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Published in: International Archives of Occupational and Environmental Health 8/2019

Open Access 01-11-2019 | Original Article

Sleepiness among personnel in the Norwegian Air Ambulance Service

Authors: Tine Almenning Flaa, Anette Harris, Bjørn Bjorvatn, Hilde Gundersen, Erik Zakariassen, Ståle Pallesen, Siri Waage

Published in: International Archives of Occupational and Environmental Health | Issue 8/2019

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Abstract

Purpose To examine the effects of shift work and extended working hours on sleepiness among pilots and Helicopter Emergency Medical Service (HEMS) crew members in the Norwegian Air Ambulance.

Methods

This field study investigated sleepiness during 3 consecutive weeks: the week before work, the work week, and the week after work. The pilots and HEMS crew members (N = 50) kept a wake diary during all 3 weeks and completed reaction time tests during the work week.

Results

The overall sleepiness scores were low during all 3 weeks. When comparing the 3 weeks, the lowest sleepiness levels were found for the work week. There was a small difference across work days, in which subjective sleepiness scores were highest the first duty day. No change in the reaction time tests was evident during the work week. The crew members reported being most sleepy at midnight, compared to all the other timepoints over the course of a duty day. Regarding workload and total work time, having larger workload was associated with lower sleepiness scores, while having higher total work time was associated with higher sleepiness score, both compared to the medium category.

