sleep. Results showed that the ability to maintain wakefulness and to perform simple visuo-attentive tasks is substantially spared during the night. On the other hand, sleep tendency and performance on a more complex and monotonous task (Letter Cancellation Task) reveal, respectively, increasing sleepiness and degrading performance.     

A quantitative model of work-related fatigue: empirical evaluations

Systematic and quantitative management of work-related fatigue within workplaces has been a challenging task due to a lack of useful tools. A previous paper provided background and development of a work-related fatigue modelling approach. The current paper outlines model evaluations using sleep deprivation experiments and recommendations of work scheduling. Previous studies have reported cumulative effects of sleep restriction (4–5 h per night) on a number of measures. Model predictions were correlated against psychomotor vigilance task lapses (r= 0.92) and reaction time responses (slowest 10%,r= 0.91) as well as sleep latency (r=-0.97). Further correlations were performed on four measures from a 64 h continuous sleep deprivation study; that is objective vigilance (r=-0.75) as well as subjective performance (r=-0.75), sleepiness (r= 0.82) and tiredness (r= 0.79). Evaluation against current scheduling recommendations illustrated consistency with the literature with the exception that forward rotation did not provide benefits over backward rotation. The results indicate that model predictions correlate well across a range of objective and subjective measures. This relationship also appears to hold for cumulative and continuous sleep deprivation protocols. Future studies will also focus on field-based evaluation.     

A quantitative model of work-related fatigue: empirical evaluations

Systematic and quantitative management of work-related fatigue within workplaces has been a challenging task due to a lack of useful tools. A previous paper provided background and development of a work-related fatigue modelling approach. The current paper outlines model evaluations using sleep deprivation experiments and recommendations of work scheduling. Previous studies have reported cumulative effects of sleep restriction (4-5 h per night) on a number of measures. Model predictions were correlated against psychomotor vigilance task lapses (r = 0.92) and reaction time responses (slowest 10%, r = 0.91) as well as sleep latency (r = -0.97). Further correlations were performed on four measures from a 64 h continuous sleep deprivation study; that is objective vigilance (r = -0.75) as well as subjective performance (r = -0.75), sleepiness (r = 0.82) and tiredness (r = 0.79). Evaluation against current scheduling recommendations illustrated consistency with the literature with the exception that forward rotation did not provide benefits over backward rotation. The results indicate that model predictions correlate well across a range of objective and subjective measures. This relationship also appears to hold for cumulative and continuous sleep deprivation protocols. Future studies will also focus on field-based evaluation.     

Sleepiness in long distance truck driving: an ambulatory EEG study of night driving

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.     

Time estimation during prolonged sleep deprivation and its relation to activation measures

This is the first study to analyze variations in time estimation during 60 h of sleep deprivation and the relation between time estimation performance and the activation measures of skin resistance level, body temperature, and Stanford Sleepiness Scale (SSS) scores. Among 30 healthy participants 18 to 24 years of age, for a 10-s interval using the production method, we found a lengthening in time estimations that was modulated by circadian oscillations. No differences in gender were found in the time estimation task during sleep deprivation. The variations in time estimation correlated significantly with body temperature, skin resistance level, and SSS throughout the sleep deprivation period. When body temperature is elevated, indicating a high level of activation, the interval tends to be underestimated, and vice versa. When the skin resistance level or SSS is elevated (low activation), time estimation is lengthened, and vice versa. This lengthening is important because many everyday situations involve duration estimation under moderate to severe sleep loss. Actual or potential applications of this research include transportation systems, emergency response work, sporting activities, and industrial settings in which accuracy in anticipation or coincidence timing is important for safety or efficiency.     

A field study of sleep and fatigue in a regular rotating 12-h shift system

The aim of this study was to examine a regular rotating 12-h shift system (2D2N4Off) at an Australian Smelter. Sleep behavior, subjective fatigue and neurobehavioral performance were investigated over a 14-day period for 20 employees. Activity monitors, sleep/wake diaries, and 5-min psychomotor vigilance tasks were used. Sleep data showed differences between day and night shifts. While sleep prior to night1 was increased relative to day shifts, a reduced sleep length carried into the period leading to night2. Total wakefulness at the end of shift, and subjective fatigue were increased for night shifts, particularly night1. Decrements in performance data supported these findings. Both prior wakefulness and prior sleep are important in a 12-h shift system. Employees may “sleep in” after day shifts, rather than taking extra sleep prior to night work. Thus, sleep between day and night shifts is based on recovery rather than preparation.     

