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Cited by 52Sleep and Work-Related FatigueCircadian rhythm and melatoninSleep and Wakefulness Research

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Sleepiness and driving events in shift workers: the impact of circadian and homeostatic factors

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Mulhall, Megan D, Sletten, Tracey L, Magee, Michelle, Stone, Julia E, Ganesan, Saranea, Collins, Allison, Anderson, Clare, Lockley, Steven W, Howard, Mark E, Rajaratnam, Shantha M W·2019·Sleep
DOI 10.1093/sleep/zsz074
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Abstract

We aimed to characterize objective and subjective sleepiness and driving events during short work commutes and examine the impact of circadian and homeostatic factors across different shift types in a shift worker population. Thirty-three nurses were monitored for 2 weeks over day (07:00-15:30), evening (13:00-21:30), and night shifts (21:00-07:30). Sleep was measured via daily sleep logs and wrist actigraphy. Driving logs were completed for each work commute, reporting driving events and a predrive Karolinska Sleepiness Scale (KSS). Ocular data from a subset of participants (n = 11) assessed objective sleepiness using infrared oculography during commutes. Circadian phase was assessed at three time points via urinary 6-sulphatoxymelatonin (aMT6s) collected over 24-48 hours. Subjective and objective sleepiness and sleep-related and hazardous driving events significantly increased following night shift compared with preshift. There were significant shift differences with KSS, sleep-related and inattention-related events highest during the postnight shift commute, compared with day and evening shifts. Sleep-related events were highest following the first night shift, while inattention-related events were most frequent after consecutive night shifts. KSS, sleep-related and hazardous events were increased during drives following ≥16 hours of wakefulness. KSS and sleep-related events increased during drives within ±3 hours of aMT6s acrophase. An interaction between homeostatic and circadian processes was observed, with KSS and sleep-related events highest within ±3 hours of acrophase, when wakefulness was ≥16 hours. In naturalistic conditions, subjective and objective sleepiness and driving events are increased following night shifts, even during short (~30 minutes) commutes and exacerbated by an interaction between circadian phase and duration of wakefulness.

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Metadata

Authors
Mulhall, M. D., Sletten, T. L., Magee, M., Stone, J. E., Ganesan, S., Collins, A., Anderson, C., Lockley, S. W., Howard, M. E., & Rajaratnam, S. M. W.
Affiliations
  • Monash University (AU)
  • Austin Hospital (AU)
  • Brigham and Women's Hospital (US)
Corresponding author
  • Sletten, Tracey L
  • Rajaratnam, Shantha M W
ORCID
Venue
Sleep
Publisher
Oxford University Press (OUP)
Published
2019-03-18
Volume
42
Issue
6
ISSN
  • 0161-8105 (ISSN-L)
  • 1550-9109
DOI
10.1093/sleep/zsz074
OpenAlex
W2922317513
Cited by
52
References
4
Citations by year
2026: 5 · 2025: 5 · 2024: 4 · 2023: 6 · 2022: 10 · 2021: 13 · 2020: 8 · 2019: 1
FWCI
9.43
Type
journal article
Language
en
Open access
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • SLEEP (publishedVersion)
  • PubMed (publishedVersion)
  • Monash University Research Portal (Monash University) (submittedVersion, other-oa)
  • Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
Funders
Cooperative Research Centre
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
Keywords
sleepiness, shift work, night shift work, circadian rhythm, homeostatic sleep drive, nurses, 6-sulfatoxymelatonin, Karolinska Sleepiness Scale, eye movement recording, inattention
MeSH terms
Shift Work Schedule, Sleepiness, Adult, Automobile Driving, Circadian Rhythm, Cognition, Female, Homeostasis, Humans, Male, Melatonin, Middle Aged, Nurses, Sleep, Transportation, Wakefulness, Work Schedule Tolerance, Sleep Disorders, Circadian Rhythm, Young Adult, Actigraphy

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