Karolinska Sleepiness Scale

卡罗林斯卡嗜睡量表
  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    目的:本研究提出了一种移动平均(MA)方法来动态处理心率变异性(HRV),并通过使用长期短期记忆(LSTM)网络开发了异常驾驶行为(ADB)预测模型。
    背景:与疲劳相关的ADB具有交通安全影响。已经开发了许多基于生理反应来预测此类行为的模型,但仍处于胚胎阶段。
    方法:本研究连续四天记录了20名商业巴士司机在日常任务中的数据,随后要求他们填写问卷,包括主观睡眠质量,驾驶员行为问卷和卡罗林斯卡嗜睡量表。使用导航移动应用程序和手表确定驾驶行为和相应的HRV。使用动态加权MA(DWMA)和指数加权MA以5分钟的间隔处理HRV。独立地分离数据用于训练和测试。用10倍交叉验证策略对模型进行了训练,对它们的准确性进行了评估,和Shapley加性解释(SHAP)值用于确定特征重要性。
    结果:NN间隔(SDNN)的标准偏差显着增加,连续心跳间隔差的均方根(RMSSD),在事件发生前阶段观察到高频(nHF)的归一化频谱。基于DWMA的模型对两种驾驶员类型均表现出最高的准确性(城市:84.41%;高速公路:80.56%)。SDNN,RMSSD,和nHF表现出相对较高的SHAP值。
    结论:HRV指标可以作为精神疲劳的指标。基于DWMA的LSTM可以预测与ADB相关的疲劳水平的发生。
    结论:所建立的模型可用于现实的驾驶场景。
    OBJECTIVE: This study proposed a moving average (MA) approach to dynamically process heart rate variability (HRV) and developed aberrant driving behavior (ADB) prediction models by using long short-term memory (LSTM) networks.
    BACKGROUND: Fatigue-associated ADBs have traffic safety implications. Numerous models to predict such acts based on physiological responses have been developed but are still in embryonic stages.
    METHODS: This study recorded the data of 20 commercial bus drivers during their routine tasks on four consecutive days and subsequently asked them to complete questionnaires, including subjective sleep quality, driver behavior questionnaire and the Karolinska Sleepiness Scale. Driving behaviors and corresponding HRV were determined using a navigational mobile application and a wristwatch. The dynamic-weighted MA (DWMA) and exponential-weighted MA were used to process HRV in 5-min intervals. The data were independently separated for training and testing. Models were trained with 10-fold cross-validation strategy, their accuracies were evaluated, and Shapley additive explanation (SHAP) values were used to determine feature importance.
    RESULTS: Significant increases in the standard deviation of NN intervals (SDNN), root mean square of successive heartbeat interval differences (RMSSD), and normalized spectrum of high frequency (nHF) were observed in the pre-event stage. The DWMA-based model exhibited the highest accuracy for both driver types (urban: 84.41%; highway: 80.56%). The SDNN, RMSSD, and nHF demonstrated relatively high SHAP values.
    CONCLUSIONS: HRV metrics can serve as indicators of mental fatigue. DWMA-based LSTM could predict the occurrence of the level of fatigue associated with ADBs.
    CONCLUSIONS: The established models can be used in realistic driving scenarios.
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  • 文章类型: English Abstract
    OBJECTIVE: To assess the objectivity of measuring the level of sleepiness in the subjects using a monotonous psychomotor bimanual tapping test developed by us, performed on mobile devices running Android OS.
    METHODS: Four hundred and ninety-four hour-long experiments with the performance of a psychomotor test were conducted on 102 students. Using the method of mixed linear models, correlations between the levels of sleepiness according to the Karolinska Sleepiness Scale (KSS) and the Epworth Sleepiness Scale (ESS) and the behavioral indicators of the test were evaluated.
    RESULTS: Statistically significant correlations between the increase in KSS scores and such indicators as a decrease in the total number of button taps and an increase in the frequency of «microsleep» episodes are shown. Statistically significant correlations of ESS score characteristics with the behavioral indicators of the test were not found.
