• Science of Emotion and Sensibility
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• v.5 no.4
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• pp.11-32
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• 2002

This article evaluates the existing subjective measures that have been utilized in surface transportation to assess various aspects of operator status such as fatigue, sleepiness, arousal, mood, etc. Specifically, the representative six subjective instruments - Epworth Sleepiness Scale, Karolinska Sleepiness Scale, Pearson and Byars Fatigue Checklist, Stanford Sleepiness Scale, Stress-Arousal Checklist, and NPRU Mood Scale - are compared and contrasted in terms of reliability, . validity, sensitivity, and appropriateness for application. Recommendations for application of the subjective measures in surface transportation are discussed.

• Sleep Medicine and Psychophysiology
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• v.9 no.2
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• pp.106-114
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• 2002

Objectives: Daytime sleepiness is a common symptom and is associated with sleep behavior, sleep deprivation, and night shift, etc. It is also one of the most important symptoms of sleep disorders like obstructive sleep apnea (OSA). According to our survey on Korean literature, a few studies have dealt with daytime sleepiness, and we have not been able to locate any study comparing normal subjects with polysomnography-proven sleep disorder patients regarding daytime sleepiness. We aimed at comparing daytime sleepiness among normal healthy daytime workers, medical students being expected to have daytime sleepiness due to chronic sleep deprivation, and patients having sleep disorders diagnosed with polysomnography. We also studied the association between subjective daytime sleepiness and objective polysomnographic findings in patients with sleep disorders. Methods: One hundred three hospital workers, 137 medical students, and patients with sleep disorders were studied. Sleep disorders included OSA, periodic limb movements in sleep (PLMS), insomnia, and narcolepsy. The degree of subjective sleepiness in each group was measured by the Korean version of Epworth sleepiness scale and compared. The relationship between polysomnographic findings reflecting severity of sleep disorder in each patient group and subjective sleepiness was analyzed. As for patients with narcolepsy, the relationship between the mean sleep latency and subjective sleepiness was studied. Results: There was a significant difference of ESS score (F=68.190, dF=5.752, p<0.001) among daytime workers, medical students, and sleep disorder patients. In OSA patient group, the degree of the sleepiness had no significant correlation either with mean O2 satuaration (p=0.062) or with RDI (p=0.807). In PLMS patient group, there was no correlation between periodic limb movement index (PLMI) and subjective sleepiness (p=0.761). In narcolepsy patient group, the subjective sleepiness had no correlation with mean sleep latency measured with MSLT (p=0.055). Conclusion: We found a significant difference of subjective sleepiness among daytime workers, medical students, and patients with sleep disorders. However, no consistent correlation was found between severity of subjective sleepiness and objective polysomnographic findings reflecting severity of each sleep disorder. This research confirms that the evaluation of subjective sleepiness is important clinically, but it cannot substitute the objective measures such as nocturnal polysomnography and MSLT.

• Sleep Medicine and Psychophysiology
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• v.10 no.1
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• pp.12-19
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• 2003

Sleepiness, or hypersomnia, is a relatively common complaint and one of the main problems of modern society. Accurate evaluation and diagnosis of sleepiness are important. The methods used for evaluating sleepiness are subjective measures or self-evaluations, performance decrease measures, sleep propensity measures, and arousal decrease measures. A clear and detailed history is important in differential diagnosis of sleepiness because symptoms of sleepiness may be expressed in terms of 'tiredness' or 'fatigue' that do not directly denote sleepiness. Comprehensive diagnostic evaluation is also invaluable because these symptoms may result from a variety of causes ranging from medical disorders to insufficient nocturnal sleep.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.2
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• pp.195-204
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• 1997

Objectives : The behavioral and physiological effects following low doses and high doses of melatonin have not been fully explored. In this study the authors investigated the nature and extent of the hypnotic effects, oral temperature, blood pressure effects, performance effects and subjective feelings following the acute administration of low pharmacological oral doses of melatonin at mid-day. Methods : Thirty-five healthy young medical students were randomly assigned to receive 6mg of oral melatonin(N=11), 12mg of oral melatonin(N=12) or a placebo(N=12) in a double-blind, placebo controlled trial. Measures of the behavioral and physiological effects used in the study were Stanford Sleepiness Scale, Digit Symbol Substitution Test, Trail test and visual analogue scale for subjective feelings. Oral temperature and blood pressure were measured. The subjects were studied between 10:00 and 16:00 hours. Data were analyzed by using repeated-measures analyses of variance(ANOVA). Results: Melatonin produced statistically significant effects on oral temperature, but there were no significant effects on time and the $dose{\times}time$ interaction. There was a significant difference on oral temperature between the 12mg oral melatonin group and the placebo group at 12:00 and 16:00 hours, but no significant difference between the 12mg and the 6mg oral melatonin groups. Melatonin produced a dose-related increase in subjective sleepiness and had significant effects on time, the $dose{\times}time$ interaction. There was a significant difference on subjective sleepiness among the placebo, 6mg, 12mg oral melatonin groups at 13:00-16:00 hours. Melatonin did not produce statistically significant dose-related effects on subjective fatigue but produced significant effects on time and the $dose{\times}time$ interaction. There was a significant difference on subjective fatigue between the 12mg, the 6mg oral melatonin groups and the placebo group at 13:00 hour. Conclusions : These data indicated that acute administration of melatonin at mid-day increased subjective sleepiness and fatigue but decreased oral temperatures. These effects were shown especially in 12mg oral melatonin group.