Can small shifts in circadian phase affect performance?

Small shifts in circadian timing occur frequently as a result of daylight saving time or later weekend sleep. These subtle shifts in circadian phase have been shown to influence subjective sleepiness, but it remains unclear if they can significantly affect performance. In a retrospective analysis we examined performance on the Psychomotor Vigilance Test before bedtime and after wake time in 11 healthy adults on fixed sleep schedules based on their habitual sleep times. The dim light melatonin onset, a marker of circadian timing, was measured on two occasions. An average 1.1?h shift away from a proposed optimal circadian phase angle (6?h between melatonin onset and midpoint of sleep) significantly slowed mean, median and fastest 10% reaction times before bedtime and after wake time (p?相似文献   

Effects of 60 hours of total sleep deprivation on two methods of high-speed ship navigation

This study investigated how workload and performance in high-speed ship navigation was affected by sleep deprivation using methods based on either paper charts or electronic chart display and information systems (ECDIS). In two separate weeks, five navigators sailed 10 routes in high-fidelity simulators while undergoing progressive sleep deprivation for up to 60 h. Results showed that navigation performance was better using ECDIS, but was largely unaffected by sleep deprivation in both. There was significant interaction between speed, sleep deprivation and navigation method, indicating that navigators using ECDIS reduced their speed more while sleepy. Secondary task performance was reduced by sleep deprivation, but was equally affected in both conditions. Workload was higher in the ECDIS condition, as indicated by subjective ratings and heart rate variability. No significant differences in sleepiness were found, but electroencephalographic recordings indicated more frequent microsleep episodes in the ECDIS condition. This may be influenced by lower overall arousal while navigating with ECDIS.     

Can a short nap and bright light function as implicit learning and visual search enhancers?

The present study examined effects of a short nap (20 min) and/or bright light (2000 lux) on visual search and implicit learning in a contextual cueing task. Fifteen participants performed a contextual cueing task twice a day (1200–1330 h and 1430–1600 h) and scored subjective sleepiness before and after a short afternoon nap or a break period. Participants served a total of four experimental conditions (control, short nap, bright light and short nap with bright light). During the second task, bright light treatment (BLT) was applied in the two of the four conditions. Participants performed both tasks in a dimly lit environment except during the light treatment. Results showed that a short nap reduced subjective sleepiness and improved visual search time, but it did not affect implicit learning. Bright light reduced subjective sleepiness. A short nap in the afternoon could be a countermeasure against sleepiness and an enhancer for visual search.

Practitioner Summary: The study examined effects of a short afternoon nap (20 min) and/or bright light (2000 lux) on visual search and implicit learning. A short nap is a powerful countermeasure against sleepiness compared to bright light exposure in the afternoon.     

The effects of extended work under sleep deprivation conditions on team-based performance

Teamwork is becoming increasingly common in today's workplaces; however, little research has examined how well teams perform under sleep deprivation conditions. The purpose of the current study was to examine the effect of extended work under sleep deprivation conditions on team performance. A total of 24 participants were sleep deprived for 30 h and completed 16 h of sustained operations during the last portion of the sleep deprivation period. The participants completed the Wombat, a complex task including vigilance and cognitive components, with a partner in four 24-min testing sessions during the sustained operations period. The results indicated that team performance increased during the work period while, within each testing session, team performance on vigilance tasks remained stable and overall performance decreased. The current results suggest that performance on two-person teams results in improved performance but does not fully counteract the decreases in performance within each work period. Performance in two-person teams increased across an extended work shift under sleep deprivation conditions. However, vigilance performance remained stable while overall performance decreased when examining performance in 8-min segments. These results suggest that averaging team-based performance over a longer testing period may mask the negative effects of sleep deprivation.

Statement of Relevance: Performance in two-person teams increased across an extended work shift under sleep deprivation conditions. However, vigilance performance remained stable while overall performance decreased when examining performance in 8-min segments. These results suggest that averaging team-based performance over a longer testing period may mask the negative effects of sleep deprivation.     

Short nap versus short rest: recuperative effects during VDT work

The effects of a 20-min nap during 2 h of visual display terminal (VDT) work were examined. Ten young healthy adults took a 20-min nap or a 20-min rest I h after VDT work, followed by another 1 h of VDT work. A 20-min rest temporarily restored subjective sleepiness, but it deteriorated during the additional 1 h of work. In contrast, a 20-min nap maintained subjective alertness and performance level at a higher level and mental fatigue at a lower level for the additional 1 h of work. These results suggest that a short nap would be useful to both fatigue recovery and fatigue prevention during continuous VDT work. The present findings may provide a new work/rest strategy.     

