NA SA/TM-2001-211385

Crew

Factors

Alertness
Education
Mark

in Flight

Operations

Management
Module

R. Rosekind,

November

DOT/FAA/AR-01-01

2001

Philippa

H. Gander,

in Flight

Linda

X:
Operations

J. Connell,

and Elizabeth

L. Co

The NASA STI Program

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Information

NASA/TM-2001-211385

Crew Factors
Alertness
Education
Mark

R. Rosekind

Ames

Research

PhiIippa

in Flight

Operations

Management
Module

in Flight

Center,

California

Moffett

Field,

H. Gander

San Jose State

University

Ames

Research

Linda

J. Connell

Ames

Research

Elizabeth

Foundation

Center,

Moffett

Field,

California

Center,

Moffett

Field,

California

L. Co

San Jose
Ames

DOT/FAA/AR-01-01

State

University

Research

National

Center,

Aeronautics

Foundation
Moffett

Field,

and

Space Administration
Ames

Research

Moffett

November

Field,

Center

California

2001

94035-1000

California

X:
Operations

Acknowledgments
We thank

the many

supported

the activities

acknowledge
unions

Along
activities

ates);

the hundreds

that have

program

provided

were

Airlines);
Simmons

colleagues:

David

of Medicine),

Moline

School

of Medicine),

the structure
Aerospace
of Aviation

Keenan

of workshops

collaboration

support,

and Charlie

School

Sharon

pilots

Billings,

many

(School

Medicine,
Medicine,

(Institute
Dement

and Timothy
of Sleep

to implement

of the following:

Dinges
William

Hans

(Boeing)

and the

contributions

and

Anthony
Broderick,
William White,
and Preventive
Medicine
AssociHospital

School

(University

provided
Activities

Alex

operations;

and Clay Foushee

of Pennsylvania

this module.

possible;

this area for scientific

(Stanford

Monk

We wish to

the program

of the original

Graeber

Medicine)

Wegmann,

made

to flight

and support

of R. Curtis

in or otherwise

Program.

who have

and access

to highlight

due to the efforts

participated

Countermeasures

James Jenkins at NASA Headquarters;

at the FAA; Donald Hudson (Aviation

and academic
(Comell

Fatigue

pushed

with John Lauber

who have

of volunteer

resources,

continually

of Pennsylvania
Medicine).

and individuals

of the NASAAmes

that have

research.

(Northwest
and Ronald

air carriers,

particularly

the air carriers

pilot

pilots,

Samel,

of Pittsburgh

helpful
have

and University

of Medicine),
guidance

included

Margaret

School

of

in establishing

the International

and Alex Gundel

(DLR

Institute

of

Germany);
Anthony
Nicholson
and Peta Pascoe (Royal Air Force Institute
United Kingdom);
Barbara
Stone (Army Personnel
Research
Establish-

ment, United Kingdom);

Roderick
Barnes and Geoffrey
Bennett (Civil Aviation
Authority,
United Kingdom);
and Mitsuo Sasaki (Japan Air Lines and the Jikei School of Medicine,
Japan).

The Fatigue

Countermeasures

Program

has been

fortunate

to receive

tremendous

support from many individuals

at NASA Ames Research
Center, especially
William Reynard.
J. Victor Lebacqz,
former Chief of the Flight Human Factors Branch at Ames, has recently
made

invaluable

Countermeasures
dedicated
people

contributions

to all aspects

of the program.

Program
is an entity very much
actively involved in the program:

Lissa Webbon,
Keri Weldon,
and Malachi
Boyle.

Julie M. Johnson,

This publication

to John K. Lauber,

significant

is dedicated

contributions

to this subject

Ray

Hanover, MD 21076-1320
(301) 621-0390

Information

Finally,

Ph.D.,

the NASA

Ames

Fatigue

by the energetic,
hardworking,
and
Miller, Kevin Gregory, Roy Smith,

Oyung,

and to aviation

Available
NASA Center for AeroSpace
7121 Standard Drive

defined
Donna

Roxanne

and Charles

M. Johnson,

E. Billings,

Ron Anguilar,

M.D.,

for their

safety.

from:
National

Technical

Information

Service

5285 Port Royal Road

Springfield,
VA 22161
(703) 487-4650

CONTENTS

Foreword

........................................................................................................................................

