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  • 101.
    Radun, Igor
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University of Helsinki, Finland.
    Radun, Jenni
    Kaistinen, Jyrki
    Olivier, Jake
    Parkkari, Inkeri
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Suicide by crashing into a heavy vehicle: Professional drivers' views2019In: Traffic Injury Prevention, ISSN 1538-9588, E-ISSN 1538-957X, Vol. 20, no 8, p. 826-831Article in journal (Refereed)
    Abstract [en]

    Objective: Every profession has its own safety and health risks. In addition to the risk of being involved in a normal road crash, professional heavy vehicle drivers are at risk of becoming victims of people attempting suicide by crashing into their vehicles. Road suicides are not that rare, at least not in Finland, where they represent about 12% of all fatal road crashes. The purpose of this study was to survey professional heavy vehicle drivers about their experiences, views and opinions regarding road suicides.

    Methods: The sample included heavy vehicle drivers (N = 863) randomly recruited from a transport workers' union.

    Results: About 18% of the respondents reported a suspected suicide attempt of a motor vehicle driver crashing into their vehicle, with 15% of these (i.e.2.8% of the whole sample) also reporting a resulting crash. More than half of the respondents reported personally knowing another professional driver who had experienced a crash caused by a suicidal driver. Almost 80% of the drivers reported being afraid that someone would attempt suicide by crashing into their vehicle; however, thinking about such a possibility produces a level of anxiety in less than half of all respondents. Most respondents agreed about the challenges of avoiding a crash if somebody deliberately drives their car towards their vehicle.

    Conclusion: Heavy vehicle drivers perceive road suicides as an occupational risk in their profession. We discuss possible preventive measures against suicide attempts by crashing into a heavy vehicle.

  • 102.
    Radun, Igor
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University of Helsinki, Finland.
    Radun, Jenni
    Kaistinen, Jyrki
    Parkkari, Inkeri
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Olivier, Jake
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Suicide by crashing into a heavy vehicle: A one-year follow-up study of professional drivers2020In: Transportation Research Part F: Traffic Psychology and Behaviour, ISSN 1369-8478, E-ISSN 1873-5517, Vol. 73, p. 318-324Article in journal (Refereed)
    Abstract [en]

    Train and heavy vehicle drivers can experience a traumatic event caused by people attempting suicide by crashing into their vehicles or jumping in front of them. While there are a number of studies on train drivers showing the negative consequences these events can have on their well-being, there are no studies on heavy vehicle drivers involved in these types of crashes. In the current study, we surveyed Finnish heavy vehicle drivers (N = 15) involved in a suicide crash in the year 2017 regarding their experiences and coping approximately one month (T1) and one year (T2) after the crash. Ten of these drivers reported one or various combinations of measurable consequences such as minor physical injuries, shorter or longer sickness absences, significant posttraumatic stress symptoms (measured using the Impact of Events Scale-Revised) and requiring psychological help. Posttraumatic stress symptoms decreased over time; however, three out of the four drivers who had a high IES-R score at T1 were still around the IES-R cut-off score at T2. This research raises questions whether and what kind of support heavy vehicle drivers who have been involved in a suicide crash should be given.

  • 103.
    Radun, Igor
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University of Helsinki, Finland.
    Radun, Jenni
    Wahde, Mattias
    Watling, Christopher N.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Queensland University of Technology, Australia.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University Nijmegen, The Netherlands.
    Self-reported circumstances and consequences of driving while sleepy2015In: Transportation Research Part F: Traffic Psychology and Behaviour, ISSN 1369-8478, E-ISSN 1873-5517, Vol. 32, p. 91-100Article in journal (Refereed)
    Abstract [en]

    Abstract Driver surveys are indispensable sources of information when estimating the role of sleepiness in crash causation. The purpose of the study was to (1) identify the prevalence of driving while sleepy among Finnish drivers, (2) determine the circumstances of such instances, and (3) identify risk factors and risk groups. Survey data were collected from a representative sample of active Finnish drivers (N = 1121). One-fifth of the drivers (19.5%) reported having fallen asleep at the wheel during their driving career, with 15.9% reporting having been close to falling asleep or having difficulty staying awake when driving during the previous twelve months. Epworth Sleepiness Scale scores were found to be associated with both types of sleepiness-related driving instances, while sleep quality was associated only with the latter. Compared to women, men more often reported falling asleep at the wheel; the differences were somewhat smaller with respect to fighting sleep while driving during the previous twelve months. The reported discrepancy in sleepiness-related instances (high prevalence of fighting sleep while driving during the previous twelve months and lower proportion of actually falling asleep) identifies young men (⩜25 years) as one of the main target groups for safety campaigns. Approximately three-quarters of drivers who had fallen asleep while driving reported taking action against falling asleep before it actually happened. Furthermore, almost all drivers who had fallen asleep while driving offered at least one logical reason that could have contributed to their falling asleep. These data indicate some degree of awareness about driving while sleepy and of the potential pre-trip factors that could lead to sleepiness while driving, and supports the notion that falling asleep at the wheel does not come as a (complete) surprise to the driver.

  • 104.
    Radun, Igor
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University of Helsinki, Finland.
    Wahde, M
    Ingre, Michael
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Benderius, O
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Driving while fatigued in slippery road conditions - a neglected issue2014In: Journal of sleep research, Special issue: 22nd Congress of the European Sleep Research Society, 16-20 September, 2014, Tallin, Estonia, 2014Conference paper (Other academic)
  • 105. Rocha, Felipe Pereira
    et al.
    Marqueze, Elaine Cristina
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    de Castro Moreno, Claudia Roberta
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. University of São Paulo, Brazil.
    Evaluation of truck driver rest locations and sleep quality2022In: Sleep Science, ISSN 1984-0659, E-ISSN 1984-0063, Vol. 15, no 1, p. 55-61Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Truck drivers’ work organization requires that rest and sleep be taken in various locations, where sleep quality might be affected by the discomfort of these environments. The purpose of this study was to evaluate truck drivers’ rest locations and their association with sleep quality utilizing an ergonomic approach. MATERIAL AND METHODS: The sleep quality of 81 truck drivers was assessed using the Pittsburgh sleep quality index (PSQI). An adapted version of the ergonomics workplace analysis (EWA) instrument was used to evaluate 44 rest locations. RESULTS: Half of the workers preferred sleeper berths (51.2%) as a rest place. Sleep was classified as poor by 71.6% of the drivers. Dorms were rated more positively (p<0.001) by truck drivers (2.0±1.1) than by the analyst (2.6±0.6). Sleeper berths and dorms were rated statistically different by truck drivers (p=0.002), as well as by the analyst (p=0.003). No correlation was found between EWA evaluations and total score for sleep quality. Separate analyses of dorms and truck berths showed very few correlations. The higher the noise of roommates in dorms, the worse the sleep quality. Conversely, noise in corridors or outside the room positively impacted sleep quality. CONCLUSION: Noise in the rest place may affect sleep in both directions, negatively or positively. Sleep was classified as poor regardless of resting place. The quality of resting places seemed to have little effect on sleep quality of truck drivers. Factors other than rest place, such as work scheduling, are probably more important for promoting good sleep quality.

  • 106. Sallinen, Mikael
    et al.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Shift work, sleep and sleepiness - differences between shift schedules and systems2010In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 36, no 2, p. 121-133Article in journal (Refereed)
    Abstract [en]

    In this narrative review, we examined what level of research evidence is available that shift workers' sleep-wake disturbances can be minimized through ergonomic shift scheduling. We classified the pertinent studies conducted on real shift workers in field conditions by the type of shift system and study design (ie, whether the shift systems were modified or not - "treatment" versus "no treatment"). The results of the observational studies in which no changes to the shift system were made (ie, no treatment) showed that, irrespective of the shift system, night and early-morning shifts and quick returns are associated with short sleep and increases in sleepiness. The same is true for very long shifts (>16 hours) and extremely long weekly working hours (>55 hours). For all categories of shift systems, there was a lack of controlled intervention studies, limiting the possibility to provide solution-focused recommendations for shift scheduling. Most of the controlled intervention studies had been conducted on workers under regular 3-shift systems. These studies suggested that a change from slowly backward-rotating shifts to rapidly forward-rotating shifts is advantageous for alertness and, to some degree, sleep. We also found that a change from an 8- to 12-hour shift system does not necessarily result in impairments in the sleep-wake pattern. The level of research evidence was affected by many of the studies' frequent methodological limitations in measuring sleep and sleepiness. In all, to have reliable and solution-focused recommendations for shift scheduling, methodologically sound controlled intervention studies are required in different categories of shift systems.