• International Journal of Contents
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• v.12 no.1
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• pp.44-48
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• 2016

Driver fatigue is a major cause of fatal road accidents and has significant implications in road safety. In recent years, researchers have investigated steering wheel grip force as an alternative method to detect driver fatigue noninvasively and in real time. In this study, a fatigue detection system was developed by monitoring the grip force and changes in the grip force were measured while participants' engaged in an interactive simulated driving task. The study also measured the participants' subjective sleepiness to ensure the validity of measuring grip force. The results indicated that while participants engaged in a driving task, steering wheel grip force decreased and subjective sleepiness increased concurrently over time. The possible applications of the driver fatigue detection system by steering wheel grip force and future guidelines are discussed.

• Journal of Korean Academy of Nursing
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• v.36 no.5
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• pp.829-836
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• 2006

Purpose: The purpose of the present study was to identify prevalence of excessive daytime sleepiness(EDS) and its associations with sleep habits, sleep problems, depression, subjective health status and obesity in community dwelling adults. Method: Data was collected from adults aged 20-59 years by random sampling. Subjects completed a questionnaire which was composed of the Epworth Sleepiness Scale, Center for Epidemiologic Studies Depression Scale, and questions that included items about sleep habits, sleep problems, subjective health status and sociodemographic characteristics. Height and weight were measured for calculation of body mass index. The statistical analyses was based on 3,302 adults (51.5% males and 48.5% females). Descriptive statistics, univariate logistic regression and multiple logistic regression were used. Result: The prevalence of EDS was 17.1% Multiple logistic regression showed that the associated factors of EDS were depression, obesity, dissatisfaction with sleep time, irregular sleep, and habitual snoring. Depression was the most significant associated factor(adjusted odds ratio for severe depression=2.27, 95% Confidence Interval=1.73-2.96). Conclusion: EDS is a common symptom in adults. Our finding suggested that persons with a complaint of EDS should be completely assessed for depression and obesity as well as sleep problems.

• Korean journal of aerospace and environmental medicine
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• v.31 no.2
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• pp.38-44
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• 2021

Purpose: This study aimed to identify the prevalence of fatigue and its associated factors leading to the fatigue among Korean commercial airline pilots. Methods: An anonymous, web-based questionnaire collecting data on sleep related characteristics was completed by airline pilots. The final 1,029 samples of completed questionnaires were analyzed. The association of the risk factors with fatigue was determined using logistic regression analysis. Results: The prevalence of fatigue was 60% (Fatigue Severity Scale index≥3.2), disturbed sleep 28% (Pittsburgh Sleep Quality Index≥9), daytime sleepiness 17% (Epworth Sleepiness Scale≥10), and sleep apnea (Berlin Questionnaire≥2) 11%. The fully adjusted logistic regression showed that quality of life (odds ratio [OR]=0.16, confidence interval [CI]=0.11-0.24), daytime sleepiness (OR=1.26, CI=1.18-1.34), sleep quality (OR=1.44, CI=1.29-1.61), mental workload (OR=1.10, CI=1.05-1.14), vigorous physical activity (OR=0.82, CI=0.72-0.92), late starts (OR=1.25, CI=1.06-1.46) and average weekly flying hours (OR=1.02, CI=1.00-1.03) were associated with higher levels of fatigue. Conclusion: Lower quality of life, disturbed sleep, more subjective sleepiness, shorter sleep duration, higher mental workload, less vigorous physical activity, frequent late starts, and longer flying hour were shown to be risk factors for fatigue in airline pilots. These findings should be taken into account in the development of sleep and fatigue countermeasures for airline pilots.