Introduction

....................................................................................................................................

Presentation

Materials

with Text

Appendix

A:

Brief

Introduction

Appendix

B:

Brief Introduction

Appendix

C:

NASA

Ames

Representative

Appendix

D:

NASA

Ames

Representative

Appendix

E:

General

vii

....................................................................................................

to Sleep

Disorders

to Relaxation

Fatigue
NASA

Fatigue

Skills

Countermeasures
Technical

and Sleeping

Pills .........................................

.....................................................................

55

61

Program

Memoranda

Countermeasures

Publications

Readings

Operational

Summaries

....................

63

Program

......................................................................................

.....................................................................................................

83

87

FOREWORD

This report is another in a series of research reports from Ames Research

Center on the subject of
fatigue and jet lag in airline flight operations.
However,
the focus of this report is a bit different from
that of the others--rather
than being a scientific study of the causes and effects of fatigue and jet lag, it
is a compendium
of useful tips and personal
management
strategies
for better coping with such causes
and effects. The information
provided here is intended to be used by airline flight crew members to
help them develop effective
countermeasures
for the debilitating
effects of flight schedules
like the
following
one, which provided
me with my first glimpse of such operations.
The report's basic premise
is that in the modem world, there will always be a requirement
for 24-hour flight operations,
and that it
is possible for individual
crew members
to more effectively
manage rest and sleep periods, diet,
exercise, and other personal
factors in such a way that adverse performance
effects of such operations
will be minimized.
It is another tool that can be used by the professional
pilot to further enhance both
the quality

of performance

and the quality

of life.

JOHN K. LAUBER,
Member
National Transportation
December
1994

vii

Ph.D.
Safety

Board

INTRODUCTION

In 1980, in response
Lag Program

to a congressional

to examine

meridian

flying

transport

operations.

whether

and a potential

request,

"there

problem

''1 Since

NASA

is a safety

Ames

problem,

due to fatigue

1980, the Program

Research

Center

of uncertain

in association

has pursued

created

magnitude,

with various

the following

factors

three

goals:

mine the extent of fatigue, sleep loss, and circadian

disruption in flight operations;
effect of these factors on flight crew performance;
and (3) to develop and evaluate
reduce

the adverse

has been
extensive

a priority
research

went a name
increased

of these factors

since the Program's

to the operators--the

change,

becoming

of the Program,

became

important

rhythms

in flight

Although
Education
purpose

specific

and evaluation

is to promote

objectives:

With

this increased

It
under-

Program,

the

to highlight

(For a more complete

emphasis
about

and alertness.

acquired through its

In 1991, the Program

countermeasures.

what had been learned

is presented

in three

operations

affect these physiological

distinct

on countermeasures,

fatigue,

it

sleep, and circadian

factors.

in flight operations.

state of knowledge

how this knowledge

sleepiness,

The second

fatigue

to improving

management.

factors

in flight

and how flight

some widely

recommendations

and Training

to

the physiological

rhythms,

part identifies

This Education

about

for alertness

circadian

the third part provides

It is intended

can be applied

The first part addresses

on sleep,

why they are false. Finally,

and productivity.

and (3) to offer strategies

parts.

basic information

performance,

the current

and alertness;

It provides

strategies

safety,

(2) to demonstrate

operations.

tions and shows

aviation

(1) to explain

fatigue;

crew sleep, performance,

management

of fatigue

2 below.)

and disseminate

Countermeasures

the
to

to accumulate,
there is now enough scientific and operational data to create this
Module on strategies for alertness management
in flight operations.
The overall

underlying

This module

Fatigue

in air

operations.

of this module

mechanisms

Ames

found

(1) to deter-

(2) to determine
countermeasures

flight crew performance

inception
to return the information
line pilots, air carriers, and others.

see footnote

to organize

data continue
and Training

meet three

and to maximize

the NASA

focus on the development

description

flight

effects

a Fatigue/Jet
due to trans-

held misconcepfor alertness

Module

is intended

to be

offered as a live presentation

by a trained individual.
Its interactive
format will provide a forum
discussions
of how this information
and the recommended
strategies
can be applied in specific

for
flight

operations.
This NASA/FAA
includes
Ames

document

a foreword
Fatigue/Jet

by Dr. John K. Lauber,

Lag Program

The information

contained

I Pilot

Circadian

Fatigue

August

was developed

attd

26-28,1980.