Conclusions

The findings indicate that the work schedules and setting for this distinct occupational group do not seem to negatively affect the sleepiness levels.
Literature
go back to reference Akerstedt T, Gillberg M (1990) Subjective and objective sleepiness in the active individual. Int J Neurosci 52(1–2):29–37CrossRef Akerstedt T, Gillberg M (1990) Subjective and objective sleepiness in the active individual. Int J Neurosci 52(1–2):29–37CrossRef
go back to reference Akerstedt T, Kecklund G (2005) The future of work hours—the European view. Ind Health 43(1):80–84CrossRef Akerstedt T, Kecklund G (2005) The future of work hours—the European view. Ind Health 43(1):80–84CrossRef
go back to reference Akerstedt T, Wright KP (2009) Sleep loss and fatigue in shift work and shift work disorder. Sleep Med Clin 4(2):257–271CrossRef Akerstedt T, Wright KP (2009) Sleep loss and fatigue in shift work and shift work disorder. Sleep Med Clin 4(2):257–271CrossRef
go back to reference Amann U, Holmes A, Caldwell J, Hilditch C (2014) Sleep and sleepiness of pilots operating long-range airplane emergency medical missions. Aviat Space Environ Med 85(9):954–959CrossRef Amann U, Holmes A, Caldwell J, Hilditch C (2014) Sleep and sleepiness of pilots operating long-range airplane emergency medical missions. Aviat Space Environ Med 85(9):954–959CrossRef
go back to reference Bjorvatn B, Stangenes K, Øyane N, Forberg K, Lowden A, Holsten F, Akerstedt T (2006) Subjective and objective measures of adaptation and readaptation to night work on an oil rig in the North Sea. Sleep 29(6):821–829CrossRef Bjorvatn B, Stangenes K, Øyane N, Forberg K, Lowden A, Holsten F, Akerstedt T (2006) Subjective and objective measures of adaptation and readaptation to night work on an oil rig in the North Sea. Sleep 29(6):821–829CrossRef
go back to reference Borbély AA, Daan S, Wirz-Justice A, Deboer T (2016) The two-process model of sleep regulation: a reappraisal. J Sleep Res 25(2):131–143CrossRef Borbély AA, Daan S, Wirz-Justice A, Deboer T (2016) The two-process model of sleep regulation: a reappraisal. J Sleep Res 25(2):131–143CrossRef
go back to reference Caruso CC (2014) Negative impacts of shiftwork and long work hours. Rehabil Nurs 39(1):16–25CrossRef Caruso CC (2014) Negative impacts of shiftwork and long work hours. Rehabil Nurs 39(1):16–25CrossRef
go back to reference Cullip T, Hudson A, Lyon R, McWhirter E (2014) Testing alertness of Helicopter Emergency Medical Service (HEMS) crews—a feasibility study (Report) 22(9026) Cullip T, Hudson A, Lyon R, McWhirter E (2014) Testing alertness of Helicopter Emergency Medical Service (HEMS) crews—a feasibility study (Report) 22(9026)
go back to reference Forberg K, Waage S, Moen B, Bjorvatn B (2010) Subjective and objective sleep and sleepiness among tunnel workers in an extreme and isolated environment: 10-h shifts, 21-day working period, at 78 degrees north. Sleep Med 11(2):185–190CrossRef Forberg K, Waage S, Moen B, Bjorvatn B (2010) Subjective and objective sleep and sleepiness among tunnel workers in an extreme and isolated environment: 10-h shifts, 21-day working period, at 78 degrees north. Sleep Med 11(2):185–190CrossRef
go back to reference Gillberg M, Kecklund G, Akerstedt T (1994) Relations between performance and subjective ratings of sleepiness during a night awake. Sleep 17(3):236–241CrossRef Gillberg M, Kecklund G, Akerstedt T (1994) Relations between performance and subjective ratings of sleepiness during a night awake. Sleep 17(3):236–241CrossRef
go back to reference Goode JH (2003) Are pilots at risk of accidents due to fatigue? J Saf Res 34(3):309–313CrossRef Goode JH (2003) Are pilots at risk of accidents due to fatigue? J Saf Res 34(3):309–313CrossRef
go back to reference Gregory KB, Winn W, Johnson K, Rosekind MR (2010) Pilot fatigue survey: exploring fatigue factors in air medical operations. Air Med J 29(6):309–319CrossRef Gregory KB, Winn W, Johnson K, Rosekind MR (2010) Pilot fatigue survey: exploring fatigue factors in air medical operations. Air Med J 29(6):309–319CrossRef
go back to reference Gundersen H, Helland CA, Raeder MB, Hugdahl K, Wester K (2007) Visual attention in patients with intracranial arachnoid cysts. J Neurol 254(1):60–66CrossRef Gundersen H, Helland CA, Raeder MB, Hugdahl K, Wester K (2007) Visual attention in patients with intracranial arachnoid cysts. J Neurol 254(1):60–66CrossRef
go back to reference Guyette FX, Morley JL, Weaver MD, Patterson PD, Hostler D (2013) The effect of shift length on fatigue and cognitive performance in air medical providers. Prehosp Emerg Care 17(1):23–28CrossRef Guyette FX, Morley JL, Weaver MD, Patterson PD, Hostler D (2013) The effect of shift length on fatigue and cognitive performance in air medical providers. Prehosp Emerg Care 17(1):23–28CrossRef
