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  • Quantitative model for vigilance regulat...
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    Plan

    Plan détaillé Texte intégral I – The three-process model of alertness II – Prediction of involuntary sleep Bibliographie Auteurs

    Vigilance et transports

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    Table des matières

    Quantitative model for vigilance regulation and its application in transport operations

    T. Âkerstedt et S. Folkard

    p. 199-206

    Résumés

    Cet article résume les études de validation et de développement d’un modèle quantitatif de prédiction de la somnolence dans le domaine des transports (ainsi qu’en conditions de laboratoire). Le modèle repose essentiellement sur une composante circadienne (durée de l’éveil précédent) et sur une composante homéostasique (durée du sommeil précédent). Ces deux composantes ont à peu près la même importance mais interagissent dans la prédiction de la somnolence. La vigilance est au maximum en début de soirée après un long sommeil nocturne et une courte durée d’éveil. Les bas niveaux de vigilance prédits par le modèle (< 7 sur l’échelle du modèle de vigilance) coïncident avec l’apparition des signes du sommeil à l’EEG et l’EOG et avec la sensation de somnolence chez les opérateurs, les conducteurs de camion et de train qui travaillent de nuit, ainsi que chez les volontaires sains en privation de sommeil au laboratoire.

    This paper summarizes work to validate and develop further a quantitative model for predicting work hour related sleepiness in transport operations (as well as in the lab). The model basically consists of a circadian component and a homeostatic component (amount of prior wake and amount of prior sleep). Both have approximately similar weight but internet to yield predicted sleepiness. Alertness is highest in the early evening after long sleep and short prior waking. Low levels of alertness predicted by the model (<7 on the scale of model alertness) coincide with intrusions of sleep patterns in the EEG and EOG (as well as perceived sleepiness) in process operators, truck drivers and train drivers working at night and in laboratory subjects during sleep deprivation.

    Texte intégral Bibliographie Références Auteurs

    Texte intégral

    1 In previous studies we have demonstrated that train drivers and truck drivers exhibit pronounced subjective and behavioral sleepiness towards particularly the early morning. (Kecklund and Akerstedt, 1993 ; Torsvall and Âkerstedt, 1987). The physiological changes include increased alpha and theta power density and slow rolling eye movements. The same phenomenon may be observed in process operators in the industry (fig.l), although here sleepiness frequently develops into full-blown sleep episodes (Torsvall et al, 1989). Interestingly, in this study the sleep episodes during work were not recognized by the subject, although the experience of sleepiness was.

    Figure 1. Hypnogram from 24h ambulatory recording of a three-shift worker. R = REM sleep. The subject falls asleep three times during work

    Image

    Observations such as those above have led us to develop a quantitative model of alertness regulation. The purpose of this presentation is to describe this model.

    I – The three-process model of alertness

    2The inspiration for the development of the alertness model was the « two-process model of sleep regulation » which had shown that sleep length and slow wave activity could be described by a combination of a homeostatic and a circadian influence (Borbély, 1982). This model was based on the amount of EEG slow wave activity during sleep but it seemed likely that a similar approach could be used to model and predict alertness variations.

    3To construct the model we used published data from experiments with life on a 22. Oh day (Folkard étal, 1985), sleep deprivation (Folkard and Akerstedt, 1991 ; Fröberg et al, 1975 ; Fröberg et al, 1975 ; Fröberg, 1977) and other studies. It should be emphasized that these studies are completely independent of those used for the Borbély model and also use a completely different parameter : subjective sleepiness. We found that subjective sleepiness (or alertness) was, indeed, predictable using three processes : S, C, and W. Space does not permit a discussion of the derivation of the model but the reader is referred to Folkard and Akerstedt (1991). Here will be described the main traits of the model.

    Figure 2. Parameters of the three-process model of alertness regulation. S = homeostatic component during waking. S’ = homeostatic component during sleep. C = circadian component. W = wake up component. S+C = the alertness prediction (excluding W). « 7 » = level of risk

    Image

    4Process C represents sleepiness due to circadian influences and has the general sinusoidal form indicated in fig. 2. Our attempts to model empirical data suggest that the phase estimate may have to be delayed by up to four hours in students, shift workers or other groups in which evening type preferences dominate.