NASA

to complement

one of the original

and a former

Member

in the presentation

Desynchronosis.
Technical

the live presentation

slides

(1980).

Memorandum

constitutes

Report
No.

investigators

of the National

Moffett

held
Field,

who started

Transportation

the main

of a workshop

81275.

of the Module.

the NASA

Safety

Board.

body of this publication.

in San Francisco,
CA:

It

National

CA,

Aeronautics

on
and Space

Administration.

2Rosekind,
NASA

Ames

M.R.,

Gander,

Fatigue

P.H.,

Miller,

Countermeasures

D.L.,
Program.

Gregory,
FAA

K.B.,
Aviation

ix

McNally,
Safety

K.L.,
Journal,

Smith,

R.M.,

3(1),

20-25.

and

Lebacqz,

J.V.

(1993).

Brief introductions

to sleep disorders

and B, respectively.
in short-haul,
in long-haul

Appendix

long-haul,
flying.

and to relaxation

C contains

and helicopter

summaries

The format

of this publication

a reference

for those

of relevant

operations,

The last two appendixes

NASA Ames Fatigue Countermeasures

sleep disorders, and circadian
rhythms

is designed

NASA

in appendixes

publications,

studies

publications

from the

(1) to facilitate
the slides

including
cockpit

D) and a list of general

For trainers,

study on planned

a list of representative

(appendix
E).

for two purposes:

who use the information.

are presented

and the NASA/FAA

provide

Program
(appendix

techniques

readings

training

provide

rest

on sleep,

and (2) to provide

presentation

material,

while the text provides

the Module. For those

some guidelines
as to what information
should be addressed
when presenting
applying the information,
the text elaborates
on the slides for later reference.

This is the first formal

step taken by the NASA

education
recommend
advances
mendations.
appreciated.
MS 262-4,

and training
strategies
are made,

this module

Therefore,
Please
Moffett

information

on fatigue,

for managing

alertness

will evolve

any comments,

Ames
sleep,

Fatigue

Program

Countermeasures
rhythms

in flight

on the flight deck. As future

and circadian

scientific

to incorporate,

questions,

the latest findings,

or requests

address them to: Fatigue Countermeasures

Field, California
94035-1000.

regarding
Program,

operations,

NASA

and to

and operational

information,

this module

to provide

and recom-

would

Ames

be greatly

Research

Center,

Alertness

NASA

Ames

Management

Research

Human Factors Research

in Flight Operations

Center

and Technology

Division
Fatigue

Countermeasures

Program

Objectives
Explain the current state of knowledge about
the physiological
mechanisms
underlying fatigue
Demonstrate
how this knowledge
can be applied to improving flight crew
sleep, performance,and
alertness
Recommend

alertness

management

strategies

Fabgue Countermeasures

In response
initiated

to a 1980 congressional

a Fatigue/Jet

disruption

Lag Program

in aviation.

environments

using

physiological).
Program,

Research
a range

and performance

Aviation

Administration
research
From

and other

the inception
from

community.

The

objectives

has been

specific

learned

fatigue

of the aeronautics
safety

and policy

operational
of fatigue,

research

about

the application
countermeasure
industry,

environment
sleep

Ames

sleep

loss,

of flight

to performance

into the Fatigue

Over

to

Countermeasures

of strategies

to maintain

the years,

a collaborative

a principal

and other

the Federal

partner

in support

Program

goal

was to return

activities

of

and Training

Module

the physiological

mechanisms

that underlie

of this information

in flight

recommendations.
pilots,

maintenance

crews,

that challenges

human

disruption.

attendants,
and

are to explain

operations,

It is intended

flight

others

physiological

the

to the operational

of this Education

loss, and circadian

Center

and circadian

in a variety

self-report

settings.