  • 107. Sallinen, Mikael
    et al.
    Sihvola, Maria
    Puttonen, Sampsa
    Ketola, Kimmo
    Tuori, Antti
    Härmä, Mikko
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Karolinska Institute, Sweden.
    Sleep, alertness and alertness management among commercial airline pilots on short-haul and long-haul flights2016In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 98, p. 320-329Article in journal (Refereed)
    Abstract [en]

    Airline pilots' sleep and on-duty alertness are important focus areas in commercial aviation. Until now, studies pertaining to this topic have mainly focused on specific characteristics of flights and thus a comprehensive picture of the matter is not well established. In addition, research knowledge of what airline pilots actually do to maintain their alertness while being on duty is scarce. To address these gaps in research knowledge, we conducted a field study on a representative sample of the airline pilots of a medium-sized airline. The sample consisted of 90 pilots, of whom 30 flew long-haul (LH) routes, 30 short-haul (SH) routes, and 30 flew both. A total of 86 pilots completed the measurements that lasted for almost two months per pilot. The measurements resulted in a total of 965 flight duty periods (FDPs) including SH flights and 627 FDPs including LH flights. During the measurement periods, sleep was measured by a diary and actigraphs, on-duty alertness by the Karolinska Sleepiness Scale (KSS) in all flight phases, and on-duty alertness management strategies by the diary. Results showed that SH and LH FDPs covering the whole domicile night (00:00-06:00 at home base) were most consistently associated with reduced sleep-wake ratio and subjective alertness. Approximately every 3rd FDP falling into this category involved a reduced sleep-wake ratio (1:3 or lower) and every 2nd a reduced level of subjective alertness (KSS rating 8-9 in at least one flight phase). The corresponding frequencies for the SH and LH FDPs that partly covered the domicile night were every 10th and every 5th FDP and for the pure non-night FDPs every 30th and every 36th FDP, respectively. The results also showed that the pilots tended to increase the use of effective on-duty alertness management strategies (consuming alertness-promoting products and taking strategic naps) in connection with the FDPs that overlapped the domicile night. Finally, the results showed that the frequency of flights involving reduced subjective alertness depended on how alertness was assessed. If it was assessed solely in the flight phase just before starting the landing procedures (top of descent) the phenomenon was less frequent than if the preceding cruise phase was also taken into account. Our results suggest that FDPs covering the whole domicile night should be prioritised over the other FDPs in fatigue management, regardless of whether an FDP is a short-haul or a long-haul. In addition, the identification of fatigue in flight operations requires one to assess pilots' alertness across all flight phases, not only at ToD. Due to limitations in our data, these conclusions can, however, be generalise to only LH FDPs during which pilots can be expected to be well acclimatised to the local time at their home base and SH night FDPs that include at least 3h of flying in the cruise phase.

  • 108. Sandberg, David
    et al.
    Anund, Anna
    Fors, Carina
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Karlsson, Johan G.
    Wahde, Mattias
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    The characteristics of sleepiness during real driving at night - a study of driving performance, physiology and subjective experience2011In: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 34, no 10, p. 1317-25Article in journal (Refereed)
    Abstract [en]

    STUDY OBJECTIVES: Most studies of sleepy driving have been carried out in driving simulators. A few studies of real driving are available, but these have used only a few sleepiness indicators. The purpose of the present study was to characterize sleepiness in several indicators during real driving at night, compared with daytime driving.

    DESIGN: Participants drove 55 km (at 90km/h) on a 9-m-wide rural highway in southern Sweden. Daytime driving started at 09:00 or 11:00 (2 groups) and night driving at 01:00 or 03:00 (balanced design).

    SETTING: Instrumented car on a real road in normal traffic.

    PARTICIPANTS: Eighteen participants drawn from the local driving license register.

    INTERVENTIONS: Daytime and nighttime drives.

    MEASUREMENT AND RESULTS: The vehicle was an instrumented car with video monitoring of the edge of the road and recording of the lateral position and speed. Electroencephalography and electrooculography were recorded, together with ratings of sleepiness every 5 minutes. Pronounced effects of night driving were seen for subjective sleepiness, electroencephalographic indicators of sleepiness, blink duration, and speed. Also, time on task showed significant effects for subjective sleepiness, blink duration, lane position, and speed. Sleepiness was highest toward the end of the nighttime drive. Night driving caused a leftward shift in lateral position and a reduction of speed. The latter two findings, as well as the overall pattern of sleepiness indicators, provide new insights into the effects of night driving.

    CONCLUSION: Night driving is associated with high levels of subjective, electrophysiologic, and behavioral sleepiness. CITATION: Sandberg D; Anund A; Fors C; Kecklund G; Karlsson JG; Wahde M; Åkerstedt T. The characteristics of sleepiness during real driving at night-a study of driving performance, physiology and subjective experience. 

  • 109.
    Sandberg, David
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Wadhe, Mattias
    Anund, Anna
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    The impact of sleepiness on lane positioning in truck drivers2013In: Driver Distraction and Inattention: Advances in Research and Countermeasures, Volume 1 / [ed] Michael A. Regan, John D. Lee, Trent W. Victor, Farnham: Ashgate, 2013, p. 405-416Chapter in book (Other academic)
    Abstract [en]

    This chapter concerns the detection of sleepiness in truck drivers. Data obtained from a driver sleepiness study involving real-world driving are used in order to analyse the performance of several sleepiness indicators based on driving behavior; such as, for example, variability in lateral position and heading angle. Contrary to the results obtained for passenger cars, for heavy trucks it is found that indicators based on variability provide little or no information; their performance does not rise significantly above chance levels. However, the data indicate that there is a significant difference in the average lane position for sleepy and alert drivers, respectively, such that a sleepy driver generally places the vehicle closer (by about 0.2 m) to the centre of the road than an alert driver. The analysis also shows a significant, monotonous, increase in average lateral position (measured from the right, outer, lane boundary towards the lane centre) between the four cases of (i) daytime alert driving, (ii) daytime sleepy driving, (iii) night-time alert driving and (iv) nighttime sleepy driving.

  • 110. Sandberg, David
    et al.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Anund, Anna
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Wahde, Mattias
    Detecting Driver Sleepiness Using Optimized Nonlinear Combinations of Sleepiness Indicators2011In: IEEE transactions on intelligent transportation systems (Print), ISSN 1524-9050, E-ISSN 1558-0016, Vol. 12, no 1, p. 97-108Article in journal (Refereed)
    Abstract [en]

    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), Linkoping, 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.

  • 111. Santoft, Fredrik
    et al.
    Hedman-Lagerlöf, Erik
    Salomonsson, Sigrid
    Lindsäter, Elin
    Ljótsson, Brjánn
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden.
    Andreasson, Anna
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Macquarie University, Australia.
    Inflammatory cytokines in patients with common mental disorders treated with cognitive behavior therapy2020In: Brain, Behavior, & Immunity - Health, ISSN 2666-3546, Vol. 3, article id 100045Article in journal (Refereed)
    Abstract [en]

    Peripheral inflammation has been found associated with psychiatric disorders. However, results are inconclusive as to its role in common mental disorders (CMDs), i.e., depression, anxiety, insomnia and stress-related disorders. Further, some research suggests that cognitive behavior therapy (CBT) could reduce inflammatory markers in CMDs. In the present study, we measured pro-inflammatory cytokines (tumor necrosis factor alpha [TNF-α], interleukin-6 [IL-6] and IL-8) pre- and post-treatment in two clinical trials (N ​= ​367) investigating CBT for patients with CMDs in primary care. We hypothesized that higher levels of these cytokines would be associated with more severe psychiatric symptoms (i.e., symptoms of depression, stress and anxiety). We also hypothesized that level of cytokines would decrease after CBT and that the reduced levels would correlate with a reduction in symptoms. Results showed that in men, higher levels of TNF-α were associated with more severe psychiatric symptoms. Further, age moderated the association between TNF-α, as well as IL-6, and stress, and exploratory stratified analyses revealed significant associations in subgroups. No other significant associations between cytokines and psychiatric symptoms were found. None of the cytokines were reduced following CBT, and the marked improvements in psychiatric symptoms after treatment were not associated with changes in cytokines. In conclusion, although inflammation might be of relevance in subgroups, it seems to be of limited importance for clinical improvements across mild to moderate CMDs.