Short nap versus short rest: recuperative effects during VDT work

The effects of a 20-min nap during 2 h of visual display terminal (VDT) work were examined. Ten young healthy adults took a 20-min nap or a 20-min rest 1 h after VDT work, followed by another 1 h of VDT work. A 20-min rest temporarily restored subjective sleepiness, but it deteriorated during the additional 1 h of work. In contrast, a 20-min nap maintained subjective alertness and performance level at a higher level and mental fatigue at a lower level for the additional 1 h of work. These results suggest that a short nap would be useful to both fatigue recovery and fatigue prevention during continuous VDT work. The present findings may provide a new work/rest strategy.     

The role of naps in alleviating sleepiness during an irregular sleep-wake schedule

Abstract

Four groups of four subjects have been studied in an isolation unit on an irregular schedule of sleep and waking. Sleep periods of 6h duration were taken at irregular times during the 9-day protocol; they were arranged such that the waking periods lasted 6, 12 or 18 h and were also in an irregular sequence. One-hour naps were taken after 6 and 12 h of waking if the next sleep was not due then. Just before either a nap or a full sleep, subjects assessed their sleepiness and, on rising, they assessed how well sleep had been initiated and maintained. A mathematical model was developed which enabled the effects upon sleepiness of circadian rhythmicity, of the length of the waking period since the last full sleep (time-since-sleep), and of the subjective value of the previous full sleep or nap to be independently quantified. Results showed that there was a tendency for sleepiness to increase, in some cases quite markedly, as the irregular schedule proceeded. There were also effects upon sleepiness due to circadian changes and the amount of time since the last full sleep. These two effects were similar in size and larger than the benefits to be derived from a previous nap or full sleep that had been assessed at the time as having been a good one. We conclude that one-hour naps can play a small role in decreasing an individual's sleepiness and suggest possible means by which their subjective value might be increased.     

The effects of physical vibration on heart rate variability as a measure of drowsiness

We investigated the effects of low frequency whole body vibration on heart rate variability (HRV), a measure of autonomic nervous system activation that differentiates between stress and drowsiness. Fifteen participants underwent two simulated driving tasks for 60?min each: one involved whole-body 4–7?Hz vibration delivered through the car seat, and one involved no vibration. The Karolinska Sleepiness Scale (KSS), a subjective measure of drowsiness, demonstrated a significant increase in drowsiness during the task. Within 15–30?min of exposure to vibration, autonomic (sympathetic) activity increased (p?p?Practitioner summary: The effects of physical vibration on driver drowsiness have not been well investigated. This laboratory-controlled study found characteristic changes in heart rate variability (HRV) domains that indicated progressively increasing neurological effort in maintaining alertness in response to low frequency vibration, which becomes significant within 30?min.

Abbreviations: ANS: autonomic nervous system; Ctrl: control; EEG: electroencephalography; HF: the power in high frequency range (0.15 Hz-0.4Hz) in the PSD relected parasympathetic activity only; HRV: heart rate variability; KSS: karolinska sleepiness scale; LF: the power in low frequency range (0.04 Hz-0.15Hz) in the PSD reflected both sympathetic and parasympathetic activity of the autonomic nervous system; LF/HF ratio: the ratio of LF to HF indicated the balance between sympathetic and parasympathetic activity; RMSSD: the root mean square of difference of adjacent RR interval; pNN50: the number of successive RR interval pairs that differed by more than 50 ms divided by the total number of RR intervals; RR interval: the differences between successive R-wave occurrence times; PSD: power spectral density; RTP: research training program; SD: standard deviation; SEM: standard error of the Mean; Vib: vibration     

Vigilance on the civil flight deck: incidence of sleepiness and sleep during long-haul flights and associated changes in physiological parameters