Research

activities.

including

personnel,

fatigue,

and evaluation

of the Program,

learned

demonstrate

evolved

has become

Program

NASA

fatigue

(from

in operational
(FAA)

information
what

of measures

the development

alertness
fatigue

to examine

has examined

In 1991, the program

emphasizing

request,

Program

fatigue,

and offer

some

for all segments

managers,
involved

schedulers,

in an

capabilities

because

Overview
Fatigue

Factors

in Flight Operations

Common

Misconceptions

Alertness

Management

Strategies

Discussion
Fatigue

The presentation
there

that fatigue
(i.e.,

is divided

is a description

of fatigue

is of national

sleep and sleep

flight

operations

misconceptions
information
Third,

on these

to use during
reader's
examples

and a discussion
rhythms

fatigue

factors).

of countermeasures
going

duty periods.

Finally,

activities.

a critical

provided

The discussion

of how this information

differences,

audience.

It is intended

to be highly

including

notions

of the

are incorrect.

preventive

as well as operational

component

approaches

of this module

is the

of the audience's

is intended

to demonstrate

and give

to different

interactive

types

operational

with specific

that

countermeasures

demands

and the varying

of

of common

to the specific

can be applied

physiological

examples

and application

why these

are presented,

on duty or on layovers,

of fatigue

and the effects

several

are presented,

First,

a demonstration
causes

disruption,

Second,

Program

by a discussion.
including

of the principal

and their

in aviation

individual
participants.

followed

in the first part demonstrates

of the information
flight

parts,

in flight operations,

physiological

regarding

can be used before

application

interest

loss, circadian

provided

a variety

into three

factors

Countermeasures

of flight

specific
schedules,

requirements
examples

or

provided

of a given
by

Fatigue Factors in
Flight Operations

Fatigue Countermeasures

The first two sections

of this part

will discuss

the two main

Program

physiological

factors

that affect fatigue:

1) sleep and sleep loss, and 2) circadian
rhythms.
With the principles
of these physiological
factors as a background,
a third section will then discuss the
effects

of flight

operations

on fatigue.

Is Fatigue a Concern in Flight Operations?

National

Transportation

Safety

Board

(NTSB)

- "...it is time for an aggressive Federal program to address the

problems of fatigue and sleep issues in transportation safety"
- "...educate pilots about the detrimental effects of fatigue and
strategies for avoiding falJgue and countering its effects"
- Fatigue cited as probable cause in Guantanamo Bay aviation acddent

Federal

Aviation

Administration

(FAA)

- An objective of the National Plan for Aviation Human Factors

Fatigue

The following
a national
level.

sources

indicate

that fatigue

is a concern

Countermeasures

Program

acknowledged

at

The National
Transportation
Safety Board (NTSB) has stated the following
in
Safety Recommendations
1-89-1, 1-89-2, and 1-89-3:
"Based on its experience
in
accident
investigation,
the Safety Board believes
it is time for an aggressive
Federal
program
to address the problems
of fatigue and sleep issues in transportation
safety."
On January
19, 1994, based on a Safety Study Review,
the NTSB
recommended
that the FAA "Require
U.S. carriers operating
under 14 CFR Part
121 to include, as part of pilot training,
a program to educate pilots about the
detrimental
effects of fatigue, and strategies
for avoiding
fatigue and countering

its

effects."
A parallel recommendation
was made regarding
Part 135 carriers.
For the
first time, the NTSB cited fatigue as a probable
cause in the Guantanamo
Bay
aviation
accident.
Through
the research
and other activities
of the NASA Ames
Fatigue Countermeasures
Program,
the FAA, and the NTSB, aviation is ahead of
most other modes of transportation
in examining
the issue of fatigue and,
especially,

in developing

The FAA's

National

potential

countermeasures.

Plan for Aviation

Human

Factors

identifies

fatigue

as an

area for continued

basic and applied research.
These are only three examples
of
highly visible national agencies
that acknowledge
and call for continued
activities
addressing
the issue of fatigue in aeronautical
operations.

What Can Be Done About

Change

the FARsmtakes

Research

Apply

fatigue

strategies

an act of Congress

i,ssues that support

Fatigue?

better

FAA efforts

cope with the current

Fatigue

This presentation
complex

issue

will clearly

that can be addressed

should

receive

attention.