  • 112. Santoft, Fredrik
    et al.
    Salomonsson, Sigrid
    Hesser, Hugo
    Lindsäter, Elin
    Ljótsson, Brjánn
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    Öst, Lars-Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology. Karolinska Institutet, Sweden.
    Hedman-Lagerlöf, Erik
    Mediators of Change in Cognitive Behavior Therapy for Clinical Burnout2019In: Behavior Therapy, ISSN 0005-7894, E-ISSN 1878-1888, Vol. 50, no 3, p. 475-488Article in journal (Refereed)
    Abstract [en]

    Evidence supporting the effectiveness of cognitive behavior therapy (CBT) for stress-related illness is growing, but little is known about its mechanisms of change. The aim of this study was to investigate potential mediators of CBT for severe stress in form of clinical burnout, using an active psychological treatment as comparator. We used linear mixed models to analyze data from patients (N = 82) with clinical burnout who received either CBT or another psychological treatment in a randomized controlled trial. Potential mediators (i.e., sleep quality, behavioral activation, perceived competence, and therapeutic alliance) and outcome (i.e., symptoms of burnout) were assessed weekly during treatment. The results showed that the positive treatment effects on symptoms of burnout favoring CBT (estimated between-group d = 0.93) were mediated by improvements in sleep quality, ab = -0.017,95% CIasymmetric [-0.037, -0.002], and increase in perceived competence, ab = -0.037, 95% CIasymmetric [-0.070, -0.010]. Behavioral activation, ab = -0.004 [-0.016, 0.007], and therapeutic alliance, ab = 0.002 [-0.006, 0.011], did not significantly mediate the difference in effects between the treatments. Improving sleep quality and increasing perceived competence may thus constitute important process goals in order to attain symptom reduction in CBT for clinical burnout.

  • 113. Santoft, Fredrik
    et al.
    Salomonsson, Sigrid
    Hesser, Hugo
    Lindsäter, Elin
    Ljótsson, Brjánn
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Öst, Lars-Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology. Karolinska Institutet, Sweden.
    Hedman-Lagerlöf, Erik
    Processes in cognitive behavior therapy for social anxiety disorder: Predicting subsequent symptom change2019In: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 67, article id 102118Article in journal (Refereed)
    Abstract [en]

    Although cognitive behavior therapy (CBT) is an effective treatment for social anxiety disorder, little is known about the processes during treatment that bring about change. The aim of this study was to investigate whether the proposed processes of change according to the cognitive model of social anxiety disorder predicted subsequent symptom reduction in CBT delivered as therapist-guided bibliotherapy. We analyzed data from patients with social anxiety disorder (N = 61) who participated in an effectiveness trial of CBT in primary care. Seven putative processes and outcome (i.e., social anxiety) were assessed on a weekly basis throughout treatment. We used linear mixed models to analyze within-person relations between processes and outcome. The results showed a unidirectional effect of reduced avoidance on subsequent decrease in social anxiety. Further, we found support for reciprocal influences between four of the proposed processes (i.e., estimated probability and cost of adverse outcome, self-focused attention, and safety behaviors) and social anxiety. The remaining two processes, (i.e., anticipatory and post-event processing) did not predict subsequent social anxiety, but were predicted by prior symptom reduction. The findings support that several of the change processes according to the cognitive model of social anxiety disorder are involved in symptom improvement.

  • 114.
    Schiller, Helena
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Rajaleid, Kristiina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hellgren, Carina
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Barck-Holst, Peter
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    The impact of reduced worktime on sleep and perceived stress – a group randomized intervention study using diary data2017In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 43, no 2, p. 109-116Article in journal (Refereed)
    Abstract [en]

    Objective Insufficient time for recovery between workdays may cause fatigue and disturbed sleep. This study evaluated the impact of an intervention that reduced weekly working hours by 25% on sleep, sleepiness and perceived stress for employees within the public sector.

    Method Participating workplaces (N=33) were randomized into intervention and control groups. Participants (N=580, 76% women) worked full-time at baseline. The intervention group (N=354) reduced worktime to 75% with preserved salary during 18 months. Data were collected at baseline and after 9 and 18 months follow-up. Sleep quality, sleep duration, sleepiness, perceived stress,and worries and stress at bedtime were measured with diary during one week per data collection.

    Result A multilevel mixed model showed that compared with the control group, at the 18-month follow-up, the intervention group had improved sleep quality and sleep duration (+23 minutes) and displayed reduced levels of sleepiness, perceived stress, and worries and stress at bedtime on workdays (P<0.002). The same effects were shown for days off (P<0.006), except for sleep length. Effect sizes were small (Cohen’s f2<0.08). Adding gender, age, having children living at home, and baseline values of sleep quality and worries and stress at bedtime as additional between-group factors did not influence the results.

    Conclusion A 25% reduction of weekly work hours with retained salary resulted in beneficial effects on sleep, sleepiness and perceived stress both on workdays and days off. These effects were maintained over an 18-month period. This randomized intervention thus indicates that reduced worktime may improve recovery and perceived stress.

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  • 115.
    Schiller, Helena
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Rajaleid, Kristiina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hellgren, Carina
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Barck-Holst, Peter
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    Total workload and recovery in relation to worktime reduction – a randomized controlled intervention study with time-use dataManuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: A 25% reduction of weekly work hours for full-time employees has been shown to improve sleep and alertness and reduce stress during both workdays and days off. The aim of the present study was to investigate how employees use their time during such an intervention: does total workload (paid and non-paid work) decrease, and recovery time increase, when work hours are reduced?

    Methods: Full-time employees within the public sector (N=636; 75% women) were randomized into intervention group and control group. The intervention group (N=370) reduced worktime to 75% with preserved salary during 18 months. Data were collected at baseline, after 9 months and 18 months. Time-use was reported every half hour daily between 06 and 01 a.m. during one week at each data collection. Data were analyzed with multilevel mixed modeling.

    Results: Compared to the control group, the intervention group increased the time spent on domestic work and relaxing hobby activities during workdays when worktime was reduced (p≤0.001). On days off, more time was spent in free-time activities (p=0.003). Total workload decreased (-65 minutes) and time spent in recovery activities increased on workdays (+53 minutes). The pattern of findings was similar in subgroups defined by gender, family status and job situation.

    Conclusions: A worktime reduction of 25% for full-time workers resulted in decreased total workload and an increase of time spent in recovery activities, which is in line with the suggestion that worktime reduction may be beneficial for long-term health and stress.

  • 116.
    Schiller, Helena
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Rajaleid, Kristiina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hellgren, Carina
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Barck-Holst, Peter
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands .
    Total workload and recovery in relation to worktime reduction: a randomised controlled intervention study with time-use data2018In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 75, no 3, p. 218-226Article in journal (Refereed)
    Abstract [en]

    Objectives A 25% reduction of weekly work hours for full-time employees has been shown to improve sleep and alertness and reduce stress during both workdays and days off. The aim of the present study was to investigate how employees use their time during such an intervention: does total workload (paid and non-paid work) decrease, and recovery time increase, when work hours are reduced?

    Methods Full-time employees within the public sector (n=636; 75% women) were randomised into intervention group and control group. The intervention group (n=370) reduced worktime to 75% with preserved salary during 18 months. Data were collected at baseline, after 9 months and 18 months. Time-use was reported every half-hour daily between 06:00 and 01:00 during 1 week at each data collection. Data were analysed with multilevel mixed modelling.

