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  • 151.
    Watling, Christopher N.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Queensland University of Technology, Australia.
    Åkerstedt, Torbjörn
    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, Netherlands.
    Anund, Anna
    Do repeated rumble strip hits improve driver alertness?2016In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 25, no 2, p. 241-247Article in journal (Refereed)
    Abstract [en]

    Driving while sleepy is associated with increased crash risk. Rumble strips are designed to alert a sleepy or inattentive driver when they deviate outside their driving lane. The current study sought to examine the effects of repeated rumble strip hits on levels of physiological and subjective sleepiness as well as simulated driving performance. In total, 36 regular shift workers drove a high-fidelity moving base simulator on a simulated road with rumble strips installed at the shoulder and centre line after a working a full night shift. The results show that, on average, the first rumble strip occurred after 20 min of driving, with subsequent hits occurring 10 min later, with the last three occurring approximately every 5 min thereafter. Specifically, it was found that the first rumble strip hit reduced physiological sleepiness; however, subsequent hits did not increase alertness. Moreover, the results also demonstrate that increased subjective sleepiness levels, via the Karolinska Sleepiness Scale, were associated with a greater probability of hitting a rumble strip. The present results suggest that sleepiness is very resilient to even strongly arousing stimuli, with physiological and subjective sleepiness increasing over the duration of the drive, despite the interference caused by rumble strips.

  • 152. Westerlund, Anna
    et al.
    Trolle Lagerros, Ylva
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands; Karolinska Institutet, Sweden.
    Axelsson, John
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Relationships Between Questionnaire Ratings of Sleep Quality and Polysomnography in Healthy Adults2016In: Behavioural Sleep Medicine, ISSN 1540-2002, E-ISSN 1540-2010, Vol. 14, no 2, p. 185-199Article in journal (Refereed)
    Abstract [en]

    This study aimed to examine the association between polysomnographic sleep and subjective habitual sleep quality and restoration from sleep. Thirty-one normal sleepers completed the Karolinska Sleep Questionnaire and multiple home polysomnography recordings (n = 2-5). Using linear regression, sleep quality and restoration were separately analyzed as functions of standard polysomnography parameters: sleep efficiency, total sleep time, sleep latency, stage 1 and 2 sleep, slow-wave sleep, rapid eye movement sleep, wake time after sleep onset, and awakenings (n), averaged across recordings. Stage 2 and slow-wave sleep predicted worse and better sleep quality, respectively. Also, slow-wave sleep predicted less subjective restoration, although adjustment for age attenuated this relation. Our findings lend some physiological validity to ratings of habitual sleep quality in normal sleepers. Data were less supportive of a physiological correlate of ratings of restoration from sleep.

  • 153.
    Xu, Tianwei
    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. University of Copenhagen, Copenhagen, Denmark; National Research Centre for the Working Environment, Copenhagen, Denmark.
    Rugulies, Reiner
    Vahtera, Jussi
    Stenholm, Sari
    Pentti, Jaana
    Magnusson Hanson, Linda
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    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.
    Mathisen, Jimmi
    Nordentoft, Mads
    Kivimäki, Mika
    Rod, Naja Hulvej
    Workplace Psychosocial Resources and Risk of Sleep Disturbances Among Employees2023In: JAMA Network Open, E-ISSN 2574-3805, Vol. 6, no 5, article id e2312514Article in journal (Refereed)
    Abstract [en]

    Importance: Workplace psychosocial resources naturally tend to cluster in some work teams. To inform work-related sleep health promotion interventions, it is important to determine the associations between clustering of workplace resources and sleep disturbances when some resources are high while others are low and to mimic an actual intervention using observational data.

    Objective: To examine whether clustering of and changes in workplace psychosocial resources are associated with sleep disturbances among workers.

    Design, Setting, and Participants: This population-based cohort study used data from the Swedish Longitudinal Occupational Survey of Health (2012-2018), the Work Environment and Health in Denmark study (2012-2018), and the Finnish Public Sector Study (2008-2014), collected biennially. Statistical analysis was conducted from November 2020 to June 2022.

    Exposure: Questionnaires were distributed measuring leadership quality and procedural justice (ie, vertical resources) as well as collaboration culture and coworker support (ie, horizontal resources). Resources were divided into clusters of general low, intermediate vertical and low horizontal, low vertical and high horizontal, intermediate vertical and high horizontal, and general high.

    Main Outcomes and Measures: Odds ratios (ORs) and 95% CIs were reported from logistic regression models for the associations between the clustering of resources and concurrent and long-term sleep disturbances. Sleep disturbances were measured by self-administered questionnaires.

    Results: The study identified 114 971 participants with 219 982 participant-observations (151 021 [69%] women; mean [SD] age, 48 [10] years). Compared with participants with general low resources, other groups showed a lower prevalence of sleep disturbances, with the lowest observed in the general high group concurrently (OR, 0.38; 95% CI, 0.37-0.40) and longitudinally after 6 years (OR, 0.52; 95% CI, 0.48-0.57). Approximately half of the participants (27 167 participants [53%]) experienced changes in resource clusters within 2 years. Improvements in vertical or horizontal dimensions were associated with reduced odds of persistent sleep disturbances, and the lowest odds of sleep disturbances was found in the group with improvements in both vertical and horizontal dimensions (OR, 0.53; 95% CI, 0.46-0.62). A corresponding dose-response association with sleep disturbances was observed for decline in resources (eg, decline in both dimensions: OR, 1.74; 95% CI, 1.54-1.97).

