Measuring subjective sleepiness at work in hospital nurses: validation of a modified delivery format of the Karolinska Sleepiness Scale

Details

• Personal Author:
  Blair L ; Geiger Brown J ; Hinds PS ; Scharf SM ; Warren J ; Wieroney M ; Zhu S
• Description:
  Introduction: Sleepiness during the work shift is common and can be hazardous to workers and, in the case of nurses, to patients under their care. Thus, measuring sleepiness in occupational studies is an important component of workplace health and safety. The Karolinska Sleepiness Scale (KSS) is usually used as a momentary assessment of a respondent's state of sleepiness; however, end-of-shift measurement is sometimes preferred based on the study setting. We assessed the predictive validity of the KSS as an end-of-shift recall measurement, asking for "average" sleepiness over the shift and "highest" level of sleepiness during the shift. Method: Hospital registered nurses (N=40) working 12-h shifts completed an end-of-shift diary over 4 weeks that included the National Aeronautical and Space Administration Task Load Index (NASA-TLX) work intensity items and the KSS (498 shifts over 4 weeks). Vigilant attention was assessed by measuring reaction time, lapses, and anticipations using a 10-min performance vigilance task (PVT) at the end of the shift. The Horne-Ostberg Questionnaire, Epworth Sleepiness Scale, General Sleep Disturbance Scale, and Cleveland Sleep Habits Questionnaire were also collected at baseline to assess factors that could be associated with higher sleepiness. We hypothesized that higher KSS scores would correlate with vigilant attention parameters reflective of sleepiness (slower reaction times and more lapses and anticipations on a performance vigilance task) and also with those factors known to produce higher sleepiness. These factors included the following: (1) working night shifts, especially for those with "morningness" trait; (2) working sequential night shifts; (3) having low physical and mental work demands and low time pressure; (4) having concomitant organic sleep disorders; and (5) having greater "trait" sleepiness (Epworth Sleepiness Scale). Linear mixed models and generalized linear mixed models were used to test associations that could assess the predictive validity of this format of administering the KSS. Results: Greater sleepiness, as measured by higher KSS scores, was found on shifts with nurses working night shift, the third sequential night compared to the first, those with sleep disorder symptoms (especially insomnia), and in nurses with trait sleepiness on the Epworth scale. Less sleepiness (lower KSS scores) was seen in shifts with a high level of time pressure and in nurses with a biologic predisposition to be more alert in the morning (morningness trait) who worked the day shift. Conclusion: We found partial support for using the Karolinska Sleepiness Scale in the recalled format based on our multiple tests of predictive validity. [Description provided by NIOSH]
• Subjects:
  Fatigue Health Personnel Mental Health Occupational Health Periodicity Respiratory System Safety Shift Work Schedule Sleep Sleep Initiation And Maintenance Disorders Surveys And Questionnaires Women Workload

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• Keywords:
  Airway-obstruction Analytical-instruments Analytical-models Author Keywords: Work Schedule Tolerance Biological-rhythms Breathing Health-care-personnel Health-surveys Humans Karolinska Sleepiness Scale Nurses Nurse Schedule Nursing Occupational Fatigue Physiological-measurements Psychological-fatigue Questionnaires Reaction-rates Shift-workers Sleep-deprivation Sleep-disorders Sleepiness Work-capacity Work-intervals Work-performance

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• ISSN:
  1520-9512
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  District of Columbia ; Maryland ; OSHA Region 3
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  18
• Issue:
  4
• NIOSHTIC Number:
  nn:20046530
• Citation:
  Sleep Breath 2014 Dec; 18(4):731-739
• Contact Point Address:
  J. Geiger Brown, Center for Health Outcomes Research, University of Maryland, School of Nursing, 655 West Lombard St, Baltimore, MD 21201, USA
• Email:
  jgeiger@son.umaryland.edu
• Federal Fiscal Year:
  2015
• Performing Organization:
  University of Maryland, Baltimore
• Peer Reviewed:
  True
• Start Date:
  20110901
• Source Full Name:
  Sleep and Breathing
• End Date:
  20140831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:85d654c37cf5f6992e184c43203b7709cc590078e8ce87ef82161dd5d3a89fa38f2778afa2b411d0b091b0a6dde7f4f51d23fd24b2657e1153ca973d388efea1
• Download URL:
  https://stacks.cdc.gov/view/cdc/201555/cdc_201555_DS1.pdf
• File Type:
  [PDF - 177.24 KB ]