    Results Compared with the control group, the intervention group increased the time spent on domestic work and relaxing hobby activities during workdays when worktime was reduced (P≤0.001). On days off, more time was spent in free-time activities (P=0.003). Total workload decreased (-65 min) and time spent in recovery activities increased on workdays (+53 min). The pattern of findings was similar in subgroups defined by gender, family status and job situation.

    Conclusions A worktime reduction of 25% for full-time workers resulted in decreased total workload and an increase of time spent in recovery activities, which is in line with the suggestion that worktime reduction may be beneficial for long-term health and stress.

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  • 117.
    Schiller, Helena
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Söderström, Marie
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Rajaleid, Kristiina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    A randomized controlled intervention of workplace-based group cognitive behavioral therapy for insomniaManuscript (preprint) (Other academic)
    Abstract [en]

    Purpose: Sleep disturbance is common in the working population, often associated with work stress, health complaints and impaired work performance. This study evaluated a group intervention at work, based on Cognitive Behavioral Therapy (CBT) for insomnia, and the moderating effects of burnout scores at baseline.

    Methods: This is a randomized controlled intervention with a waiting-list control group. Participants were employees working at least 75% of full time, reporting self-perceived regular sleep problems. Data were collected at baseline, post-intervention and at a three-month follow-up through diaries, wrist-actigraphy and questionnaires including the Insomnia Severity Index (ISI) and the Shirom-Melamed Burnout Questionnaire (SMBQ). Fifty-one participants (63% women) completed data collections.

    Results: A multilevel mixed model showed no significant differences between groups for sleep over time, while there was a significant effect on insomnia symptoms when excluding participants working shifts (N=11) from the analysis (p=0.044). Moreover, a moderating effect of baseline-levels of burnout scores was observed on insomnia symptoms (p=0.009). A post-hoc analysis showed that individuals in the intervention group with low burnout scores at baseline (SMBQ<3.75) displayed significantly reduced ISI scores at follow-up, compared to individuals with high burnout scores at baseline (p=0.005).

    Conclusions: Group CBT for insomnia given at the workplace did not reduce sleep problems looking at the group as a whole, while it was indicated that the intervention reduced insomnia in employees with regular daytime work. The results also suggest that workplace-based group CBT may improve sleep in employees with primary insomnia if not concomitant with high burnout scores. 

  • 118.
    Schiller, Helena
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Söderström, Marie
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. KBT-Centralen, Sweden.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Rajaleid, Kristiina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    A randomized controlled intervention of workplace-based group cognitive behavioral therapy for insomnia2018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 4, p. 413-424Article in journal (Refereed)
    Abstract [en]

    Sleep disturbance is common in the working population, often associated with work stress, health complaints and impaired work performance. This study evaluated a group intervention at work, based on cognitive behavioral therapy (CBT) for insomnia, and the moderating effects of burnout scores at baseline. This is a randomized controlled intervention with a waiting list control group. Participants were employees working at least 75% of full time, reporting self-perceived regular sleep problems. Data were collected at baseline, post-intervention and at a 3-month follow-up through diaries, wrist-actigraphy and questionnaires including the Insomnia Severity Index (ISI) and the Shirom-Melamed Burnout Questionnaire (SMBQ). Fifty-one participants (63% women) completed data collections. A multilevel mixed model showed no significant differences between groups for sleep over time, while there was a significant effect on insomnia symptoms when excluding participants working shifts (N = 11) from the analysis (p = 0.044). Moreover, a moderating effect of baseline-levels of burnout scores was observed on insomnia symptoms (p = 0.009). A post-hoc analysis showed that individuals in the intervention group with low burnout scores at baseline (SMBQ < 3.75) displayed significantly reduced ISI scores at follow-up, compared to individuals with high burnout scores at baseline (p = 0.005). Group CBT for insomnia given at the workplace did not reduce sleep problems looking at the group as a whole, while it was indicated that the intervention reduced insomnia in employees with regular daytime work. The results also suggest that workplace-based group CBT may improve sleep in employees with primary insomnia if not concomitant with high burnout scores.

  • 119.
    Schwarz, Johanna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Axelsson, John
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Gerhardsson, Andreas
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Tamm, Sandra
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Fischer, Håkan
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Mood impairment is stronger in young than in older adults after sleep deprivation2019In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 28, no 4, article id e12801Article in journal (Refereed)
    Abstract [en]

    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.

  • 120.
    Schwarz, Johanna F. A.
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology. Karolinska Institute, Stockholm, Sweden.
    Freidle, Malin
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    van Leeuwen, Wessel
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology. Karolinska Institute, Stockholm, Sweden.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology. Karolinska Institute, Stockholm, Sweden.
    Sleep in everyday life – relationship to mood and performance in young and older adults: a study protocol2023In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 14, article id 1264881Article in journal (Refereed)
    Abstract [en]

    Laboratory based sleep deprivation studies demonstrate that lack of sleep impairs well-being and performance ability, but suggest that these effects are mitigated in older adults. Yet, much less is known whether day-to-day variations of sleep have similar consequences in the context of everyday life. This project uses an intensive longitudinal design to investigate the occurrence of day-to-day variations in sleep and their impact on mood and performance in everyday life and to examine whether effects differ between young and older adults. We aim to include 160 young (18–30 years) and 160 older adults (55–75 years) to complete a 21-day experience sampling method (ESM) protocol. During the ESM period, participants are asked to fill in (i) a brief morning questionnaire, (ii) 8 short daytime questionnaires addressing momentary well-being, sleepiness, stress, and mind wandering, followed by a 1 min cognitive task and (iii) a brief evening questionnaire, all delivered via a mobile phone application. Sleep will be measured using self-reports (daily questions) and objectively with wrist actigraphy. The impact of adult age on mean levels and intraindividual variability of sleep will be analyzed using mixed-effects location scale models. The impact of sleep on daily cognitive performance will be analyzed using multilevel linear mixed models. The relationship of sleep to mean values and variability of positive and negative affect in young and older adults will be analyzed using mixed-effects location scale modeling. The overarching purpose of the project is improving the current knowledge on the occurrence of day-to-day variations in sleep and their relationship to performance as well as positive and negative affect in young and older adults.

  • 121.
    Schwarz, Johanna F. A.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Ingre, Michael
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Fors, Carina
    Anund, Anna
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Taillard, Jacques
    Phillip, Pierre
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    In-car countermeasures open window and music revisited on the real road: popular but hardly effective against driver sleepiness2012In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 21, no 5, p. 595-599Article in journal (Refereed)
    Abstract [en]

    This study investigated the effects of two very commonly used countermeasures against driver sleepiness, opening the window and listening to music, on subjective and physiological sleepiness measures during real road driving. In total, 24 individuals participated in the study. Sixteen participants received intermittent 10-min intervals of: (i) open window (2 cm opened); and (ii) listening to music, during both day and night driving on an open motorway. Both subjective sleepiness and physiological sleepiness (blink duration) was estimated to be significantly reduced when subjects listened to music, but the effect was only minor compared with the pronounced effects of night driving and driving duration. Open window had no attenuating effect on either sleepiness measure. No significant long-term effects beyond the actual countermeasure application intervals occurred, as shown by comparison to the control group (n = 8). Thus, despite their popularity, opening the window and listening to music cannot be recommended as sole countermeasures against driver sleepiness.

  • 122.
    Schwarz, Johanna F A
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Lindberg, Eva
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Sleep as a means of recovery and restitution in women: the relation with psychosocial stress and health2014In: Psychosocial Stress and Cardiovascular Disease in Women / [ed] Kristina Orth-Gomer, Springer, 2014, p. 107-127Chapter in book (Other academic)
  • 123.
    Schwarz, Johanna F. A.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lindberg, E.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Theorell-Haglöw, J.
    Sleep length misperception and its association to subjective sleep quality and objective sleep duration in a large sample of women2013Conference paper (Refereed)
  • 124.
    Schwarz, Johanna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Gerhardsson, Andreas
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Fischer, Håkan
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Axelsson, John
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Age-dependent effects of sleep deprivation on task performance and mind wandering2017In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 40, no Suppl. 1, article id e297Article in journal (Refereed)
    Abstract [en]

    Introduction: Mind wandering, the drift of attention from the current task at hand to self-generated thought is commonly associated with poorer performance, and could be a potential pathway through which sleep deprivation affects performance. Little is known about this, however. Therefore, the aim of the present study was to address the effect of sleep deprivation on mind wandering and performance in a sustained attention task. In addition, we studied age as moderating factor, since older individuals are generally less prone to mind wandering.