    Conclusions and Relevance: In this cohort study of workplace psychosocial resources and sleep disturbances, clustering of favorable resources was associated with a lower risk of sleep disturbances.

  • 154. Åkerstedt Miley, Anna
    et al.
    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.
    Comparing two versions of the Karolinska Sleepiness Scale (KSS)2016In: Sleep and Biological Rhythms, ISSN 1446-9235, E-ISSN 1479-8425, Vol. 14, no 3, p. 257-260Article in journal (Refereed)
    Abstract [en]

    The Karolinska Sleepiness Scale (KSS) is frequently used to study sleepiness in various contexts. However, it exists in two versions, one with labels on every other step (version A), and one with labels on every step (version B) on the 9-point scale. To date, there are no studies examining whether these versions can be used interchangeably. The two versions were here compared in a 24 hr wakefulness study of 12 adults. KSS ratings were obtained every hour, alternating version A and B. Results indicated that the two versions are highly correlated, do not have different response distributions on labeled and unlabeled steps, and that the distributions across all steps have a high level of correspondence (Kappa = 0.73). It was concluded that the two versions are quite similar.

  • 155.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Axelsson, John
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Individual validation of model predictions of sleepiness and sleep hours2007In: Somnologie, Vol. 11, p. 169-174Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Several mathematical models for prediction of sleepiness have been developed. Few validations on individual levels are available.

    Background

    The present study was designed to provide validation on the individual level of predictions using the Three Process-Model of alertness regulation. Model predictions of sleep timing were also tested.

    Method

    Sixteen shift workers participated in the study. Ratings of sleepiness were made every 2h across three shifts. The model was used to predict empirical ratings using as input only information of beginning and end of work shifts, as well as using information on sleep from actigraphs (in a separate analysis).

    Results

    The prediction using only information on work shifts correlated r=0.55 (p<0.001) with empirical ratings. Predictions were generally within ±1 confidence interval of the ratings. Adding actigraphy sleep data improved predictions marginally. The model predictions of onset and offset of sleep were generally close to the target.

    Conclusion

    It was concluded that model predictions have a rather high validity both with respect to sleepiness and to sleep timing. It is probable that other information on individual differences will further improve predictability.

  • 156.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Axelsson, John
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Orsini, Nicola
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    The daily variation in sleepiness and its relation to the preceding sleep episode - a prospective study across 42days of normal living2013In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 22, no 3, p. 258-265Article in journal (Refereed)
    Abstract [en]

    Sleepiness is linked to accidents and reduced performance, and is usually attributed to short/poor prior sleep and sleepiness. However, while the link between reduced sleep and subsequent sleepiness is well established in laboratory experiments of sleep reduction, very little is known about the day-to-day variation of sleepiness in everyday life and its relation to the immediately preceding sleep episode. The purpose of the present study was to investigate the characteristics of this relation across 42 consecutive days. Fifty volunteers participated. Self-reports of sleep were given in the morning and recorded with actigraphy; health was rated in the evening; and sleepiness was rated at eight points during the day (on a scale of 1-9). Results from mixed-model regression analyses showed that, on average, total sleep time predicted sleepiness during the rest of the day across the 42 days, with sleepiness increasing with shorter preceding sleep (β = -0.15 units h(-1) , P < 0.001). Sleepiness also increased with earlier time of rising and lower-rated sleep quality. Days off reduced sleepiness, but was accounted for by sleep. Self-rated health improved when sleepiness was low during the same day (β = -0.36 unit unit(-1) of rated health, P < 0.001), but the two were measured simultaneously. Napping was related to high sleepiness during the same day. Actigraphy measures of sleep duration showed similar, but somewhat weaker, effects than diary measures. It was concluded that the main determinants of daytime sleepiness in a real-life day-to-day context were short sleep, poor sleep and early rising, and that days with high sleepiness ended with ratings of poorer health.

  • 157.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Garefelt, Johanna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Richter, Anne
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Sverke, Magnus
    Stockholm University, Faculty of Social Sciences, Department of Psychology. North West University, South Africa.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Work and Sleep - A Prospective Study of Psychosocial Work Factors, Physical Work Factors, and Work Scheduling2015In: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 38, no 7, p. 1129-1136Article in journal (Refereed)
    Abstract [en]

    Study Objectives: There is limited knowledge about the prospective relationship between major work characteristics (psychosocial, physical, scheduling) and disturbed sleep. The current study sought to provide such knowledge. Design: Prospective cohort, with measurements on two occasions (T1 and T2) separated by two years. Setting: Naturalistic study, Sweden. Participants: There were 4,827 participants forming a representative sample of the working population. Measurements and Results: Questionnaire data on work factors obtained on two occasions were analyzed with structural equation modeling. Competing models were compared in order to investigate temporal relationships. A reciprocal model was found to fit the data best. Sleep disturbances at T2 were predicted by higher work demands at T1 and by lower perceived stress at T1. In addition, sleep disturbances at T1 predicted subsequent higher perception of stress, higher work demands, lower degree of control, and less social support at work at T2. A cross-sectional mediation analysis showed that (higher) perceived stress mediated the relationship between (higher) work demands and sleep disturbances; however, no such association was found longitudinally. Conclusions: Higher work demands predicted disturbed sleep, whereas physical work characteristics, shift work, and overtime did not. In addition, disturbed sleep predicted subsequent higher work demands, perceived stress, less social support, and lower degree of control. The results suggest that remedial interventions against sleep disturbances should focus on psychosocial factors, and that such remedial interventions may improve the psychosocial work situation in the long run.