    5Process S is an exponential function of the time since awakening. Maximum alertness is reached upon awakening and alertness initially falls rapidly but levels out and gradually approaches an asymptote. The rate of decrease of the exponential function corresponds to 3.5 % of the previous value per hour. At sleep onset process S is reversed and called S’ and recovery occurs as an exponential function that initially increases at a very rapid rate but subsequently levels off towards an upper asymptote. The rate of increase of the exponential function is 28.7 % per hour, i.e. much steeper than the decay during the day. It is of interest to note that the exponential functions arrived at are very similar to those demonstrated by Borbély et al. (1982).

    6The final component is the wakeup process W, or sleep inertia, after forced awakenings. This function is also exponential but with an even steeper initial decrease – the rate of decrease is 62.7 % per hour, i.e. already after the first hour most of the inertia has dissipated. W is subtracted from the S+C level. Spontaneous awakenings constitute a special problem since the exact time of awakening often is not available, and since the time between the first formal awakening and the time of finally rising might be considerable. Tentatively, we assume that such a process might take approximately 1 hour.

    7The estimated alertness (or sleepiness) is then expressed as the arithmetic sum of the three functions above (S+C in figure 2). It should be emphasized that the homeostatic function involves, not only prior time awake, but also the amount of prior sleep. It also recognizes that recuperation is more rapid in the initials hours of sleep and that loss of alertness is more rapid during the initial hours of wakefulness. Furthermore, the recuperative process (S’) increases in speed with increasing sleep loss and the loss of alertness is less rapid if initial alertness is low. Incidentally, the S’ function has recently been demonstrated to predict slow wave activity (Åkerstedt et al, 1992) and total sleep length (Kecklund et al., 1992).

    II – Prediction of involuntary sleep

    8Using the three-process model we have found it possible to predict with high accuracy the variation of subjective sleepiness under conditions of sleep deprivation and various experimental or naturally occurring alternations of sleep/wake behavior (Folkard and Âkerstedt, 1991). In these validation studies it was also found that level 7 of predicted alertness corresponded to a point when slow eye movements (SEM) started to occur during waking polysomnography under conditions of five minutes of open eyes. This has been taken to indicate a level of sleep onset risk. This is admittedly arbitrary but contains considerable face value.

    9To continue the validation work we have tried to predict alpha power density (after spectral analysis of the CzPz derivation) in two field studies with ambulatory EEG recordings. The first derives from 15 truck drivers during a night drive (Kecklund and Âkerstedt, 1993). On the whole, alpha power density rises as predicted alertness falls (figure 3). The right part of the figure illustrâtes the close relation between the alpha power density and predicted alertness. Baseline levels (100 %) coincide with predicted levels of 10 and above and characterized daytime driving (not in the figure). This means that the relation between predicted alertness and alpha (and thêta) intrusions is in effect curvilinear – the point of inflection appears around the level of 7-8. This is very close to the earlier observation that SEM (as well as alpha and thêta intrusions) are completely absent for high to medium levels of alertness (14-9) but start to appear around 7 together with perceptions of « fighting sleep » (Folkard and Âkerstedt, 1991).

    Figure 3. Left : Mean alpha power density and predicted alertness plotted against time of day for truck drivers working at night. Right : Mean alpha power density plotted against predicted alertness for the same group. 100 % = baseline (daytime values). N = 15 subjects at each point

    Image

    10Figure 4 shows a similar analysis carried out with 15 train drivers during night work (Torsvall and Åkerstedt, 1987). Here, the covariation between predicted alertness and alpha power density during the night drive is even higher than for the truck drivers. Again, daytime driving is associated with an absence of alpha or theta activity beyond baseline, and with high-to-medium levels of predicted alertness. Thus the true relationship is curvilinear between predicted alertness and sleep intrusions into the waking EEG, and the first increase above base line occurs around the level 7-8 of predicted alertness.

