Ingre Michael, Akerstedt Torbjörn, Peters Björn, Anund Anna, Kecklund Göran, Pickles Andrew
National Institute for Psychosocial Medicine (IPM), and Department of Psychology, Stockholm University, Stockholm, Sweden.
J Sleep Res. 2006 Jun;15(2):142-8. doi: 10.1111/j.1365-2869.2006.00517.x.
The present study of sleepiness and accident risk in a HI-FI car simulator aimed to provide subject-level relative risks (RR) with 95% confidence intervals (CI) for different levels of subjective sleepiness measured with the Karolinska Sleepiness Scale (KSS), 1 = very alert, 9 = very sleepy, fighting sleep, an effort to staying awake. Five male and five female shift workers, mean age 37 years, participated with a 2-h drive (08:00-10:00 hours) in a dynamic high-fidelity moving base driving simulator, after a night of work and after a night of sleep. Subjective sleepiness was measured with KSS every 5 min and events of incidents (two wheels outside the right lane), accidents (two wheels off the road or four wheels in opposite lane) and crashes (four wheels off the road) were recorded. The probability of an accident was modelled with a Generalized Linear Mixed Model approach to estimate subject-specific effects, rather than group average effects, to avoid the ecological fallacy. The results showed that sleepiness was strongly related to accident risk. An average subject was estimated at 28.2 times (95% CI RR = 10.7-74.1) increased risk at KSS = 8 and at 185 times (95% CI RR = 42-316) at KSS = 9 compared with KSS = 5. There were large individual differences in event propensity that complicates the prediction of absolute accident risk for individual subjects.
本研究在高保真汽车模拟器中对嗜睡与事故风险进行了研究，旨在针对使用卡罗林斯卡嗜睡量表（KSS）测量的不同主观嗜睡水平，提供受试者层面的相对风险（RR）及其95%置信区间（CI），其中1表示非常警觉，9表示非常困倦，困得想睡觉，努力保持清醒。五名男性和五名女性轮班工人，平均年龄37岁，在夜间工作一晚后和夜间睡眠一晚后，于动态高保真移动基座驾驶模拟器中进行了2小时的驾驶（08:00 - 10:00）。每隔5分钟用KSS测量主观嗜睡程度，并记录事件（右车道外两轮）、事故（两轮驶离道路或四轮驶入对向车道）和碰撞（四轮驶离道路）情况。采用广义线性混合模型方法对事故概率进行建模，以估计受试者个体效应而非群体平均效应，从而避免生态学谬误。结果表明，嗜睡与事故风险密切相关。与KSS = 5相比，平均受试者在KSS = 8时事故风险估计增加28.2倍（95% CI RR = 10.7 - 74.1），在KSS = 9时增加185倍（95% CI RR = 42 - 316）。事件倾向存在较大个体差异，这使得预测个体受试者的绝对事故风险变得复杂。