  • 158.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Hallvig, David
    Anund, Anna
    Fors, Carina
    Schwarz, Johanna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Having to stop driving at night because of dangerous sleepiness - awareness, physiology and behaviour2013In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 22, no 4, p. 380-388Article in journal (Refereed)
    Abstract [en]

    A large number of accidents are due to the driver falling asleep at the wheel, but details of this link have not been studied on a real road. The purpose of the present study was to describe the development of sleepiness indicators, leading to the drive being terminated prematurely by the onboard expert driving instructor because of imminent danger. Eighteen individuals participated during a day drive and a night drive on a motorway (both 90 min). Eight drivers terminated (N) prematurely (after 43 min) because of sleep-related imminent danger [according to the driving instructor or their own judgement (two cases)]. The results showed very high sleepiness ratings (8.5 units on the Karolinska Sleepiness Scale) immediately before termination (<7 at a similar time interval for those 10 who completed the drive). Group N also showed significantly higher levels of sleep intrusions on the electroencephalography/electro-oculography (EEG/EOG) than those who completed the drive (group C). The sleep intrusions were increased in group N during the first 40 min of the night drive. During the day drive, sleep intrusions were increased significantly in group N. The night drive showed significant increases of all sleepiness indicators compared to the day drive, but also reduced speed and driving to the left in the lane. It was concluded that 44% of drivers during late-night driving became dangerously sleepy, and that this group showed higher perceived sleepiness and more sleep intrusions in the EEG/EOG.

  • 159.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Hallvig, David
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Normative data on the diurnal pattern of the Karolinska Sleepiness Scale ratings and its relation to age, sex, work, stress, sleep quality and sickness absence/illness in a large sample of daytime workers2017In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 26, no 5, p. 559-566Article in journal (Refereed)
    Abstract [en]

    Self-rated sleepiness responds to sleep loss, time of day and work schedules. There is, however, a lack of a normative reference showing the diurnal pattern during a normal working day, compared with a day off, as well as differences depending on stress, sleep quality, sex, age and being sick listed. The present study sought to provide such data for the Karolinska Sleepiness Scale. Participants were 431 individuals working in medium-sized public service units. Sleepiness (Karolinska Sleepiness Scale, scale 1-9) was rated at six times a day for a working week and 2 days off (>90.000 ratings). The results show a clear circadian pattern, with high values during the morning (4.5 at 07:00 hours) and evening (6.0 at 22:00 hours), and with low values (3-4) during the 10:0016: 00 hours span. Women had significantly higher (0.5 units) Karolinska Sleepiness Scale values than men, as did younger individuals (0.3 units), those with stress (1.3 units above the low-stress group) and those with poor sleep quality (1.0 units above those with qood sleep quality). Days off showed reduced sleepiness (0.7 units), while being sick listed was associated with an increased sleepiness (0.8 units). Multiple regression analysis of mean sleepiness during the working week yielded mean daytime stress, mean sleep quality, age, and sex as predictors (not sleep duration). Improved sleep quality accounted for the reduced sleepiness during days off, but reduced stress was a second factor. Similar results were obtained in a longitudinal mixed-model regression analysis across the 7 days of the week. The percentage of ratings at Karolinska Sleepiness Scale risk levels (8 + 9) was 6.6%, but most of these were obtained at 22:00 hours. It was concluded that sleepiness ratings are strongly associated with time of day, sleep quality, stress, work day/day off, being ill, age, and sex.

  • 160.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Ingre, Michael
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Anund, Anna
    Sandberg, David
    Wahde, Mattias
    Philip, Pierre
    Kronberg, Peter
    Reaction of sleepiness indicators to partial sleep deprivation, time of day and time on task in a driving simulator - the DROWSI project2010In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 19, no 2, p. 298-309Article in journal (Refereed)
    Abstract [en]

    Studies of driving and sleepiness indicators have mainly focused on prior sleep reduction. The present study sought to identify sleepiness indicators responsive to several potential regulators of sleepiness: sleep loss, time of day (TOD) and time on task (TOT) during simulator driving. Thirteen subjects drove a high-fidelity moving base simulator in six 1-h sessions across a 24-h period, after normal sleep duration (8 h) and after partial sleep deprivation (PSD; 4 h). The results showed clear main effects of TOD (night) and TOT but not for PSD, although the latter strongly interacted with TOD. The most sensitive variable was subjective sleepiness, the standard deviation of lateral position (SDLAT) and measures of eye closure [duration, speed (slow), amplitude (low)]. Measures of electroencephalography and line crossings (LCs) showed only modest responses. For most variables individual differences vastly exceeded those of the fixed effects, except for subjective sleepiness and SDLAT. In a multiple regression analysis, SDLAT, amplitude/peak eye-lid closing velocity and blink duration predicted subjective sleepiness bouts with a sensitivity and specificity of about 70%, but were mutually redundant. The prediction of LCs gave considerably weaker, but similar results. In summary, SDLAT and eye closure variables could be candidates for use in sleepiness-monitoring devices. However, individual differences are considerable and there is need for research on how to identify and predict individual differences in susceptibility to sleepiness.