    CONCLUSIONS: A large statistical material shows a reliable correlation of the parameters of the psychomotor test with the level of sleepiness on the Karolinska scale, which allows using the mobile application developed by us to determine the current level of sleepiness /alertness in the field.
    UNASSIGNED: Оценка объективности измерения уровня сонливости у испытуемых при помощи разработанного монотонного психомоторного бимануального тэппинг-теста, выполняемого на мобильных устройствах под ОС Android.
    UNASSIGNED: На 102 студентах проведено 494 часовых эксперимента с выполнением психомоторного теста. С помощью метода смешанных линейных моделей оценивали корреляции между уровнями сонливости по Каролинской шкале сонливости (KSS) и Эпвортской шкале сонливости (ESS) и поведенческими показателями теста.
    UNASSIGNED: Показаны статистически значимые взаимосвязи между увеличением баллов по KSS и такими показателями, как снижение общего количества нажатий на кнопку и увеличение частоты эпизодов «микросна». Статистически значимых взаимосвязей балльных характеристик ESS с поведенческими показателями теста не выявлено.
    UNASSIGNED: На большом статистическом материале показана достоверная корреляция параметров психомоторного теста с уровнем сонливости по KSS, что позволяет использовать разработанное мобильное приложение для определения текущего уровня сонливости/бдительности в полевых условиях.
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  • 文章类型: Journal Article
    Objectives.当前通过生理特征检测异常驾驶行为(ADB)的方法,包括超速,突然转向,紧急制动和积极的加速,正在发展。这项研究提出了使用机器学习方法结合心率变异性(HRV)参数来预测ADB的发生。方法。连续4天收集台湾10名高速公路公交车司机每日路线的自然驾驶数据。他们在驾驶任务期间的驾驶行为和生理数据是使用导航移动应用程序和心率手表确定的。参与者自我报告的睡眠数据,驾驶相关经验,获得了有关天气和交通拥堵程度的开源数据。五种机器学习模型-逻辑回归,随机森林,天真的贝叶斯,支持向量机和门控递归单元(GRU)-用于预测ADB。结果。大多数亚行司机的睡眠效率较低(≤80%),驾驶员行为问卷的失误和错误子类别以及卡罗林斯卡嗜睡量表的得分明显高于没有ADB的得分。此外,基线和ADB前事件测量之间的HRV参数显着不同。GRU的准确率最高(81.16-84.22%)。Conclusions.睡眠不足可能与疲劳水平的增加以及从基于HRV的模型中预测的ADB发生有关。
    Objectives. Current approaches via physiological features detecting aberrant driving behaviour (ADB), including speeding, abrupt steering, hard braking and aggressive acceleration, are developing. This study proposes using machine learning approaches incorporating heart rate variability (HRV) parameters to predict ADB occurrence. Methods. Naturalistic driving data of 10 highway bus drivers in Taiwan from their daily routes were collected for 4 consecutive days. Their driving behaviours and physiological data during a driving task were determined using a navigation mobile application and heart rate watch. Participants\' self-reported data on sleep, driving-related experience, open-source data on weather and the traffic congestion level were obtained. Five machine learning models - logistic regression, random forest, naive Bayes, support vector machine and gated recurrent unit (GRU) - were employed to predict ADBs. Results. Most drivers with ADB had low sleep efficiency (≤80%), with significantly higher scores in driver behaviour questionnaire subcategories of lapses and errors and in the Karolinska sleepiness scale than those without ADBs. Moreover, HRV parameters were significantly different between baseline and pre-ADB event measurements. GRU had the highest accuracy (81.16-84.22%). Conclusions. Sleep deficit may be related to the increased fatigue level and ADB occurrence predicted from HRV-based models among bus drivers.