    Materials and methods: Healthy young (18-30years) and older (60-72years) subjects participated in either a normal night sleep (NSD) or a total sleep deprivation (SD) condition, i.e. 4 conditions: NSD (n=31), SD (n=30), NSDold (n = 24), SDold (n= 24). Performance was measured using the Sustained Attention to Response Task, during which 10 thought probes were included that prompted the subjects to answer a question on what they were you just thinking about, using predefined answer alternatives. Mind wandering was quantified as occurrence of task-unrelated thoughts.

    Results: Applying a 2 (age) X 2 (sleep deprivation) ANOVA, significant main effects for sleep deprivation and age were observed for omissions, indicating worse performance after sleep deprivation and in young participants (p's < .05). These main effects were dominated by an age*sleep deprivation interaction (p = .04), which was due to sleep deprivation causing significantly more omission errors in young subjects (Mean ±SEM; NSD: 2.3 ±0.9; SD: 13.1 ±4.1) but not in older subjects (NSDold: 1.9 ±0.4; SDold: 2.8 ±0.9).

    Likewise, main and interaction effects for age and sleep deprivation were significant for task-unrelated thoughts (p's < 0.01). Task unrelated thoughts were significantly more frequent after sleep loss in young (NSD: 1.5 ±0.2; SD: 4.3 ±0.6), but not older subjects (NSDold: 0.3 ±0.2; SDold: 0.5 ±0.2) (interaction age*sleep deprivation p < .01). Young subjects had significantly more task-unrelated thoughts than older, regardless of sleep condition.

    Task-unrelated thoughts correlated with errors of omission (r = 0.65, p < .001). Also, including task unrelated thoughts as covariate in the age * sleep deprivation ANOVA, main and interactions effect of age and sleep deprivation were no longer significant.

    Reaction time was significantly slower in older adults, but no main or interaction effect of sleep deprivation occurred. Errors of commission were not affected by condition.

    Conclusions: The results show that sleep deprivation caused both mind wandering and poorer task performance in young but not older participants. In addition, mind wandering rates correlated with errors of omission, which may indicate that a diminished ability to shut down off-task thoughts after sleep deprivation could be an important pathway to performance decrements after sleep loss. In line with previous research, mind wandering appears to occur less frequently in older individuals compared with younger. This lower occurrence of mind wandering in older subjects may potentially enable them to better maintain performance after sleep deprivation and partially explain the higher resilience of older adults to sleep deprivation.

  • 125.
    Schwarz, Johanna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Gerhardsson, Andreas
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Van Leeuwen, Wessel
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Fischer, Håkan
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Axelsson, John
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    The effect of sleep loss on the response to acute psychosocial stress in young and elderly2016In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 25(S1), p. 48-48, article id 245Article in journal (Refereed)
    Abstract [en]

    Both sleep loss and social stress are risk factors for health and performance ability. It is assumed that sleep and stress are bidirectional linked, but most of the previous research has focused on studying sleep problems as consequence of stress. We believe that it is important to improve our understanding of the reverse connection, which is less studied. This presentation will cover recent experimental human studies that have investigated how sleep loss affects stress responses and whether it makes individuals more vulnerable to psychosocial stress. A study by Minkel et al. (Health Psychology, 2014) reported that the cortisol response to an acute stress situation was increased after sleep deprivation compared with a control condition indicating a more pronounced activation of the hypothalamic-pituitary-adrenal stress axis. I will also present recently collected data from young (18–30 years) and older (60–72 years) subjects that participated in four conditions (between subject design):

    (i) normal night sleep.

    (ii) normal night sleep & acute stress (Trier Social Stress Test).

    (iii) total sleep deprivation.

    (iv) total sleep deprivation & acute stress.

    The presentation thus provides state of the art knowledge of the link between sleep loss and vulnerability to stress.

  • 126.
    Schwarz, Johanna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Gerhardsson, Andreas
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    van Leeuwen, Wessel
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Ericson, Mats
    Fischer, Håkan
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Does sleep deprivation increase the vulnerability to acute psychosocial stress in young and older adults?2018In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 96, p. 155-165Article in journal (Refereed)
    Abstract [en]

    Sleep loss and psychosocial stress often co-occur in today’s society, but there is limited knowledge on the combined effects. Therefore, this experimental study investigated whether one night of sleep deprivation affects the response to a psychosocial challenge. A second aim was to examine if older adults, who may be less affected by both sleep deprivation and stress, react differently than young adults. 124 young (18–30 years) and 94 older (60–72 years) healthy adults participated in one of four conditions: i. normal night sleep & Placebo-Trier Social Stress Test (TSST), ii. normal night sleep & Trier Social Stress Test, iii. sleep deprivation & Placebo-TSST, iv. sleep deprivation & TSST. Subjective stress ratings, heart rate variability (HRV), salivary alpha amylase (sAA) and cortisol were measured throughout the protocol. At the baseline pre-stress measurement, salivary cortisol and subjective stress values were higher in sleep deprived than in rested participants. However, the reactivity to and recovery from the TSST was not significantly different after sleep deprivation for any of the outcome measures. Older adults showed higher subjective stress, higher sAA and lower HRV at baseline, indicating increased basal autonomic activity. Cortisol trajectories and HRV slightly differed in older adults compared with younger adults (regardless of the TSST). Moreover, age did not moderate the effect of sleep deprivation. Taken together, the results show increased stress levels after sleep deprivation, but do not confirm the assumption that one night of sleep deprivation increases the responsivity to an acute psychosocial challenge.

  • 127.
    Stenfors, Cecilia U. D.
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology. Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Stengård, Johanna
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology. Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Magnusson Hanson, Linda
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology. Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology. Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology. Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Green sleep: Immediate residential greenspace and access to larger green areas are associated with better sleep quality, in a longitudinal population-based cohort2023In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 234, article id 116085Article in journal (Refereed)
    Abstract [en]

    Objective: Sleep is pivotal to health, wellbeing and functioning in daily life, but sleep difficulties are common and may be affected by modifiable qualities in the residential surrounding environment, in terms of greenspace. However, population-based studies on individual-level greenspace and sleep are limited. The objective of the current study was thus to investigate prospective associations between fine-grained individual-level residential greenspace and sleep, and moderating effects of life style (physical activity, work status) and sex, in a nationwide population-based Swedish cohort.

    Methods: Participants of the Swedish Longitudinal Occupational Survey of Health (SLOSH)-a population-based sample of adults in Sweden-were studied during 2014-2018 (19,375 individuals; 43,062 observations). Residential greenspace land cover, and coherent green area size, were assessed via high resolution geographic information systems, at 50, 100, 300, 500 and 1000 m buffers around residences. Prospective greenspace and sleep associations were assessed via multilevel general linear models, adjusting for demographic, socioeconomic (individual and neighborhood), life style and urban factors.

    Results: Higher greenspace availability in the immediate residential surroundings (50 m and 100 m buffer zones) was associated with less sleep difficulties, even after adjustment for confounders. Greenspace effects were generally greater among non-working individuals. Among the physically active, and among non-working, greenspace and green area size further away from home (300, 500 and 1000 m, i.e. dependent on mobility) were also associated with less sleep difficulties.

    Conclusions: Residential greenspace in the immediate residential surroundings is associated with significantly less sleep difficulties. Greenspace further away from home was associated with better sleep especially among the physically active, and non-working individuals. The results highlight the importance of greenspace in the immediate residential-surrounding environment for sleep, and the need to integrate health and environmental policies, urban planning and greening.

  • 128.
    Sundelin, Tina
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Van Someren, Eus J. W.
    Olsson, Andreas
    Axelsson, John
    Cues of fatigue: effects of sleep deprivation on facial appearance2013In: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 36, no 9, p. 1355-1360Article in journal (Refereed)
    Abstract [en]

    STUDY OBJECTIVE: To investigate the facial cues by which one recognizes that someone is sleep deprived versus not sleep deprived.