  • 161.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Sleep, Work, and Occupational Stress2012In: The Oxford Handbook of Sleep and Sleep disorders / [ed] Charles M. Morin, Colin Espie, New York: Oxford University Press , 2012, p. 248-265Chapter in book (Refereed)
  • 162.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Säkerhet, arbetstider och trötthet2013In: Patientsäkerhet: teori och praktik / [ed] Synnöve Ödegård, Stockholm: Liber, 2013Chapter in book (Other academic)
  • 163.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    What work schedule characteristics constitute a problem to the individual? A representative study of Swedish shift workers2017In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 59, p. 320-325Article in journal (Refereed)
    Abstract [en]

    The purpose was to investigate which detailed characteristics of shift schedules that are seen as problems to those exposed. A representative national sample of non-day workers (N = 2031) in Sweden was asked whether they had each of a number of particular work schedule characteristics and, if yes, to what extent this constituted a "big problem in life". It was also inquired whether the individual's work schedules had negative consequences for fatigue, sleep and social life. The characteristic with the highest percentage reporting a big problem was "short notice (<1 month) of a new work schedule" (30.5%), <11 h off between shifts (27.8%), and split duty (>1.5 h break at mid-shift, 27.2%). Overtime (>10 h/week), night work, morning work, day/night shifts showed lower prevalences of being a "big problem". Women indicated more problems in general. Short notice was mainly related to negative social effects, while <11 h off between shifts was related to disturbed sleep, fatigue and social difficulties. It was concluded that schedules involving unpredictable working hours (short notice), short daily rest between shifts, and split duty shifts constitute big problems. The results challenge current views of what aspects of shift work need improvement, and negative social consequences seem more important than those related to health.

  • 164.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Axelsson, John
    Impaired sleep after bedtime stress and worries.2007In: Biol Psychol, ISSN 0301-0511, Vol. 76, no 3, p. 170-3Article in journal (Other academic)
    Abstract [en]

    Akerstedt T, Kecklund G, Axelsson J.

    torbjorn.akerstedt@stressforskning.su.se

    Stress is assumed to impair sleep, but there is very little empirical evidence for this using sleep recordings. Here, we recorded sleep (at home) in 33 normal participants on three nights, which followed days with low, high and intermediate stress. The participants made daily ratings of the level of stress/worries at bedtime and also two-hourly ratings of stress. Only those 16 individuals who differed in stress/worries between two nights were analysed. There was a significantly lower sleep efficiency (81.0% versus 85.2%) a higher percent Wake (22.6% versus 15.6%) and a longer latency to Stage 3 (33.9 versus 18.3 min) during the nights with a higher stress/worry bedtime rating. None of the other sleep variables were affected. Also mean daytime stress ratings were significantly higher on the day preceding and following the high stress/worries sleep. It was concluded that moderate increases in stress/worries at bedtime are associated with moderately impaired sleep.

    PMID: 17884278 [PubMed - in process]

  • 165.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Axelsson, John
    Subjective and objective quality of sleep: [Subjektive und objektive Schlafqualität]2008In: Somnologie, ISSN 1432-9123, E-ISSN 1439-054X, Vol. 12, p. 104-109Article in journal (Other academic)
    Abstract [en]

    Relatively few studies have tried to relate subjective sleep quality to objective sleep parameters and most have been carried out in laboratory settings and often with patients and usually only for a single night. The present study used a group of 33 subjects who had sleep polysomnographically recorded in their homes for three nights during a period of several weeks. First a multiple regression analysis was carried out for each night with a 4-item sleep quality index as the dependent variable and conventional sleep parameters as predictors. This yielded a significant beta value for percent Stage O for each of the three nights. Sleep efficiency showed a significant correlation with sleep quality for two nights but did not enter the regression. When the night with the best and poorest sleep were compared, the only significant variable became percent SWS. It was suggested that the differing results may have been due to the large age span confusing SWS/quality correlations.

  • 166.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Selén, Jan
    Disturbed sleep and fatigue as predictors of return from long-term sickness absence2010In: Industrial Health, ISSN 0019-8366, E-ISSN 1880-8026, Vol. 48, no 2, p. 209-14Article in journal (Refereed)
    Abstract [en]

    Long-term sickness absence has doubled in Sweden, as has complaints of disturbed sleep. The present study sought to investigate the prospective link between long-term sickness absence and disturbed sleep or fatigue. Sleep and fatigue from a representative national sample was followed up 1.5-2 yr later in terms of return from long-term (>or=90 d) and intermediate term (14-89 d) sickness absence. 8,300 individuals participated in the survey, out of which 372 were on long-term and 1,423 were on intermediate term sick leave. The data was analyzed using logistic regression analysis with adjustment for background and work environment variables. Separate analyses were carried out for disturbed sleep and fatigue since they were correlated. The results showed that those with disturbed sleep at the start had an Odds Ratio (OR) of 0.56 (95% Confidence Interval (CI)=0.35-0.90) for returning from long-term sickness absence. For fatigue the results were OR=0.56 (CI=0.34-0.90). Intermediate term sickness absence showed similar, but slightly weaker, results. The results indicate that disturbed sleep and fatigue are predictors of lack of return from long term and intermediate term sickness absence.