go back to reference Härmä M, Kecklund G (2010) Shift work and health—how to proceed? Environ Health 36(2):81–84 Härmä M, Kecklund G (2010) Shift work and health—how to proceed? Environ Health 36(2):81–84
go back to reference Härmä M, Sallinen M, Ranta R, Mutanen P, Müller K (2002) The effect of an irregular shift system on sleepiness at work in train drivers and railway traffic controllers. J Sleep Res 11(2):141–151CrossRef Härmä M, Sallinen M, Ranta R, Mutanen P, Müller K (2002) The effect of an irregular shift system on sleepiness at work in train drivers and railway traffic controllers. J Sleep Res 11(2):141–151CrossRef
go back to reference Härmä M, Karhula K, Puttonen S, Ropponen A, Koskinen A, Ojajärvi A, Kivimäki M (2018) Shift work with and without night work as a risk factor for fatigue and changes in sleep length: a cohort study with linkage to records on daily working hours. J Sleep Res 28:e12658CrossRef Härmä M, Karhula K, Puttonen S, Ropponen A, Koskinen A, Ojajärvi A, Kivimäki M (2018) Shift work with and without night work as a risk factor for fatigue and changes in sleep length: a cohort study with linkage to records on daily working hours. J Sleep Res 28:e12658CrossRef
go back to reference Harrington JM (2001) Health effects of shift work and extended hours of work. Occup Environ Med 58(1):68–72CrossRef Harrington JM (2001) Health effects of shift work and extended hours of work. Occup Environ Med 58(1):68–72CrossRef
go back to reference Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545CrossRef Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545CrossRef
go back to reference Lo JC, Ong JL, Leong RL, Gooley JJ, Chee MW (2016) Cognitive performance, sleepiness, and mood in partially sleep deprived adolescents: the need for sleep study. Sleep 39(3):687–698CrossRef Lo JC, Ong JL, Leong RL, Gooley JJ, Chee MW (2016) Cognitive performance, sleepiness, and mood in partially sleep deprived adolescents: the need for sleep study. Sleep 39(3):687–698CrossRef
go back to reference Müller R, Wittmer A, Drax C (2014) Aviation risk and safety management: methods and applications in aviation organizations, 2014th edn. Springer International Publishing, ChamCrossRef Müller R, Wittmer A, Drax C (2014) Aviation risk and safety management: methods and applications in aviation organizations, 2014th edn. Springer International Publishing, ChamCrossRef
go back to reference Mullins HM, Cortina JM, Drake CL, Dalal RS (2014) Sleepiness at work: a review and framework of how the physiology of sleepiness impacts the workplace. J Appl Psychol 99(6):1096CrossRef Mullins HM, Cortina JM, Drake CL, Dalal RS (2014) Sleepiness at work: a review and framework of how the physiology of sleepiness impacts the workplace. J Appl Psychol 99(6):1096CrossRef
go back to reference Myers JA, Powell DMC, Aldington S, Sim D, Psirides A, Hathaway K, Haney MF (2017) The impact of fatigue on the non-technical skills performance of critical care air ambulance clinicians. Acta Anaesthesiol Scand 61(10):1305–1313CrossRef Myers JA, Powell DMC, Aldington S, Sim D, Psirides A, Hathaway K, Haney MF (2017) The impact of fatigue on the non-technical skills performance of critical care air ambulance clinicians. Acta Anaesthesiol Scand 61(10):1305–1313CrossRef
go back to reference Pallesen S, Nordhus IH, Omvik S, Sivertsen B, Tell GS, Bjorvatn B (2007) Prevalence and risk factors of subjective sleepiness in the general adult population. Sleep 30(5):619CrossRef Pallesen S, Nordhus IH, Omvik S, Sivertsen B, Tell GS, Bjorvatn B (2007) Prevalence and risk factors of subjective sleepiness in the general adult population. Sleep 30(5):619CrossRef
go back to reference Persson R, Ørbaek P, Kecklund G, Akerstedt T (2006) Impact of an 84-hour workweek on biomarkers for stress, metabolic processes and diurnal rhythm. Scand J Work Environ Health 32(5):349CrossRef Persson R, Ørbaek P, Kecklund G, Akerstedt T (2006) Impact of an 84-hour workweek on biomarkers for stress, metabolic processes and diurnal rhythm. Scand J Work Environ Health 32(5):349CrossRef
go back to reference Posner MI, Driver J (1992) The neurobiology of selective attention. Curr Opin Neurobiol 2(2):165–169CrossRef Posner MI, Driver J (1992) The neurobiology of selective attention. Curr Opin Neurobiol 2(2):165–169CrossRef
go back to reference Powell D, Spencer MB, Holland D, Petrie KJ (2008) Fatigue in two-pilot operations: implications for flight and duty time limitations. Aviat Space Environ Med 79(11):1047–1050CrossRef Powell D, Spencer MB, Holland D, Petrie KJ (2008) Fatigue in two-pilot operations: implications for flight and duty time limitations. Aviat Space Environ Med 79(11):1047–1050CrossRef
go back to reference Previc FH, Lopez N, Ercoline WR, Daluz CM, Workman AJ, Evans RH, Dillon NA (2009) The effects of sleep deprivation on flight performance, instrument scanning, and physiological arousal in pilots. Int J Aviat Psychol 19(4):326–346CrossRef Previc FH, Lopez N, Ercoline WR, Daluz CM, Workman AJ, Evans RH, Dillon NA (2009) The effects of sleep deprivation on flight performance, instrument scanning, and physiological arousal in pilots. Int J Aviat Psychol 19(4):326–346CrossRef