    Figure 4. Left : Mean alpha power density and predicted alertness plotted against time of day for train drivers with night work. Right : Alpha power density plotted against predicted alertness. 100 % = baseline (day). N = 13 in each point

    Image

    11The percentage increase in train and truck drivers differs considerably. This difference is not possible to interpret, however, since many factors may have influenced the calculation of the relative values – the subjects were different in age and occupation and the studies were carried out with different techniques many years apart.

    12In order to further test the prediction of the model we used a 64 hour sleep deprivation study (Gillberg and Åkerstedt, 1981) in which EEG measures were obtained in connection with performance tests. The study involved 12 male subjects living on a semi-constant routine. The latter included isolation from environmental time cues and a three-hourly control of activity and intake of food and fluid. In each three-hour module ratings of sleepiness were carried out and a 32 minute monotonous vigilance test was used.

    13Figure 5 shows the time elapsed before the first miss due to sleep (scored visually), plotted against time, together with predicted alertness from the model (the acrophase was set to 2048h). The data in the left panel show a very pronounced fall across time awake, together with a superimposition of a circadian pattern. The right panel shows that the amount of variance accounted for by the model prediction is considerable. The number of minutes without a miss increases by 2.5 for each level of the scale (above the intercept). Performance without misses appears to require a level of 13, whereas a rapid onset (<10 min.) of misses occurs at around 3. There appears to exist no obvious « critical point » in these data, but the probability of missing due to sleep is linearly related to predicted alertness.

    Figure 5. Left : Mean latency to first miss due to sleep and predicted alertness, plotted against time awake across 64 hours in three-hour intervals. N = 12. Right : Latency to miss plotted against predicted alertness

    Image

    14Taken together, the data suggest that the alertness model may be used to define levels of critical sleepiness but that the outcome will be influenced by the activity of the subject and the environmental setting. At level 3 and below occurrences of sleep seem highly likely almost regardless of the situation. Between 3 and 7 the probability of sleep intrusions are high, at least for average sedentary activity. Between 7 and 10 the risk of sleep intrusions is reduced but very definitely present for situations of monotony. Above 10 sleep is unlikely unless the situation is highly conducive to it.

    Bibliographie

    Des DOI sont automatiquement ajoutés aux références bibliographiques par Bilbo, l’outil d’annotation bibliographique d’OpenEdition. Ces références bibliographiques peuvent être téléchargées dans les formats APA, Chicago et MLA.