  • 167.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Knutsson, Anders
    Narusyte, Jurgita
    Svedberg, Pia
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University Nijmegen, Netherlands.
    Alexanderson, Kristina
    Night work and breast cancer in women: a Swedish cohort study2015In: BMJ Open, E-ISSN 2044-6055, Vol. 5, no 4, article id e008127Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Recent research has suggested a moderate link between night work and breast cancer in women, mainly through case-control studies, but non-significant studies are also common and cohort studies are few. The purpose of the present study was to provide new information from cohort data through investigating the association between the number of years with night work and breast cancer among women.

    DESIGN: Cohort study of individuals exposed to night shift work in relation to incidence of breast cancer in women.

    SETTING: Individuals in the Swedish Twin registry, with follow-up in the Swedish Cancer Registry.

    PARTICIPANTS: 13 656 women from the Swedish Twin Registry, with 3404 exposed to night work.

    OUTCOME MEASURES: Breast cancer from the Swedish Cancer Registry (463 cases) during a follow-up time of 12 years.

    RESULTS: A Cox proportional hazards regression analysis with control for a large number of confounders showed that the HR was HR=1.68 (95% CI 0.98 to 2.88) for the group with >20 years of night work. When the follow-up time was limited to ages below 60 years, those exposed >20 years showed a HR=1.77 (95% CI 1.03 to 3.04). Shorter exposure to night work showed no significant effects.

    CONCLUSIONS: The present results, together with previous work, suggest that night work is associated with an increased risk of breast cancer in women, but only after relatively long-term exposure.

  • 168.
    Åkerstedt, Torbjörn
    et al.
    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.
    Nilsonne, Gustav
    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.
    d'Onofrio, Paolo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Gruber, G.
    Schwarz, Johanna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Women sleep better and have a stronger response to late night curtailed sleep than men, particularly in older individuals - effects on polysomnographical sleep2016In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 25, p. 156-156, article id P206Article in journal (Refereed)
    Abstract [en]

    Objectives: Higher age is associated with poorer sleep and women report more sleep problems than men, despite indications of better physiological sleep. The purpose of the present study was to investigate whether a common daily life sleep problem, late night curtailed sleep, would have different effects depending on gender and age. Methods: 60 healthy individuals (equal groups of gender and age (20–30 and 65–75 years)) participated in an experiment with a full night’s sleep and one night with reduced sleep between 0400 h and 0700 h, in a balanced design. Sleep was recorded through standard polysomnography (PSG) at home. Results: The results showed the expected main effect of sleep loss. Older participants had a lower TST, N3%, sleep efficiency, but more N1%, longer N3 latency, and fewer awakenings. Women had more N3%, more REM%, more N3%, and shorter N3 latency compared with men. The curtailed late night sleep caused a stronger increase in N3%, and more pronounced reductions in REM%, a stronger reduction in N1%, and N3 latency in women than men. In the higher age group the N3% response in men was strongly attenuated compared to that of women. Conclusions: The results show that women, apart form getting more N3% and less N1% even in the normal sleep condition, have a stronger response to late night sleep, particularly in higher age groups.

  • 169.
    Åkerstedt, Torbjörn
    et al.
    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.
    Nilsonne, Gustav
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Tamm, S.
    d'Onofrio, Paolo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Fischer, Håkan
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Petrovic, P.
    Månsson, Kristoffer N.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology. Karolinska Institutet, Sweden.
    Gray Matter Volume Correlates Of Sleepiness: A Voxel-based Morphometry Study In Younger And Older Adults2018In: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 41, p. A58-A58, article id 0149Article in journal (Other academic)
    Abstract [en]

    Introduction: Sleepiness is prevalent in society, often linked to disturbed sleep, shift work, stress, or diseases. It is also associated with an increased risk of accidents. Sleepiness may be related to brain metabolism and, we hypothesize that it is associated with brain gray matter (GM) volume. The present study investigated the association between sleepiness and GM volume in thalamus and insula, with a special focus on age, since both sleepiness and GM volume change with age.

    Methods: In all, 84 healthy individuals participated in the experiment, of which 46 were in the age range 20–30 years and 38 ranging between 65–75 years. Data was collected in a 3 T scanner during a 5 minute anatomical scan (first in a several sessions in the scanner) in the evening after a full night of sleep. Momentary sleepiness (Karolinska Sleepiness Scale) was rated 7 times during the time in the scanner.

    Results: Results showed that, in older, relative to younger adults, areas within bilateral insular cortex and thalamus GM regions of interest were negatively associated (FWE-corrected) with sleepiness (Z=4.02, p=.015 left insula and Z=4.42, p=.009 for right insula; Z=3.75, p=.020 for left thalamus and Z=4.60, p=.001 for right thalamus). Larger volume was associated with low sleepiness in the older group, but not in the older group. The effect in the insula was mainly present in the mid-anterior parts of the structure.. In addition, after applying a conservative small volume correction including all ROIs simultaneously, age-interaction effects remained significant.