go back to reference Radstaak M, Geurts SA, Beckers DG, Brosschot JF, Kompier MA (2014) Work stressors, perseverative cognition and objective sleep quality: a longitudinal study among Dutch Helicopter Emergency Medical Service (HEMS) pilots. J Occup Health 56(6):469–477CrossRef Radstaak M, Geurts SA, Beckers DG, Brosschot JF, Kompier MA (2014) Work stressors, perseverative cognition and objective sleep quality: a longitudinal study among Dutch Helicopter Emergency Medical Service (HEMS) pilots. J Occup Health 56(6):469–477CrossRef
go back to reference Sallinen M, Kecklund G (2010) Shift work, sleep, and sleepiness—differences between shift schedules and systems. Scand J Work Environ Health 36(2):121–133CrossRef Sallinen M, Kecklund G (2010) Shift work, sleep, and sleepiness—differences between shift schedules and systems. Scand J Work Environ Health 36(2):121–133CrossRef
go back to reference Sallinen M, Laukkanen-Nevala P, Olkinuora A, Puttonen S, Vanttola P, Virkkunen I (2018) Working hours, sleep and alertness in HEMS personnel in Finland. In: Lecture presented at Biomedicum Helsinki Sallinen M, Laukkanen-Nevala P, Olkinuora A, Puttonen S, Vanttola P, Virkkunen I (2018) Working hours, sleep and alertness in HEMS personnel in Finland. In: Lecture presented at Biomedicum Helsinki
go back to reference Swanson LM, Arnedt JT, Rosekind MR, Belenky G, Balkin TJ, Drake C (2011) Sleep disorders and work performance: findings from the 2008 National Sleep Foundation Sleep in America poll. J Sleep Res 20(3):487–494CrossRef Swanson LM, Arnedt JT, Rosekind MR, Belenky G, Balkin TJ, Drake C (2011) Sleep disorders and work performance: findings from the 2008 National Sleep Foundation Sleep in America poll. J Sleep Res 20(3):487–494CrossRef
go back to reference Thomas F, Hopkins RO, Handrahan DL, Walker J, Carpenter J (2006) Sleep and cognitive performance of flight nurses after 12-hour evening versus 18-hour shifts. Air Med J 25(5):216–225CrossRef Thomas F, Hopkins RO, Handrahan DL, Walker J, Carpenter J (2006) Sleep and cognitive performance of flight nurses after 12-hour evening versus 18-hour shifts. Air Med J 25(5):216–225CrossRef
go back to reference Thun E, Bjorvatn B, Akerstedt T, Moen BE, Waage S, Molde H, Pallesen S (2016) Trajectories of sleepiness and insomnia symptoms in Norwegian nurses with and without night work and rotational work. Chronobiol Int 33(5):480–489CrossRef Thun E, Bjorvatn B, Akerstedt T, Moen BE, Waage S, Molde H, Pallesen S (2016) Trajectories of sleepiness and insomnia symptoms in Norwegian nurses with and without night work and rotational work. Chronobiol Int 33(5):480–489CrossRef
go back to reference van Dongen HPA, Maislin G, Mullington JM, Dinges DF (2003) The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep 26(2):117–126CrossRef van Dongen HPA, Maislin G, Mullington JM, Dinges DF (2003) The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep 26(2):117–126CrossRef
go back to reference Wagstaff A, Lie J (2011) Shift and night work and long working hours—a systematic review of safety implications. Scand J Work Environ Health 37:173–185CrossRef Wagstaff A, Lie J (2011) Shift and night work and long working hours—a systematic review of safety implications. Scand J Work Environ Health 37:173–185CrossRef
go back to reference West BT, Welch KB, Galecki AT (2014) Linear mixed models, 2nd edn. CRC Press, ArborCrossRef West BT, Welch KB, Galecki AT (2014) Linear mixed models, 2nd edn. CRC Press, ArborCrossRef
go back to reference Yang C-M, Spielman AJ, D’Ambrosio P, Serizaw S, Nunes J, Birnbaum J (2001) A single dose of melatonin prevents the phase delay associated with a delayed weekend sleep pattern. Sleep 24(3):272–281CrossRef Yang C-M, Spielman AJ, D’Ambrosio P, Serizaw S, Nunes J, Birnbaum J (2001) A single dose of melatonin prevents the phase delay associated with a delayed weekend sleep pattern. Sleep 24(3):272–281CrossRef
go back to reference Yen J-R, Hsu C-C, Yang H, Ho H (2009) An investigation of fatigue issues on different flight operations. J Air Transp Manag 15(5):236–240CrossRef Yen J-R, Hsu C-C, Yang H, Ho H (2009) An investigation of fatigue issues on different flight operations. J Air Transp Manag 15(5):236–240CrossRef
Metadata
Title
Sleepiness among personnel in the Norwegian Air Ambulance Service
Authors
Tine Almenning Flaa
Anette Harris
Bjørn Bjorvatn
Hilde Gundersen
Erik Zakariassen
Ståle Pallesen
Siri Waage
Publication date
01-11-2019
Publisher
Springer Berlin Heidelberg
Published in
International Archives of Occupational and Environmental Health / Issue 8/2019
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI
https://doi.org/10.1007/s00420-019-01449-w

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