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  • 文章类型: Journal Article
    睡眠损失和心理社会压力导致的表现存在很大的个体差异(弹性和脆弱性),但潜在的预测生物标志物仍然难以捉摸。同样,睡眠损失和压力引起的心血管系统的显著变化包括心血管疾病风险的增加。尚不清楚关键的血液动力学标志物是否,包括左心室射血时间(LVET),每搏输出量(SV),心率(HR),心脏指数(CI),血压(BP),和全身血管阻力指数(SVRI),不同的弹性与脆弱的个体,并预测睡眠损失和压力的不同表现韧性。我们首次调查了总睡眠剥夺(TSD)和心理压力的组合是否会影响健康成年人的一套全面的血液动力学指标,以及这些措施是否区分了弹性和脆弱个体的神经行为表现。32名健康成年人(年龄27-53岁;14名女性)参加了为期5天的人类探索研究模拟(HERA)实验,美国国家航空航天局(NASA)的高保真空间模拟隔离设施,由两个基线夜晚组成,39hTSD,还有两个康复之夜.改良的特里尔社会压力测试在TSD期间引起了心理压力。心血管测量收集[SV,HR,CI,LVET,BP,和SVRI]和神经行为表现测试(包括行为注意力任务和主观嗜睡的评级)发生在6个和11个时间点,分别。具有较长的研究前LVET(由研究前LVET的中值分割确定)的个体在TSD和应激期间倾向于具有较差的表现。弹性和脆弱群体(由平均TSD性能的中位数划分确定)显示出SV的显着不同特征,HR,CI和LVET。重要的是,研究前的LVET,但没有其他血液动力学测量,在TSD和压力期间可靠地区分神经行为表现,因此可能是生物标志物。未来的研究应该调查非侵入性标记物,LVET,确定不良健康结果的风险。
    There are substantial individual differences (resilience and vulnerability) in performance resulting from sleep loss and psychosocial stress, but predictive potential biomarkers remain elusive. Similarly, marked changes in the cardiovascular system from sleep loss and stress include an increased risk for cardiovascular disease. It remains unknown whether key hemodynamic markers, including left ventricular ejection time (LVET), stroke volume (SV), heart rate (HR), cardiac index (CI), blood pressure (BP), and systemic vascular resistance index (SVRI), differ in resilient vs. vulnerable individuals and predict differential performance resilience with sleep loss and stress. We investigated for the first time whether the combination of total sleep deprivation (TSD) and psychological stress affected a comprehensive set of hemodynamic measures in healthy adults, and whether these measures differentiated neurobehavioral performance in resilient and vulnerable individuals. Thirty-two healthy adults (ages 27-53; 14 females) participated in a 5-day experiment in the Human Exploration Research Analog (HERA), a high-fidelity National Aeronautics and Space Administration (NASA) space analog isolation facility, consisting of two baseline nights, 39 h TSD, and two recovery nights. A modified Trier Social Stress Test induced psychological stress during TSD. Cardiovascular measure collection [SV, HR, CI, LVET, BP, and SVRI] and neurobehavioral performance testing (including a behavioral attention task and a rating of subjective sleepiness) occurred at six and 11 timepoints, respectively. Individuals with longer pre-study LVET (determined by a median split on pre-study LVET) tended to have poorer performance during TSD and stress. Resilient and vulnerable groups (determined by a median split on average TSD performance) showed significantly different profiles of SV, HR, CI, and LVET. Importantly, LVET at pre-study, but not other hemodynamic measures, reliably differentiated neurobehavioral performance during TSD and stress, and therefore may be a biomarker. Future studies should investigate whether the non-invasive marker, LVET, determines risk for adverse health outcomes.
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  • 文章类型: Journal Article
    BACKGROUND: Mental fatigue is usually accompanied by a sense of weariness, reduced alertness, and reduced mental performance, which can lead to accidents, decrease of productivity in workplace and several other health hazards.
    OBJECTIVE: The aim of this study was to assess mental fatigue of students while reading for a prolonged duration of time by application of electroencephalography (EEG).