    DESIGN: Experimental laboratory study.

    SETTING: Karolinska Institutet, Stockholm, Sweden.

    PARTICIPANTS: Forty observers (20 women, mean age 25 ± 5 y) rated 20 facial photographs with respect to fatigue, 10 facial cues, and sadness. The stimulus material consisted of 10 individuals (five women) photographed at 14:30 after normal sleep and after 31 h of sleep deprivation following a night with 5 h of sleep.

    MEASUREMENTS: Ratings of fatigue, fatigue-related cues, and sadness in facial photographs.

    RESULTS: The faces of sleep deprived individuals were perceived as having more hanging eyelids, redder eyes, more swollen eyes, darker circles under the eyes, paler skin, more wrinkles/fine lines, and more droopy corners of the mouth (effects ranging from b = +3 ± 1 to b = +15 ± 1 mm on 100-mm visual analog scales, P < 0.01). The ratings of fatigue were related to glazed eyes and to all the cues affected by sleep deprivation (P < 0.01). Ratings of rash/eczema or tense lips were not significantly affected by sleep deprivation, nor associated with judgements of fatigue. In addition, sleep-deprived individuals looked sadder than after normal sleep, and sadness was related to looking fatigued (P < 0.01).

    CONCLUSIONS: The results show that sleep deprivation affects features relating to the eyes, mouth, and skin, and that these features function as cues of sleep loss to other people. Because these facial regions are important in the communication between humans, facial cues of sleep deprivation and fatigue may carry social consequences for the sleep deprived individual in everyday life.

  • 129.
    Sverke, Magnus
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Falkenberg, Helena
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    A Meta-Review Of Job Demands And Job Resources As Related To Work-Related Attitudes And Behaviours Among Women And Men With Different Occupations2017Conference paper (Refereed)
    Abstract [en]

    Purpose: This systematic meta-review uses the job demands-resources (JD-R) model as a starting point for reporting on how various psychosocial factors at work relate to different outcomes. Specifically, the review investigated how job demands and resources associate with job attitudes and behaviours and whether these linkages vary between genders and occupations.

    Design/Methodology: This meta-review includes meta-analyses and systematic literature reviews published during the past 10 years. The secondary studies were retrieved from combined searches in different international databases. Search terms were chosen to target a range of psychosocial factors and to retrieve published journal articles, and systematic reports linking such factors to job attitudes and behaviours.

    Results: In total, 14 job demands and 7 job resources were identified. These were linked to outcomes resulting in 147 associations being identified. Overall, the findings summarize what is known from previous systematic reviews, namely that job demands are associated with poorer attitudes and behaviours while resources typically relate to attitudes and behaviours that are beneficial both for employers and individual employees. However, for gender and occupation, considerably less is known. Importantly, however, reports of gender specific associations suggest that, overall, linkages between psychosocial factors and job attitudes and behaviours hold for both women and men.

    Limitations: The restriction to the past 10 years.

    Research/Practical Implications: The meta-review adds to understanding consequences of psychosocial factors at work and points up future research needs.

    Originality/Value: The broad approach using a meta-review allows for integrating research on several outcomes.

  • 130.
    Sverke, Magnus
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Falkenberg, Helena
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Kvinnors och mäns arbetsvillkor - betydelsen av organisatoriska faktorer och psykosocial arbetsmiljö för arbets- och hälsorelaterade utfall2016Report (Other academic)
    Abstract [sv]

    Den här kunskapssammanställningen tar sin utgångspunkt i den (starka) könssegregeringen på svensk arbetsmarknad och vilken betydelse den har för skillnader i organisatoriska och psykosociala omständigheter för kvinnor och män. Den beskriver kunskapsläget vad gäller likheter och skillnader mellan kvinnor och män med fokus på organisatoriska faktorer (som arbetstid och anställningsvillkor) samt psykosociala arbetsmiljöfaktorer i form av upplevda krav och resurser. Dessa faktorers betydelse för kvinnors och mäns psykiska ohälsa, självrapporterade hälsa, arbetsrelaterade välbefinnande samt sjukskrivning beaktas i kunskapssammanställningen. Utgångspunkt tas i offentlig statistik om arbetsskador och sjuktal, med fokus på ”kvinnodominerade” branscher som vård, skola och omsorg. Rapporten beskriver forskningsläget utifrån internationell och nationell vetenskaplig litteratur från det senaste decenniet.

  • 131.
    Sverke, Magnus
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Falkenberg, Helena
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Women and men and their working conditions: The importance of organizational and psychosocial factors for work-related and health-related outcomes2017Report (Other academic)
    Abstract [en]

    This report includes a research overview commissioned by the Swedish Work Environment Authority with the aim of detailing relationships between organizational and psychosocial factors at work, and various work-related and health-related outcomes among working women and men. A second aim involved reporting on the prevalence of the different work environment factors among women and men. To fulfil the first aim, systematic research reviews, including meta-analyses and literature reviews, were retrieved from combined searches in different international and national databases. Search terms were chosen to target the broad array of organizational and psychosocial factors, and to retrieve published journal articles and systematic reports of Swedish government agencies linking such factors to various outcomes. The time period was restricted to the past ten years.

  • 132.
    Taloyan, Marina
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Thörn, Licia
    Kjeldgård, Linnea
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Svedberg, Pia
    Alexanderson, Kristina
    Sickness presence in the Swedish Police in 2007 and in 2010: Associations with demographic factors, job characteristics, and health2016In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 54, no 2, p. 379-387Article in journal (Refereed)
    Abstract [en]

    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.

  • 133.
    Tamm, Sandra
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Nilsonne, Gustav
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    D'Onofrio, Paolo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Thuné, Hanna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Schwarz, Johanna F A
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Petrovic, P
    Fischer, H
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Effect of partial sleep deprivation on empathy for pain in an fMRI experiment.2014In: SFSS (Svensk Förening för Sömnforskning och Sömnmedicin) Årskongress 5-7 Maj 2014, Stockholm, Sweden, Stockholm: Svensk förening för sömnforskning och sömnmedicin , 2014Conference paper (Other academic)
  • 134.
    Tamm, Sandra
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Nilsonne, Gustav
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    D'Onofrio, Paolo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Thuné, Hanna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Schwarz, Johanna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Petrovic, P.
    Fischer, Håkan
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Effect of partial sleep deprivation on empathy for pain in an fMRI experiment2014Conference paper (Other academic)
  • 135.
    Tamm, Sandra
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Nilsonne, Gustav
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden .
    Schwarz, Johanna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Golkar, Armita
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology. Karolinska Institutet, Sweden.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Petrovic, Predrag
    Fischer, Håkan
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Sleep restriction caused impaired emotional regulation without detectable brain activation changes—a functional magnetic resonance imaging study2019In: Royal Society Open Science, E-ISSN 2054-5703, Vol. 6, no 3, article id 181704Article in journal (Refereed)
    Abstract [en]

    Sleep restriction has been proposed to cause impaired emotional processing and emotional regulation by inhibiting top-down control from prefrontal cortex to amygdala. Intentional emotional regulation after sleep restriction has, however, never been studied using brain imaging. We aimed here to investigate the effect of partial sleep restriction on emotional regulation through cognitive reappraisal. Forty-seven young (age 20–30) and 33 older (age 65–75) participants (38/23 with complete data and successful sleep intervention) performed a cognitive reappraisal task during fMRI after a night of normal sleep and after restricted sleep (3 h). Emotional downregulation was associated with significantly increased activity in the dorsolateral prefrontal cortex (pFWE < 0.05) and lateral orbital cortex (pFWE < 0.05) in young, but not in older subjects. Sleep restriction was associated with a decrease in self-reported regulation success to negative stimuli (p< 0.01) and a trend towards perceiving all stimuli as less negative (p = 0.07) in young participants. No effects of sleep restriction on brain activity nor connectivity were found in either age group. In conclusion, our data do not support the idea of a prefrontal-amygdala disconnect after sleep restriction, and neural mechanisms underlying behavioural effects on emotional regulation after insufficient sleep require further investigation.