The study investigated sleepiness and sleep in aircrew during long-haul flights. The objectives were to identify loss of alertness and to recommend a practical approach to the design of an alerting system to be used by aircrew to prevent involuntary sleep. The flights were between London and Miami, covering both day- and night-time sectors, each with a duration of ~9 h. The subjects were 12 British Airways pilots. Various physiological variables were measured that could potentially be used to indicate the presence of drowsiness and involuntary sleep: brain electrical activity (electroencephalogram, EEG), eye movements via the electro-oculogram (EOG), wrist activity, head movements and galvanic skin resistance. The EEG and EOG identified sleepiness and sleep, as well as being potential measures on which to base an alarm system. Ten pilots either slept or showed evidence of sleepiness as assessed by the EEG and EOG. Many of the episodes of sleepiness lasted < 20 s, which could mean that the subjects were unaware of their occurrence and of the potential consequences on performance and vigilance. All physiological parameters showed changes during sleep, although only the EEG and EOG were modified by sleepiness. During sleep, skin resistance was increased, and wrist activity and head movements were absent for long periods. The study indicated that the measurement of eye movements (either alone or in combination with the EEG), wrist activity or head movement may be used as the basis of an alarm system to prevent involuntary sleep. Skin resistance is considered to be unsuitable, however, being related in a more general way to fatigue rather than to sleep episodes. The optimal way to monitor the onset of sleep would be to measure eye movements; however, this is not feasible in the flight deck environment at the present time due to the intrusive nature of the recording methodology. Wrist activity is therefore recommended as the basis of an alertness alarm. Such a device would alert the pilot after ~4–5 min of wrist inactivity, since this duration has been shown by the present study to be associated with sleep. The possibility that sleep inertia (reduced alertness immediately after awakening from sleep) could follow periods of sleep lasting 5 min needs to be considered. The findings reported here might be applicable to other occupational environments where fatigue and sleepiness are known to occur.     

Post-lunch nap as a worksite intervention to promote alertness on the job

A worksite study was conducted to examine whether a 15-min nap during a post-lunch rest period would affect subsequent alertness, performance, and nocturnal sleep in eight factory workers under a 3-week protocol. Subjects were asked to take the nap at 12:30?h on a reclining chair during the nap week, and to remain awake during the no-nap week. The order of these 2 weeks was counterbalanced between the subjects. During the third, follow-up week, each subject determined whether or not she/he would nap. Alertness on the job and nocturnal sleep were assessed using a sleep diary. Wrist activity was also recorded during sleep at night. Choice reaction time task (RT) was performed at 10:00 and 15:00?h every day of the nap week and every other day of the no-nap and follow-up weeks. Perceived alertness was significantly higher in the afternoon after nap than after no nap at the end of the week. Similar effects were observed during the follow-up week where almost half of the subjects napped. No significant differences between the three weeks were found for RT performance or nocturnal sleep. Workers' attitudes toward the nap were favourable. Although further intervention research is required, our results suggest that post-lunch napping may have the potential to promote daytime alertness at work.     

Why stop after 20 minutes? Breaks and target prevalence in a 60-minute X-ray baggage screening task

Current EU regulation restricts continuously reviewing X-ray images of passenger baggage to 20-min duration as a precautionary measure to prevent performance decrements in airport security officers (screeners). However, this 20-min limit is not based on clear empirical evidence on how well screeners can sustain their performance over time. Our study tested screeners in a 60-min simulated X-ray cabin baggage screening task. One group took 10-min breaks after 20 min of screening; the other group worked without breaks. We found no decrease in performance over 60 min in either group. Breaks did not affect performance, but they did reduce the amount of subjective distress. By varying target prevalence, we found that d_a with a slope of about 0.6 is a more valid measure of detection performance than d'. Target prevalence caused a criterion shift. Our results provide a basis for conducting field studies of prolonged screening durations, and open the discussion on whether more flexible break policies and work schedules should be considered.     

The effects of a self-selected nap opportunity on the psychophysiological,performance and subjective measures during a simulated industrial night shift regimen

This study compared the effects of a 1 h self-selected recovery period to those of a standard night shift arrangement (with a total break time of 1-h) over a simulated three-day night shift schedule in a laboratory setting. Results showed that the inclusion of the flexible nap scheme resulted in higher performance output, improvements in physiological strain responses and reduced sleepiness during each night shift and generally over the three-night cycle. Certain variables also revealed the impact of napping compared with the standard rest break condition on the circadian rhythm. The sleep diary records show that the inclusion of the current intervention did not significantly reduce daytime recovery sleep. The results suggest that the potential benefits of flexible napping may outweigh the logistical effort it requires in a workplace environment.

Practitioner summary: Consensus on appropriate napping strategies for shift work remains a challenge. This simulated night shift laboratory study sought to determine the effects of a 1-h self-selected nap opportunity relative to a normal shift set-up. The nap improved performance and decreased sleepiness, without affecting daytime sleep.