    METHODS: Ten healthy students (27.57±3.4 years; 5 females and 5 males), participated in the study. The experimental design consisted of 5 blocks of 15-min length, in total 75 min for each participant. The experiment was done without any reading activities at the first block. In the following, participants studied the texts and corrected the mistakes. In each block EEG (beta, alpha, and theta power), and the Karolinska Sleepiness Scale (KSS) were recorded.
    RESULTS: The mean of the self-assessment of sleepiness by KSS from the first to final 15 minutes were 2.3, 3.4, 4.3, 5.2, and 6.1, respectively. The average power in the theta band decreased from 1.23μV2/Hz at the first 15-min period to 1.02μV2/Hz at the last 15-min period. Also, mean power in the alpha band decreased from 0.85μV2/Hz at the first 15-min period to 0.59μV2/Hz at the last 15-min period.
    CONCLUSIONS: The study showed that the KSS and EEG activity indicate sleepiness which were highly correlated, with both changing along with performance.
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  • 文章类型: Journal Article
    Cortisol and C-reactive protein (CRP) typically change during total sleep deprivation (TSD) and psychological stress; however, it remains unknown whether these biological markers can differentiate robust individual differences in neurobehavioral performance and self-rated sleepiness resulting from these stressors. Additionally, little is known about cortisol and CRP recovery after TSD. In our study, 32 healthy adults (ages 27-53; mean ± SD, 35.1 ± 7.1 years; 14 females) participated in a highly controlled 5-day experiment in the Human Exploration Research Analog (HERA), a high-fidelity National Aeronautics and Space Administration (NASA) space analog isolation facility, consisting of two baseline nights, 39 h TSD, and two recovery nights. Psychological stress was induced by a modified Trier Social Stress Test (TSST) on the afternoon of TSD. Salivary cortisol and plasma CRP were obtained at six time points, before (pre-study), during [baseline, the morning of TSD (TSD AM), the afternoon of TSD (TSD PM), and recovery], and after (post-study) the experiment. A neurobehavioral test battery, including measures of behavioral attention and cognitive throughput, and a self-report measure of sleepiness, was administered 11 times. Resilient and vulnerable groups were defined by a median split on the average TSD performance or sleepiness score. Low and high pre-study cortisol and CRP were defined by a median split on respective values at pre-study. Cortisol and CRP both changed significantly across the study, with cortisol, but not CRP, increasing during TSD. During recovery, cortisol levels did not return to pre-TSD levels, whereas CRP levels did not differ from baseline. When sex was added as a between-subject factor, the time × sex interaction was significant for cortisol. Resilient and vulnerable groups did not differ in cortisol and CRP, and low and high pre-study cortisol/CRP groups did not differ on performance tasks or self-reported sleepiness. Thus, both cortisol and CRP reliably changed in a normal, healthy population as a result of sleep loss; however, cortisol and CRP were not markers of neurobehavioral resilience to TSD and stress in this study.