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    Sleep. (1982). In D. Ganten & D. Pfaff (Eds.), Current Topics in Neuroendocrinology. Springer Berlin Heidelberg. https://doi.org/10.1007/978-3-642-68333-6
    Folkard, S., Hume, K. I., Minors, D. S., Waterhouse, J. M., & Watson, F. L. (1985). Independence of the circadian rhythm in alertness from the sleep/wake cycle. Springer Science and Business Media LLC. https://doi.org/10.1038/313678a0
    Fröberg, J. E. (1977). Twenty-four-hour patterns in human performance, subjective and physiological variables and differences between morning and evening active subjects. Elsevier BV. https://doi.org/10.1016/0301-0511(77)90008-4
    Torsvall, L., & åAkerstedt, T. (1987). Sleepiness on the job: continuously measured EEG changes in train drivers. Elsevier BV. https://doi.org/10.1016/0013-4694(87)90096-4
    Åkerstedt, T., & Gillberg, M. (1990). Subjective and Objective Sleepiness in the Active Individual. Informa UK Limited. https://doi.org/10.3109/00207459008994241
    ÅKERSTEDT, T., GILLBERG, M., & FOLKARD, S. (1992). Slow wave activity and prior sleep/wakefulness on an irregular schedule. Wiley. https://doi.org/10.1111/j.1365-2869.1992.tb00022.x
    Ganten, Detlev, and Donald Pfaff, eds. Sleep. Current Topics in Neuroendocrinology. Springer Berlin Heidelberg, 1982. doi:10.1007/978-3-642-68333-6.
    Folkard, Simon, Kenneth I. Hume, David S. Minors, James M. Waterhouse, and Frances L. Watson. “Independence of the Circadian Rhythm in Alertness from the Sleep Wake Cycle”. Nature. Springer Science and Business Media LLC, February 1985. doi:10.1038/313678a0.
    Fröberg, Jan E. “Twenty-Four-Hour Patterns in Human Performance, Subjective and Physiological Variables and Differences Between Morning and Evening Active Subjects”. Biological Psychology. Elsevier BV, June 1977. doi:10.1016/0301-0511(77)90008-4.
    Torsvall, Lars, and Torbjörn åAkerstedt. “Sleepiness on the Job: Continuously Measured EEG Changes in Train Drivers”. Electroencephalography and Clinical Neurophysiology. Elsevier BV, June 1987. doi:10.1016/0013-4694(87)90096-4.
    Åkerstedt, Torbjörn, and Mats Gillberg. “Subjective and Objective Sleepiness in the Active Individual”. International Journal of Neuroscience. Informa UK Limited, January 1990. doi:10.3109/00207459008994241.
    ÅKERSTEDT, TORBJÖRN, MATS GILLBERG, and SIMON FOLKARD. “Slow Wave Activity and Prior Sleep Wakefulness on an Irregular Schedule”. Journal of Sleep Research. Wiley, June 1992. doi:10.1111/j.1365-2869.1992.tb00022.x.
    Ganten, Detlev, and Donald Pfaff, editors. Sleep. Current Topics in Neuroendocrinology, Springer Berlin Heidelberg, 1982. Crossref, https://doi.org/10.1007/978-3-642-68333-6.
    Folkard, Simon, et al. “Independence of the Circadian Rhythm in Alertness from the Sleep Wake Cycle”. Nature, vols. 313, nos. 6004, Springer Science and Business Media LLC, Feb. 1985, pp. 678-9. Crossref, https://doi.org/10.1038/313678a0.
    Fröberg, Jan E. “Twenty-Four-Hour Patterns in Human Performance, Subjective and Physiological Variables and Differences Between Morning and Evening Active Subjects”. Biological Psychology, vols. 5, nos. 2, Elsevier BV, June 1977, pp. 119-34. Crossref, https://doi.org/10.1016/0301-0511(77)90008-4.
    Torsvall, Lars, and Torbjörn åAkerstedt. “Sleepiness on the Job: Continuously Measured EEG Changes in Train Drivers”. Electroencephalography and Clinical Neurophysiology, vols. 66, nos. 6, Elsevier BV, June 1987, pp. 502-11. Crossref, https://doi.org/10.1016/0013-4694(87)90096-4.
    Åkerstedt, Torbjörn, and Mats Gillberg. “Subjective and Objective Sleepiness in the Active Individual”. International Journal of Neuroscience, vols. 52, no. 1-2, Informa UK Limited, Jan. 1990, pp. 29-37. Crossref, https://doi.org/10.3109/00207459008994241.
    ÅKERSTEDT, TORBJÖRN, et al. “Slow Wave Activity and Prior Sleep Wakefulness on an Irregular Schedule”. Journal of Sleep Research, vol. 1, nos. 2, Wiley, June 1992, pp. 118-21. Crossref, https://doi.org/10.1111/j.1365-2869.1992.tb00022.x.

    Cette bibliographie a été enrichie de toutes les références bibliographiques automatiquement générées par Bilbo en utilisant Crossref.

    Références

    10.1007/978-3-642-68333-6 :

    A. Borbély, Sleep regulation : Circadian rhythm and homeostasis. D. Ganten and D. Pfaff (Eds.), Sleep. Clinical and Experimental aspects. Springer Verlag, Berlin, 1982 : 83-104.

    10.1038/313678a0 :

    S. Folkard, K. I. Hume, D. S. minors, J. M. Waterhouse, F. L. Watson, Independence of the circadian rhythm in alertness from the sleep/wake cycle. Nature, 1985 313 : 678-679.

    S. Folkard, T. Åkerstedt, A three-process model of the régulation of alertness and sleepiness. R. Ogilvie and R. Broughton (Eds.), Sleep, Amusal and Performance : Problems and Promises. Birkhàuser, Boston, 1991 : 11-26.