• Sleep Medicine and Psychophysiology
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• v.12 no.2
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• pp.117-121
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• 2005

Objectives: The purpose of this study was to assess the difference of subjective daytime sleepiness level between primary insomnia patients and healthy control subjects. We also investigated the relationship between subjective daytime sleepiness level and variables of nocturnal polysomnograghic sleep architecture of insomnia patients. Method: Total subjects were 87 patients with primary insomnia diagnosed with polysomnography and 88 normal controls. The daytime sleepiness level in each group was measured by Korean version of Epworth Sleepiness Scale (ESS). The correlations of ESS score and nocturnal polysomnographic variables were calculated in the patient group. Results: Patients with insomnia had the lower ESS scores than the control group. In patients group, the ESS score showed significant negative correlations with total sleep time, sleep efficiency%, and stage 2 sleep time%. The ESS score also showed significant positive correlations with number of awakenings, number of awakenings more than 2 minutes, and wake after sleep onset time. Conclusions: Insomnia patients showed lower level of subjective daytime sleepiness that may indicate their higher alertness comparing to control subjects. Daytime sleepiness of patients with insomnia was associated with polysomnographic variables including total sleep time, sleep efficiency%, stage 2 sleep time% and disrupted continuity of nocturnal sleep.

• Research in Community and Public Health Nursing
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• v.7 no.2
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• pp.400-409
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• 1996

To investigate industrial fatigue and low back pain, the questionaire survey for subjective symptoms of fatigue and low back pain was carried out among 591 male workers aged 20-55 employed in an automobile industry in Korea. Workers participated to this study were divided into low back pain group(LBP) and control group, according to the self-reports by written questionaires. The subjective sysptoms of fatigue comprised three groups of 10 items each, representing dullness and sleepiness(level of cerebral activation), difficulty in concentration(level of motivation) and bodily projection of fatigue. The resultant data were processed for $\chi^2-test$, t-test and a pearson's correlation coefficient to confirm the relationships. The results were as follows: 1. 30 items of fatigue subjective symptoms exeptone item, 'lack in perseverance', were directly associated with low back pain. 2. The percentage of fatigue complaint were sig nificantly higher in LBP group. 3. Of the 30 items of fatigue subjective symptoms, the highest percentage was accounted for 'eye strain'(27.9%), followed by 'whole body feels tired' and 'legs feel heavy'(22.9%), 'feel like lying'(21.4%), 'feel a pain in the low back'(18.7%), 'feel drowsy'(16.4%) and 'feel stiffness in the neck or the shoulders'(16.2%) in the order of sequence. 4. The average weighted score for the first group of fatigue items(dullness and sleepiness) was the largest among three groups and was followed by the second group(difficulty in concentration) and the third group(bodily projection of fatigue) in the order of sequence, suggesting the heavier shift work stress of the workers. 5. In the groups of the aged 30-40, work duration of 5-7yrs, heavy work amount and irregular work speed, significant high fatigue complaints were revealed in terms of eye strain, whole body feels tired, legs feel heavy, feel like lying, feel a pain in the low back and feel stiffness in the neck or the shoulders. 6. A significant negative correlations were shown between age, work duration and eleven subjective symptoms while positive reciprocal correlations were shown between eleven items with one another.

• Journal of Oral Medicine and Pain
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• v.40 no.2
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• pp.63-71
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• 2015

Purpose: To investigate the relationship between headache and sleep by evaluating sleep quality, daytime sleepiness, and specific features related to sleep-disordered breathing (SDB). Methods: One hundred one subjects with headache and 118 healthy controls were enrolled. To collect various information on headache attacks, headache group completed self-reported questionnaire about the characteristics of headache attacks and the migraine disability assessment (MIDAS) questionnaire. The subjective quality of sleep was evaluated in all of the subjects using the Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS). In addition, the following specific features of sleep were evaluated in 28 subjects selected randomly from each group: apnea-hypopnea index (AHI), prevalence of SDB, nocturnal oxygen saturation (SaO2), and oxygen desaturation index (ODI) as measured using a portable monitoring device. Results: The global PSQI and the prevalence of poor sleeping (global PSQI >5), ESS scores and the prevalence of daytime sleepiness (ESS score >10) were significantly higher in the headache group (both p<0.0001, respectively). The mean scores on the numerical rating scale and the MIDAS were significantly higher in the poor-sleeper group than in the good-sleeper group (p=0.0347 and p=0.0016, respectively). The global PQSI and prevalence of daytime sleepiness were significantly higher in the chronic-headache group than in the acute-headache group (p=0.0003 and p=0.0312, respectively). Conclusions: There is a significant association between headache and sleep. Especially, severity and chronicity of headache were significantly associated with sleep quality and daytime sleepiness.