  • 136. Tamm, Sandra
    et al.
    Nilsonne, Gustav
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Schwarz, Johanna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lamm, Claus
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Petrovic, Predrag
    Fischer, Håkan
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Åkerstedt, Torbjörn
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    It hurts me too – an fMRI study of the effects of sleep restriction and age on empathy for pain2016Conference paper (Other academic)
    Abstract [en]

    Introduction: Many emotional processes are affected by sleep restriction (Beattie et al. 2015). Whether this is likewise true for social emotions, such as empathy, is not known. Empathy for pain has previously been studied using paradigms where subjects are presented with pain in others or pictures of pain in others. These paradigms consistently activated areas in the anterior cingulate cortex and anterior insula. Aging affects both sleep (Vitiello 2012) and emotional functions (Mather 2012), but whether the role of sleep in emotional functioning is stable across age is not known. This study aims to investigate how neural and behavioral responses to pain in others are affected by sleep restriction and age, and whether age modulates the role of sleep in responses to pain in others.

    Methods: In a randomized cross-over experimental design, 47 healthy younger (age: 20-30) and 39 older (age: 65-75) volunteers underwent fMRI twice, after either normal sleep or sleep restricted to 3 hours. In an event-related fMRI task, participants viewed pictures of needles pricking a hand (pain condition) or Q-tips touching a hand (control condition), and reported their vicarious unpleasantness. Preprocessing and analyses were performed in SPM12 and included slice time correction, realignment, DARTEL normalization and smoothing with an 8x8x8 FWHM kernel. First level analyses included fixed effects for events, motion parameters and button presses. At second level a full factorial design was applied. Additional region of interest analyses were performed in anterior insula and anterior cingulate cortex.

    Results: The contrast pain > control robustly activated anterior cingulate cortex and anterior insula (FWE p < 0.05, fig 1) as well as other areas previously proposed as the core empathy for pain network (Lamm et al. 2011). Older participants generally experienced more unpleasantness in response to pictures of pain compared to younger participants (p < 0.001), and this was accompanied by higher activity in bilateral angular gyrus (FWE p < 0.05). Age and sleep interacted so that sleep restriction caused decreased unpleasantness in young and increased unpleasantness in old to pain stimuli (p < 0.01), even though there was no significant simple main effect of sleep restriction in any age group. In clusters in bilateral insula, old participants showed more activity and young less activity in response to pain after sleep restriction (p < 0.001 uncorrected).

    Conclusions: Compared to younger participants, older subjects generally responded more to pain in others, shown as subjective experience as well as brain responses. With sleep restriction, empathic responses in young and old changed in opposite directions, so that empathic responses increased in older and decreased in younger participants. Given that empathy is crucial in effective interaction with others, our findings imply possible age-related changes in prosocial behavior, amplified by short sleep.

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  • 137.
    Tamm, Sandra
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Nilssone, Gustav
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Schwarz, Johanna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Lamm, Claus
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud Universiteit, Netherlands.
    Petrovic, Predrag
    Fischer, Håkan
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    The effect of sleep restriction on empathy for pain: An fMRI study in younger and older adults2017In: Scientific Reports, E-ISSN 2045-2322, Vol. 7, article id 12236Article in journal (Refereed)
    Abstract [en]

    Age and sleep both affect emotional functioning. Since sleep patterns change over the lifespan, we investigated the effects of short sleep and age on empathic responses. In a randomized cross-over experimental design, healthy young and older volunteers (n = 47 aged 20–30 years and n = 39 aged 65–75 years) underwent functional magnetic resonance imaging (fMRI) after normal sleep or night sleep restricted to 3 hours. During fMRI, participants viewed pictures of needles pricking a hand (pain) or Q-tips touching a hand (control), a well-established paradigm to investigate empathy for pain. There was no main effect of sleep restriction on empathy. However, age and sleep interacted so that sleep restriction caused increased unpleasantness in older but not in young participants. Irrespective of sleep condition, older participants showed increased activity in angular gyrus, superior temporal sulcus and temporo-parietal junction compared to young. Speculatively, this could indicate that the older individuals adopted a more cognitive approach in response to others’ pain. Our findings suggest that caution in generalizability across age groups is needed in further studies of sleep on social cognition and emotion.

  • 138.
    Tamm, Sandra
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Stockholm .
    Schwarz, Johanna
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden.
    Thuné, Hanna
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden.
    Petrovic, Predrag
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden.
    Fischer, Håkan
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden.
    Nilsonne, Gustav
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden.
    A combined fMRI and EMG study of emotional contagion following partial sleep deprivation in young and older humans2020In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 17944Article in journal (Refereed)
    Abstract [en]

    Sleep deprivation is proposed to inhibit top-down-control in emotion processing, but it is unclear whether sleep deprivation affects emotional mimicry and contagion. Here, we aimed to investigate effects of partial sleep deprivation on emotional contagion and mimicry in young and older humans. Participants underwent partial sleep deprivation (3 h sleep opportunity at the end of night), crossed-over with a full sleep condition in a balanced order, followed by a functional magnetic resonance imaging and electromyography (EMG) experiment with viewing of emotional and neutral faces and ratings of emotional responses. The final sample for main analyses was n = 69 (n = 36 aged 20–30 years, n = 33 aged 65–75 years). Partial sleep deprivation caused decreased activation in fusiform gyri for angry faces and decreased ratings of happiness for all stimuli, but no significant effect on the amygdala. Older participants reported more anger compared to younger participants, but no age differences were seen in brain responses to emotional faces or sensitivity to partial sleep deprivation. No effect of the sleep manipulation was seen on EMG. In conclusion, emotional contagion, but not mimicry, was affected by sleep deprivation. Our results are consistent with the previously reported increased negativity bias after insufficient sleep.

    The Stockholm sleepy brain study: effects of sleep deprivation on cognitive and emotional processing in young and old. https://clinicaltrials.gov/ct2/show/NCT02000076.

  • 139.
    Thuné, Hanna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Nilsonne, Gustav
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Tamm, Sandra
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    D'Onofrio, Paolo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Schwarz, Johanna F A
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Effects of partial sleep deprivation on the neural mechanisms of face perception2014In: Journal of Sleep Research, Special issue: abstracts of the 22nd Congress of the European Sleep Research Society, 16–20 September 2014, Tallinn, Estonia, Chichester: Wiley-Blackwell, 2014, p. 245-Conference paper (Other academic)
  • 140.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, United Kingdom.
    Albrecht, Sophie
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Beckers, Debby G. J.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Work time control, sleep & accident risk: A prospective cohort study2016In: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 33, no 6, p. 619-629Article in journal (Refereed)
    Abstract [en]

    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 and p = 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 and p = 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.

  • 141.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Bejerot, Eva E
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Aronsson, Gunnar
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Doctors' work schedules and work time control2013Conference paper (Refereed)
  • 142.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, United Kingdom.
    Bejerot, Eva
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    Aronsson, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    The impact of work time control on physicians’ sleep and well-being2015In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 47, p. 109-116Article in journal (Refereed)
    Abstract [en]

    Physicians' work schedules are an important determinant of their own wellbeing and that of their patients. This study considers whether allowing physicians control over their work hours ameliorates the effects of demanding work schedules. A questionnaire was completed by hospital physicians regarding their work hours (exposure to long shifts, short inter-shift intervals, weekend duties, night duties, unpaid overtime; and work time control), sleep (quantity and disturbance) and wellbeing (burnout, stress and fatigue). Work time control moderated the negative impact that frequent night working had upon sleep quantity and sleep disturbance. For participants who never worked long shifts, work time control was associated with fewer short sleeps, but this was not the case for those who did work long shifts. Optimizing the balance between schedule flexibility and patient needs could enhance physicians' sleep when working the night shift, thereby reducing their levels of fatigue and enhancing patient care.

  • 143.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Comparing the acute effects of shiftwork on mothers and fathers2021In: Occupational Medicine, ISSN 0962-7480, E-ISSN 1471-8405, Vol. 71, no 9, p. 414-421Article in journal (Refereed)
    Abstract [en]

    Background: Shift work may impact women more negatively than men due to the increased burden of coping with demanding work schedules while also undertaking more of the domestic chores, including childcare.

