Validation of the Karolinska sleepiness scale against performance and EEG variables

Clin Neurophysiol. 2006 Jul;117(7):1574-81. doi: 10.1016/j.clinph.2006.03.011. Epub 2006 May 6.


Objective: The Karolinska sleepiness scale (KSS) is frequently used for evaluating subjective sleepiness. The main aim of the present study was to investigate the validity and reliability of the KSS with electroencephalographic, behavioral and other subjective indicators of sleepiness.

Methods: Participants were 16 healthy females aged 33-43 (38.1+/-2.68) years. The experiment involved 8 measurement sessions per day for 3 consecutive days. Each session contained the psychomotor vigilance task (PVT), the Karolinska drowsiness test (KDT-EEG alpha & theta power), the alpha attenuation test (AAT-alpha power ratio open/closed eyes) and the KSS.

Results: Median reaction time, number of lapses, alpha and theta power density and the alpha attenuation coefficients (AAC) showed highly significant increase with increasing KSS. The same variables were also significantly correlated with KSS, with a mean value for lapses (r=0.56).

Conclusions: The KSS was closely related to EEG and behavioral variables, indicating a high validity in measuring sleepiness.

Significance: KSS ratings may be a useful proxy for EEG or behavioral indicators of sleepiness.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Adult
  • Analysis of Variance
  • Electroencephalography*
  • Female
  • Humans
  • Psychomotor Performance / physiology
  • Reaction Time / physiology
  • Reproducibility of Results
  • Sleep / physiology*
  • Surveys and Questionnaires*
  • Task Performance and Analysis