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  • 文章类型: Journal Article
    昏昏欲睡的司机在保持车辆在线路范围内有问题,并且可能经常需要施加突然的或硬的校正方向盘移动。这样的运动,如果它们在湿滑的道路上行驶时发生,由于湿滑道路的无情性质,可能会增加终止道路的风险。我们检验了这个假设。十二名年轻人参加了具有两种平衡条件的驾驶模拟器实验;干滑路面×白天(警报)与夜间(困倦)驾驶。参与者在单调的两车道高速公路上行驶了52.5公里,并使用卡罗林斯卡睡意量表对他们的睡意进行了7次评分。从眼电图中提取闪烁持续时间。横向位置的标准偏差和转向事件的平稳性是驾驶性能的度量。每个结果变量都用混合效应模型与路况进行了分析,一天中的时间和任务时间作为预测因子。卡罗林斯卡睡眠量表随任务时间的增加而增加(p<0.001),并且在夜间驾驶期间更高(p<0.001),三向互动表明,在道路湿滑的情况下,夜间驾驶时间会增加睡意(p=0.012)。眨眼持续时间随着任务时间的增加而增加(p<0.01),并且一天中的时间和路况之间存在相互作用(p=0.040),因此在要求苛刻的路况下,睡眠不足的参与者的生理嗜睡降低。横向位置的标准偏差随任务时间的增加而增加(p=0.026);但是,在夜间驾驶时,它在湿滑的道路上较低(p=0.025)。结果表明,在苛刻的道路条件下(即湿滑的道路)驾驶可能会进一步耗尽已经困倦的驾驶员,虽然这在驾驶表现上没有明显体现。
    Sleepy drivers have problems with keeping the vehicle within the lines, and might often need to apply a sudden or hard corrective steering wheel movement. Such movements, if they occur while driving on a slippery road, might increase the risk of ending off road due to the unforgiving nature of slippery roads. We tested this hypothesis. Twelve young men participated in a driving simulator experiment with two counterbalanced conditions; dry versus slippery road × day (alert) versus night (sleepy) driving. The participants drove 52.5 km on a monotonous two-lane highway and rated their sleepiness seven times using the Karolinska Sleepiness Scale. Blink durations were extracted from an electrooculogram. The standard deviation of lateral position and the smoothness of steering events were measures of driving performance. Each outcome variable was analysed with mixed-effect models with road condition, time-of-day and time-on-task as predictors. The Karolinska Sleepiness Scale increased with time-on-task (p < 0.001) and was higher during night drives (p < 0.001), with a three-way interaction suggesting a small increased sleepiness with driving time at night with slippery road conditions (p = 0.012). Blink durations increased with time-on-task (p < 0.01) with an interaction between time-of-day and road condition (p = 0.040) such that physiological sleepiness was lower for sleep-deprived participants in demanding road conditions. The standard deviation of lateral position increased with time-on-task (p = 0.026); however, during night driving it was lower on a slippery road (p = 0.025). The results indicate that driving in demanding road condition (i.e. slippery road) might further exhaust already sleepy drivers, although this is not clearly reflected in driving performance.
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  • 文章类型: Journal Article
    目的:尽管对睡眠限制(SR)和总睡眠剥夺(TSD)的主观反应存在类似特质的个体差异,可靠的表征仍然难以捉摸。我们通过主观指标全面比较了定义弹性和脆弱性的多种方法。
    方法:41名成年人参加了为期13天的实验:2个基线,5SR,4恢复,和一个36小时的TSD之夜。每2小时给予卡罗林斯卡嗜睡量表(KSS)和情绪状态疲劳(POMS-F)和活力(POMS-V)。三种方法(原始分数[平均SR分数],从基线的变化[平均SR减去平均基线分数],和方差[个体SR分数方差]),和六个阈值(±1个标准偏差,得分最高/最低的12.5%,20%,25%,33%,50%)归类为弹性/弱势群体。Kendall的tau-b相关性比较了KSS内部和之间的组分类一致性,POMS-F,和POMS-V评分。偏倚校正和加速自举t检验比较了组得分。
    结果:在POMS-F的所有阈值下,所有方法之间都存在显着相关性,在KSS的原始分数和基线方法的变化之间,以及POMS-V的原始得分和方差方法之间通过原始评分方法定义的所有弹性组在整个研究中都有明显更好的分数,特别是在基线和恢复期间,而其他两种方法在措施上有所不同,阈值,或白天。测量之间的相关性在强度上有所不同,方法,或阈值。
    结论:只有原始评分方法在基线时始终区分弹性/脆弱群体,在睡眠不足期间,在恢复期间,我们推荐这种方法作为主观弹性/脆弱性分类的有效方法。所有方法都为疲劳创建了可比的分类,有些人的嗜睡程度相当,没有一个在活力方面是可比的。疲劳和活力与困倦相似,但彼此之间却没有。
    OBJECTIVE: Although trait-like individual differences in subjective responses to sleep restriction (SR) and total sleep deprivation (TSD) exist, reliable characterizations remain elusive. We comprehensively compared multiple methods for defining resilience and vulnerability by subjective metrics.