    Aims: To examine whether the combination of shift working and caring for children affects the sleep, fatigue and work–family conflict experienced by women more than it affects men.

    Methods: Using data from a survey of the Swedish working population, mixed linear regression models examined work schedule (daywork, shift work with nights, shift work without nights), gender and presence of children <13 years at home as predictors of sleep insufficiency, sleep disturbance, fatigue and work–family conflict, over up to three successive measurement occasions. Adjustments were made for age, education, full/part-time working and baseline year.

    Results: In fully adjusted models (N = 8938), shift work was associated with insufficient sleep (P < 0.01), disturbed sleep (P < 0.01), fatigue (P < 0.05) and work–family conflict (P < 0.001). Interactions in the analyses of sleep disturbance (P < 0.001) and work–family interference (P < 0.05) indicated that among participants with no children, females reported more disturbed sleep and more work–family conflict than their male counterparts, irrespective of schedule; while among participants with children, female dayworkers reported more disturbed sleep than their male counterparts, and females working shifts without nights reported more work–family interference.

    Conclusions: Having young children did not exacerbate negative effects of shift work, in either men or women. This may reflect high levels of gender equality and childcare provision in Sweden.

  • 144.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Peristera, Paraskevi
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Can psychosocial working conditions help to explain the impact of shiftwork on health in male- and female-dominated occupations?: A prospective cohort study2020In: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 37, no 9-10, p. 1348-1356Article in journal (Refereed)
    Abstract [en]

    Occupational factors are sometimes invoked to explain gender differences in the associations between shiftwork and health. We examined prospective associations between shiftwork and health, and between shiftwork and sick leave, separately for workers in female-dominated (FD) and male-dominated (MD) occupations; and whether the associations remained after controlling for psychosocial working conditions. Data from six waves of the Swedish Longitudinal Occupational Survey of Health were used to examine prospective associations with a four-year time lag between work schedule (daywork versus shiftwork involving nightwork; and daywork versus shiftwork not involving nightwork) and self-reports of depressive symptoms; incidents of short- and long-term sick leave; self-rated health; and sleep disturbance. Dynamic panel models with fixed effects were applied, using structural equation modeling. The analyses included adjustments for personal circumstances and employment conditions; and additional adjustments for psychosocial working conditions (psychological and emotional job demands; job control; worktime control; social support at work; persecution at work; and threats or violence at work). Within FD occupations, shiftwork that included night work (as compared to daytime work) predicted higher incidence of short-term sick leave (<1 week); within MD occupations, shiftwork that included nightwork predicted greater symptoms of mild depression. Despite notable differences in psychosocial working conditions between dayworkers and shiftworkers, both associations remained significant after adjustments. Thus, it was not confirmed that the associations between shiftwork and health reflected poorer working conditions of shiftworkers in either FD or MD occupations, although the possibility remains that the associations were due to other unmeasured aspects of the working environment.

  • 145. Vadeby, Anna
    et al.
    Forsman, Asa
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Sandberg, David
    Anund, Anna
    Sleepiness and prediction of driver impairment in simulator studies using a Cox proportional hazard approach2010In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 42, no 3, p. 835-41Article in journal (Refereed)
    Abstract [en]

    Cox proportional hazard models were used to study relationships between the event that a driver is leaving the lane caused by sleepiness and different indicators of sleepiness. In order to elucidate different indicators' performance, five different models developed by Cox proportional hazard on a data set from a simulator study were used. The models consisted of physiological indicators and indicators from driving data both as stand alone and in combination. The different models were compared on two different data sets by means of sensitivity and specificity and the models' ability to predict lane departure was studied. In conclusion, a combination of blink indicators based on the ratio between blink amplitude and peak closing velocity of eyelid (A/PCV) (or blink amplitude and peak opening velocity of eyelid (A/POV)), standard deviation of lateral position and standard deviation of lateral acceleration relative road (ddy) was the most sensitive approach with sensitivity 0.80. This is also supported by the fact that driving data only shows the impairment of driving performance while blink data have a closer relation to sleepiness. Thus, an effective sleepiness warning system may be based on a combination of lane variability measures and variables related to eye movements (particularly slow eye closure) in order to have both high sensitivity (many correct warnings) and acceptable specificity (few false alarms).

  • 146. van de Ven, Hardy A
    et al.
    Brouwer, Sandra
    Koolhaas, Wendy
    Goudswaard, Anneke
    de Looze, Michiel P
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    Almansa, Josue
    Bültmann, Ute
    van der Klink, Jac J. L.
    Associations between shift schedule characteristics with sleep, need for recovery, health and performance measures for regular (semi-)continuous 3-shift systems.2016In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 56, p. 203-212Article in journal (Refereed)
    Abstract [en]

    In this cross-sectional study associations were examined between eight shift schedule characteristics with shift-specific sleep complaints and need for recovery and generic health and performance measures. It was hypothesized that shift schedule characteristics meeting ergonomic recommendations are associated with better sleep, need for recovery, health and performance. Questionnaire data were collected from 491 shift workers of 18 companies with 9 regular (semi)-continuous shift schedules. The shift schedule characteristics were analyzed separately and combined using multilevel linear regression models. The hypothesis was largely not confirmed. Relatively few associations were found, of which the majority was in the direction as expected. In particular early starts of morning shifts and many consecutive shifts seem to be avoided. The healthy worker effect, limited variation between included schedules and the cross-sectional design might explain the paucity of significant results.

  • 147. Van Laethem, Michelle
    et al.
    Beckers, Debby G. J.
    Kompier, Michiel A. J.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    van den Bossche, Seth N. J.
    Geurts, Sabine A. E.
    Bidirectional relations between work-related stress, sleep quality and perseverative cognition2015In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 79, no 5, p. 391-398Article in journal (Refereed)
    Abstract [en]

    Objective

    In this longitudinal two-wave study, bidirectional relations between work-related stress and sleep quality were examined. Moreover, it was investigated whether perseverative cognition is a potential underlying mechanism in this association, related to both work-related stress and sleep quality.

    Methods

    A randomly selected sample of Dutch employees received an online survey in 2012 and 2013. Of all invited employees, 877 participated in both waves. Structural equation modeling was performed to analyze the data.

    Results

    We found evidence for reversed relations between work-related stress and sleep quality. Specifically, when controlling for perseverative cognition, work-related stress was not directly related to subsequent sleep quality, but low sleep quality was associated with an increase in work-related stress over time. Moreover, negative bidirectional associations over time were found between perseverative cognition and sleep quality, and positive bidirectional associations were found between work-related stress and perseverative cognition. Lastly, a mediation analysis showed that perseverative cognition fully mediated the relationship between work-related stress and sleep quality.

    Conclusion

    The study findings suggest that perseverative cognition could be an important underlying mechanism in the association between work-related stress and sleep quality. The bidirectionality of the studied relationships could be an indication of a vicious cycle, in which work-related stress, perseverative cognition, and sleep quality mutually influence each other over time.

  • 148.
    van Leeuwen, Wessel M A
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Barnett, M
    Peksan, C
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Long term sleep and fatigue at sea: a field study2014In: Journal of sleep research, Special issue: 22nd Congress of the European Sleep Research Society, 16-20 September 2014, Tallinn, Estonia, 2014Conference paper (Other academic)
  • 149.
    van Leeuwen, Wessel M A
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kircher, Albert
    Dahlgren, Anna
    Lützhöft, Margareta
    Barnett, Mike
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Sleep, Sleepiness, and Neurobehavioral Performance While on Watch in a Simulated 4 Hours on/8 Hours off Maritime Watch System2013In: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 30, no 9, p. 1108-1115Article in journal (Refereed)
    Abstract [en]

    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.

  • 150.
    van Leeuwen, Wessel M. A.
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Pekcan, Claire
    Barnett, Mike
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Mathematical modelling of sleep and sleepiness under various watch keeping schedules in the maritime industry2021In: Marine Policy, ISSN 0308-597X, E-ISSN 1872-9460, Vol. 130, article id 104277Article in journal (Refereed)
    Abstract [en]

    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.

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