    J. E. Fröberg, C. G. Karlsson, L. Levi, L. Lidberg, Circadian variations of catecholamine excretion, shooting range performance and self-ratings of fatigue during sleep deprivation. Biol. Psychol., 1975, 2 : 175-188.

    10.1016/0301-0511(77)90008-4 :

    J. E. Fröberg, Twenty-four hour patterns in human performance, subjective and physiological variables and differences between morning and evening active subjects. Biol. Psychol., 1977, 5 : 119-134.

    J. E. Fröberg, C. G. Karlsson, L. Levi, L. Lidberg, Psychological circadian rhythms during a 72-hour vigil. Fôrsvarsmedicin., 1975, II : 192-201.

    M. Gillberg, T. Åkerstedt, Possible measures of « sleepiness » for the evaluation of disturbed and displaced sleep. In : A. Reinberg, N. Vieux and P. Andlauer (Eds.), Night and shift work : biological and social aspects. Pergamon Press, Oxford, 1981 : 155-160.

    G. Kecklund, T. Åkerstedt, Sleepiness in long distance truck driving : an ambulatory EEG study of night driving. Ergonomics, vol. 36, N° 9 September 1993, 1007-1018.

    G. Kecklund, T. Åkerstedt, B. Göransson, K. Söderberg, Omlàggning av skift-schema : konsekvenser for valbefinnande, hälsa och arbetstrivsel. Stress Research Reports, 1992, 1-29.

    10.1016/0013-4694(87)90096-4 :

    L. Torsvall, T. Åkerstedt, Sleepiness on the job : continuously measured EEG changes in train drivers. Electroenceph. Clin. Neurophysiol., 1987, 66 : 502-511.

    L. Torsvall, T. Åkerstedt, K. Gillander, A. Knutsson, Sleep on the night shift : 24- hour EEG monitoring of spontaneous sleep/wake behavior. Psychophysiology, 1989, 26 : 352-358.

    10.3109/00207459008994241 :

    T. Åkerstedt, M. Gillberg, Subjective and objective sleepiness in the active individual. Intern. J. Neuroscience., 1990, 52 : 29-37.

    10.1111/j.1365-2869.1992.tb00022.x :

    T. Åkerstedt, M. Gillberg, S. folkard, Slow wave activity and prior sleep/wakefulness on an irregular schedule. Journal of Sleep Research., 1992, 2 : 118-121.

    Auteurs

    • T. Âkerstedt

      IPM & Departement Clinic Neuroscience, Karolinska Institute, Stockholm, Sweden

    • S. Folkard

      MRC, ESRC, SAPU, University of Sheffield, England

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    Âkerstedt, T., & Folkard, S. (1995). Quantitative model for vigilance regulation and its application in transport operations. In M. Vallet & S. Khardi (éds.), Vigilance et transports. Lyon: Presses universitaires de Lyon. https://doi.org/10.4000/books.pul.39882
    Âkerstedt, T., et S. Folkard. « Quantitative Model for Vigilance Regulation and Its Application in Transport Operations ». In Vigilance Et Transports, édité par Michel Vallet et Salah Khardi. Lyon: Presses universitaires de Lyon, 1995. doi:10.4000/books.pul.39882.
    Âkerstedt, T., et S. Folkard. « Quantitative Model for Vigilance Regulation and Its Application in Transport Operations ». Vigilance Et Transports, édité par Michel Vallet et Salah Khardi, Presses universitaires de Lyon, 1995, https://doi.org/10.4000/books.pul.39882.

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    Vallet, M., & Khardi, S. (éds.). (1995). Vigilance et transports. Lyon: Presses universitaires de Lyon. https://doi.org/10.4000/books.pul.39427
    Vallet, Michel, et Salah Khardi, éd. Vigilance et transports. Lyon: Presses universitaires de Lyon, 1995. doi:10.4000/books.pul.39427.
    Vallet, Michel, et Salah Khardi, éditeurs. Vigilance et transports. Presses universitaires de Lyon, 1995, https://doi.org/10.4000/books.pul.39427.
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