    METHODS: 41 adults participated in a 13-day experiment:2 baseline, 5 SR, 4 recovery, and one 36h TSD night. The Karolinska Sleepiness Scale (KSS) and the Profile of Mood States Fatigue (POMS-F) and Vigor (POMS-V) were administered every 2h. Three approaches (Raw Score [average SR score], Change from Baseline [average SR minus average baseline score], and Variance [intraindividual SR score variance]), and six thresholds (±1 standard deviation, and the highest/lowest scoring 12.5%, 20%, 25%, 33%, 50%) categorized Resilient/Vulnerable groups. Kendall\'s tau-b correlations compared the group categorization\'s concordance within and between KSS, POMS-F, and POMS-V scores. Bias-corrected and accelerated bootstrapped t-tests compared group scores.
    RESULTS: There were significant correlations between all approaches at all thresholds for POMS-F, between Raw Score and Change from Baseline approaches for KSS, and between Raw Score and Variance approaches for POMS-V. All Resilient groups defined by the Raw Score approach had significantly better scores throughout the study, notably including during baseline and recovery, whereas the two other approaches differed by measure, threshold, or day. Between-measure correlations varied in strength by measure, approach, or threshold.
    CONCLUSIONS: Only the Raw Score approach consistently distinguished Resilient/Vulnerable groups at baseline, during sleep loss, and during recovery‒‒we recommend this approach as an effective method for subjective resilience/vulnerability categorization. All approaches created comparable categorizations for fatigue, some were comparable for sleepiness, and none were comparable for vigor. Fatigue and vigor captured resilience/vulnerability similarly to sleepiness but not each other.
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  • 文章类型: Journal Article
    在轮班工作设置和待命操作中,当工人从睡眠中醒来后立即被要求采取行动时,可能有睡眠惯性的风险。然而,个体对睡眠惯性的易感性可能存在很大差异.我们使用来自实验室研究的数据进行了调查,在该研究中,20名健康的年轻人分别暴露于36小时的总睡眠剥夺中,之前是基线睡眠期,然后是恢复睡眠期,在三个不同的场合。在每个实验室会议的前一周和实验室的相应基线夜晚,参与者将睡眠期延长至12小时/天或限制为6小时/天。在实验室清醒的时候,在预定的觉醒后立即开始,参与者每2小时完成一次神经行为测试。测试包括卡罗林斯卡嗜睡量表来测量主观嗜睡,采用非线性混合效应回归分析数据,量化睡眠惯性.这揭示了睡眠惯性大小的个体差异,在基线和恢复期睡眠后,个体内高度稳定,不管学习条件如何。我们的结果表明,由于睡眠惯性引起的主观嗜睡的个体差异是很大的,并且构成了一种特征。
    In shift work settings and on-call operations, workers may be at risk of sleep inertia when called to action immediately after awakening from sleep. However, individuals may differ substantially in their susceptibility to sleep inertia. We investigated this using data from a laboratory study in which 20 healthy young adults were each exposed to 36 h of total sleep deprivation, preceded by a baseline sleep period and followed by a recovery sleep period, on three separate occasions. In the week prior to each laboratory session and on the corresponding baseline night in the laboratory, participants either extended their sleep period to 12 h/day or restricted it to 6 h/day. During periods of wakefulness in the laboratory, starting right after scheduled awakening, participants completed neurobehavioral tests every 2 h. Testing included the Karolinska Sleepiness Scale to measure subjective sleepiness, for which the data were analyzed with nonlinear mixed-effects regression to quantify sleep inertia. This revealed considerable interindividual differences in the magnitude of sleep inertia, which were highly stable within individuals after both baseline and recovery sleep periods, regardless of study condition. Our results demonstrate that interindividual differences in subjective sleepiness due to sleep inertia are substantial and constitute a trait.
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