    Conclusion: It was concluded that self-rated momentary sleepiness in a monotonous situation is negatively associated with GM volume in areas within both thalamus and insula in older individuals. The results are in line with notions of thalamus as a driver of arousal and of anterior insula as a structure evaluating the state of the organism. Possibly, a larger GM volume in these structures may be protective against sleepiness in older individuals, a hypothesis that needs confirmation in further studies.

  • 170.
    Åkerstedt, Torbjörn
    et al.
    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.
    Nilsonne, Gustav
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Tamm, Sandra
    D'onofrio, Paolo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Fischer, Håkan
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Schwarz, Johanna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Effects of late-night short-sleep on in-home polysomnography: relation to adult age and sex2018In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 27, no 4, article id e12626Article in journal (Refereed)
    Abstract [en]

    Bedtime is frequently delayed by many factors in life, and a homeostatic response to the delay may compensate partly for increased time awake and shortened sleep. Because sleep becomes shorter with age and women complain of disturbed sleep more often than men, age and sex differences in the homeostatic response to a delayed bedtime may modify the homeostatic response. The purpose of the present study was to investigate the effect of late-night short-sleep (3 h with awakening at about 07:00 hours) on in-home recorded sleep in men and women in two age groups (20-30 and 65-75 years). Results (N = 59) showed that late-night short-sleep was associated with an increase in percentage of N3 sleep and a decrease in percentage of rapid eye movement sleep, as well as decreases in several measures of sleep discontinuity and rapid eye movement density. Men showed a smaller decrease in percentage of rapid eye movement sleep than women in response to late-night short-sleep, as did older individuals of both sexes compared with younger. Older men showed a weaker percentage of N3 sleep in response to late-night short-sleep than younger men. In general, men showed a greater percentage of rapid eye movement sleep and a lower percentage of N3 sleep than women, and older individuals showed a lower percentage of N3 sleep than younger. In particular, older men showed very low levels of percentage of N3 sleep. We conclude that older males show less of a homeostatic response to late-night short-sleep. This may be an indication of impaired capacity for recovery in older men. Future studies should investigate if this pattern can be linked to gender-associated differences in morbidity and mortality.

  • 171.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden.
    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.
    Tamm, Sandra
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden.
    d'Onofrio, Paolo
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden.
    Kecklund, Göran
    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.
    Schwarz, Johanna
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden.
    Petrovic, Predrag
    Månsson, Kristoffer NT
    Gray Matter Volume Correlates of Sleepiness: A Voxel-Based Morphometry Study in Younger and Older Adults2020In: Nature and Science of Sleep, ISSN 1179-1608, Vol. 12, p. 289-298Article in journal (Refereed)
    Abstract [en]

    Background: Subjectively experienced sleepiness is a problem in society, possibly linked with gray matter (GM) volume. Given a different sleep pattern, aging may affect such associations, possibly due to shrinking brain volume.

    Purpose: The purpose of the present study was to investigate the association between subjectively rated sleepiness and GM volume in thalamus, insula, hippocampus, and orbitofrontal cortex of young and older adults, after a normal night’s sleep.

    Methods: Eighty-four healthy individuals participated (46 aged 20– 30 years, and 38 aged 65– 75 years). Morphological brain data were collected in a 3T magnetic resonance imaging (MRI) scanner. Sleepiness was rated multiple times during the imaging sessions.

    Results: In older, relative to younger, adults, clusters within bilateral mid-anterior insular cortex and right thalamus were negatively associated with sleepiness. Adjustment for the immediately preceding total sleep time eliminated the significant associations.

    Conclusion: Self-rated momentary sleepiness in a monotonous situation appears to be negatively associated with GM volume in clusters within both thalamus and insula in older individuals, and total sleep time seems to play a role in this association. Possibly, this suggests that larger GM volume in these clusters may be protective against sleepiness in older individuals. This notion needs confirmation in further studies.

  • 172.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lekander, Mats
    Petersén, Helena
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Axelsson, John
    Sleep Polysomnography and Reported Stress across 6 Weeks2014In: Industrial Health, ISSN 0019-8366, E-ISSN 1880-8026, Vol. 52, no 1, p. 36-42Article in journal (Refereed)
    Abstract [en]

    Despite the common notion that stress impairs sleep there is little published data showing that sleep (polysomnography [PSG]) is impaired across several sleep episodes in individuals who complain of daily stress during the same period. The present paper aimed at investigating such a connection. 33 subjects had 3 sleeps recorded with PSG at home across 6 weeks and kept a sleep/wake diary each day, including 3-hourly ratings of stress (scale 1-9). The stress ratings and the conventional PSG parameters were averaged across time. A stepwise multiple regression analysis showed that the best predictors of stress were Stage 1 sleep (beta=0.49), latency to Stage 1 sleep (0.47) (adjusted for anxiety and age). Other sleep continuity variables had significant correlations with stress (reversed) but did not enter the multiple regression analysis. The correlation between stress before the start of the study and PSG data was not significant. It was concluded that moderately increased stress over a longer period of time is related to moderate signs of disturbed sleep during that period. This may be of importance when considering stress as a work environment problem.

  • 173.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Narusyte, Jurgita
    Svedberg, Pia
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands .
    Alexanderson, Kristina
    Night work and prostate cancer in men: a Swedish prospective cohort study2017In: BMJ Open, E-ISSN 2044-6055, Vol. 7, no 6, article id e015751Article in journal (Refereed)
    Abstract [en]

    Objectives Prostate cancer is the most common cancer and the second leading cause of cancer-related deaths among men, but the contributing factors are unclear. One such may be night work because of the day/night alternation of work and the resulting disturbance of the circadian system. The purpose of the present study was to investigate the prospective relation between number of years with night work and prostate cancer in men.

    Design Cohort study comparing night and day working twins with respect to incident prostate cancer in 12 322 men.

    Setting Individuals in the Swedish Twin Registry.

    Participants 12 322 male twins.

    Outcome measures Prostate cancer diagnoses obtained from the Swedish Cancer Registry with a follow-up time of 12 years, with a total number of cases=454.

    Results Multiple Cox proportional hazard regression analysis, adjusted for a number of covariates, showed no association between ever night work and prostate cancer, nor for duration of night work and prostate cancer. Analysis of twin pairs discordant for prostate cancer (n=332) showed no significant association between night work and prostate cancer.

    Conclusions The results, together with previous studies, suggest that night work does not seem to constitute a risk factor for prostate cancer.

  • 174.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Nordin, Maria
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Umeå University, Sweden.
    Alfredsson, Lars
    Westerholm, Peter
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Predicting changes in sleep complaints from baseline values and changes in work demands, work control, and work preoccupation - The WOLF-project2012In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 13, no 1, p. 73-80Article in journal (Refereed)
    Abstract [en]

    Study objective: Stress as a cause of disturbed sleep is often taken for granted, but the longitudinal evidence is limited. The aim of this study was to evaluate new cases of poor sleep as a function of changes in reported work demands, work control, and work preoccupation. Methods: Longitudinal study of change with measures occurring twice within a 5-year interval during a period when the prevalence of impaired sleep was increasing in Sweden. The sample of companies was taken from northern Sweden (Norrland) and included 3637 individuals from the "WOLF Norrland" longitudinal cohort, collected through company health services. Measurement and results: During the measurement period, 16% of those studied developed new cases of impaired sleep. Logistic regressions adjusted for demographics, work environment factors, and disturbed sleep at T1 period one showed a significant increase in new cases for high work demands and high work preoccupation (OR = 1.37; Ci = 1.09-1.72 and OR = 1.80; CI = 1.42-2.28, respectively). The analysis of change in the predictors showed effects of a change from low to high work demands (OR = 1.39; Ci = 1.00-1.95) on new cases of impaired sleep. Consistent high work demands (high at both points) showed a similar increase (OR = 1.49; Ci = 1.06-2.11) but no effect was seen for reduced demands. Change in work preoccupation yielded stronger effects with OR = 2.47 (1.78-2.47) for increased work preoccupation and OR = 3.79 (2.70-5.31) for consistent high work preoccupation. Also, a reduction in work preoccupation was associated with a reduction in new cases of disturbed sleep. Control at work was not related to sleep. Stratification with respect to gender mainly led to fewer significant results (particularly for women) due to larger confidence intervals. Conclusions: It was concluded that self-reported work preoccupation predicts subsequent impairment of sleep and that increased preoccupation is associated with new cases of impaired sleep. Similar, but weaker, results were obtained for work demands.

  • 175.
    Åkerstedt, Torbjörn
    et al.
    National institute for psychosocial factors and health and Department of Public Health Sciences, Karolinska Institutet.
    Olsson, Birgitta
    Stockholm University, Faculty of Social Sciences, Stockholm Business School, Accounting. Lund Universitet.
    Ingre, Michael
    National institute for psychosocial factors and health and Department of Public Health Sciences, Karolinska Institutet.
    Holmgren Caicedo, Mikael
    Stockholm University, Faculty of Social Sciences, Stockholm Business School, Accounting.
    Kecklund, Göran
    National institute for psychosocial factors and health and Department of Public Health Sciences, Karolinska Institutet.
    A 6-hour working day: effects on well-being2001In: Journal of Human Ergology, ISSN 0300-8134, Vol. 30, no 1/2, p. 197-202Article in journal (Refereed)
    Abstract [en]

    The effect of the total amount of work hours and the benefits of a shortening is frequently debated, but very little data is available. The present study compared a group (N=41) that obtained a 9h reduction of the working week (to a 6h day) with a comparison group (N=22) that retained normal work hours. Both groups were constituted of mainly female health care and day care nursery personnel. The experimental group retained full pay and extra personnel were employed to compensate for loss of hours. Questionnaire data were obtained before and 1 year after the change. The data were analyzed using two-factor ANOVA with the interaction of year*group for social factors, sleep quality, mental fatigue, and heart/respiratory complaints, and attitude to work hours. In all cases the experimental group improved whereas the control group did not change. It was concluded that shortened work hours have clear social effects and moderate effects on well-being.

  • 176.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Orsini, Nicola
    Petersen, Helena
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Axelsson, John
    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.
    Predicting sleep quality from stress and prior sleep - a study of day-to-day covariation across six weeks2012In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 13, no 6, p. 674-679Article in journal (Refereed)
    Abstract [en]

    Background/objectives: The connection between stress and sleep is well established in cross-sectional questionnaire studies and in a few prospective studies. Here, the intention was to study the link between stress and sleep on a day-to-day basis across 42 days.

    Methods: Fifty participants kept a sleep/wake diary across 42 days and responded to daily questions on sleep and stress. The results were analyzed with a mixed model approach using stress during the prior day to predict morning ratings of sleep quality.

    Results: The results showed that bedtime stress and worries were the main predictors of sleep quality, but that, also, late awakening, short prior sleep, high quality of prior sleep, and good health the prior day predicted higher sleep quality.

    Conclusions: Stress during the day predicts subsequent sleep quality on a day-to-day basis across 42 days. The observed range of variation in stress/worries was modest, which is why it is suggested that the present data underestimates the impact of stress on subsequent sleep quality.

  • 177.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Perski, Aleksander
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Sleep, Occupational Stress, and Burnout2016In: Principles and Practise of Sleep Medicine / [ed] Meir H. Kryger, Thomas Roth, William C. Dement, Philadelphia: Elsevier, 2016, 6, p. 736-741Chapter in book (Refereed)
  • 178.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet.
    Philip, Pierre
    Capelli, Aurore
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet.
    Sleep loss and accidents: Work hours, life style, and sleep pathology2011In: Human Sleep and Cognition Part II: Clinical and Applied Research / [ed] Hans P. A. Van Dongen and Gerard A. Kerkhof, Elsevier Science , 2011, Vol. 190, p. 169-188Chapter in book (Refereed)
    Abstract [en]

    A very important outcome of reduced sleep is accidents. The present chapter will attempt to bring together some of the present knowledge in this area. We will focus on the driving situation, for which the evidence of the link between sleep loss and accidents is quite well established, but we will also bring up working life in general where evidence is more sparse. It should be emphasized that reduced sleep as a cause of accidents implies that the mediating factor is sleepiness (or fatigue). This link is discussed elsewhere in this volume, but here we will bring in sleepiness (subjective or physiological) as an explanatory factor of accidents. Another central observation is that many real life accident studies do not link accidents to reduced sleep, but infer reduced sleep and/or sleepiness from the context, like, for example, from work schedules, life styles, or sleep pathology. Reduced sleep is mainly due to suboptimal work schedules (or to a suboptimal life style) or to sleep pathology. We have divided the present chapter into two areas.

  • 179.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institute, Sweden.
    Sallinen, Mikael
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institute, Sweden.
    Shiftworkers’ attitude to their work hours, positive or negative, and why?2022In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 95, no 6, p. 1267-1277Article in journal (Refereed)
    Abstract [en]

    Objective Shift work is associated with impaired health and safety but there is a lack of systematic knowledge of shift workers attitude to their shift systems. This may be important for the ability to retain valuable personnel in the company/organization, and to attract new employees. The purpose of the present study was to investigate: the prevalence of shift characteristics (nights, long shifts, short rest, etc.) in traditional shift systems, the workers’ attitude to their shift systems, if combinations of problematic shift characteristics are associated with the workers’ attitude, and if work stress and poor sleep, fatigue, or social difficulties are associated with attitudes to shift systems.

    Methods A representative sample of 3,500 individuals with non-day work in the general population of Sweden were asked to participate in the study. A total of 1965 workers remained after drop-outs. The material was analyzed by Chi2 analysis and hierarchical multiple regression.

    Results The results showed that traditional shift systems included many more shift characteristics than those constituting the core of the systems. All included day work, for example. 90.2% of those with roster work had shifts > 10 h at least once a month. 66.9% of those with roster work without nights had < 11 h rest between shifts at least once a month. Less than 25% of the respondents had a rather or very negative attitude to their shift system, with the lowest level for those who work either fixed days or nights (7.6 and 5.7%, respectively) and highest for three-shift work (21.2%) and roster work without night work (24.4%). Shiftwork or roster work with nights had highest levels (> 50%) of sleep problems and fatigue. The difference across shift systems was significant at p < .001 in all cases. Combinations of the most problematic shift characteristics were associated with some increase in negative attitude to the shift schedule. Among schedule characteristics, only long weeks turned out significant in the multivariable regression. The strongest predictor of negative attitude to work hours were social difficulties due to work schedule [ß = 4.98 (95% Confidence interval (Ci) = 3.41, 7.27; p < .001], fatigue caused by schedule (ß = 3.20 Ci = 2.03, 5.05; p < .001), sleep problems caused by schedule (ß = 2.10 Ci = 1.46, 3.01; p = .01), and stressful work (ß = 1.52 Ci = 1.10, 2.11; p < .05).

    Conclusion It was concluded that shift systems often included many different shift characteristics, that night shift systems had a large proportion of long shifts, and that split shifts mainly occurred in roster day work. Furthermore, it was concluded that the attitude to the worker’s present shift systems seems to be positive for the majority, with the highest level for those who work either fixed days or nights, compared to those who work alternating shifts (including night shifts). Negative attitude to shift systems was more linked to social difficulties, fatigue or sleep problems due to the shift schedule, than to schedule characteristics per se.

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