The Federal
be a long process
established

an Aviation

the FAA

Rulemaking

policymakers

approach

is to conduct

concerned

research

with regulatory

possible

approach,

used right now by any individual

operations.

The basic

all in the aviation

situation.

information

industry

Committee
within

that examined

current

FAR

industry.

Also,

scientific

data to be used by

the information

provided

of the FARs.

the production

demands

recommendations

their ability

to cope

The

of Advisory

in this presentation

by the physiological

recently

group

the aviation

This can

requirements.

including

to improve

of incorporating

flight/duty/rest

of actions,

who want

operations

fatigue.

evaluated

or interpretation

and countermeasure

of the aviation

The FAA

working

group

that provides

challenged

is a

in flight

one means

in its own right.

issues

operations

that produce

team to examine

Program

here.

provide

and application

research can be the basis for a variety

Circulars.
In another

could

The working

a rulemaking

in flight
component

mechanisms

Advisory

and their interpretation

has established

Another

(FARs)

the physiological

requirements.

every

situation

Countermeasures

and performance

are provided

and one that can be complex

flight/duty/rest

requirements,

Rather,
alertness

examples

Regulations

about

that fatigue

answer.

to improve

Several

Aviation

what is now known

current

demonstrate

with no one simple

system

(almost)

can be
of flight

can be used by
with the existing

NASA Fatigue Countermeasures

Program

Since 1980, research on fatigue, sleep, and circadian

rhythms in different types of flight operations
Testing

and implementation

of alertness

strategies

Input to FAA
Example:
3-person

In-flight test of naps as a strategy

in
long-haul
crews; FAA in NPRM process

Scientific

and technical

publications
Fatigue Countermeasures

This information
the foundation

provides

for the development

the NASA

Ames

conducted

fatigue

Fatigue

improve

cockpit

on the Flight
of scientific
and other

An example

Deck."

information

tive Program

important

during

ongoing

critical

(NPRM)
Program

and potential

for further

reading

Since

1980,

with the FAA,

has

and implementation
NASA/FAA

of a controlled
phases

articles,

countermeasures.
are provided

study
in-flight

of flight.

process

of
nap to

The

for "Controlled

contribution

as well as industry

to fatigue

suggested

the testing

is the recent

Rulemaking

publications,

related

publications

activities

that created

Module.

in collaboration

the effectiveness

and performance

for Proposed

Another

and technical

of these

and activities

and Training

Program,

it has emphasized

demonstrated

alertness

in the Notice

into the research

of this Education

recently,

rest, which

subsequent

is currently

insight

Countermeasures

research;

of countermeasures.
planned

some

Program

FAA
Rest

is the production

reporting
Some

study

results

representa-

in appendix

D.

Causes

of Fatigue

Sleep loss ,c

Circadian

-..

"'I

rhythms

CREW
FATIGUE

Effect of flight operations on

sleep and circadian physiology
Fatigue

Fatigue

is really

for example,

physical

concentration
important

a catchall

In the context

reduces

efficiency

affected

by motivation
there

a monotonous

long or irregular

of flight operations,

or otherwise

impairs

loss and circadian

operations.

important

circadian
NASA

disruption,
Fatigue

of stimulation
causes

rhythmsnboth
be a source

Program

focuses

of muscles,

appreciating

or simply
fatigue

performance.

coming

becomes

important
fatigue

(and

if it

can be

poorer

are affected

rest can result

on these

staying

from the environment.

of fatigue

of fatigue

potentially

difficulty

Subjective

of which

to note that inadequate

and can therefore

Countermeasures

hours,

Progmrn

experiences,

group

difficulty

crewmember

physiological

performance)--sleep

subjective

a particular

task,
work

crew

or by the amount

are two systematic

It is also

of different

after overworking

during

following

awake.

However,

discomfort

difficulties
signals

term for a variety

Countermeasures

in sleep

in its own right.

factors.

by flight
loss and
The

Fatigue

Factors

in Flight Operations:

Sleep and Sleep Loss

Fatigue

This section
sleep

provides

and the effects

basic

of sleep

information

about

loss and sleepiness.

the complex

Countermeasures

Program

physiological

process

of

Sleep Physiology:
NREM

(non-rapid

Physiological
Light

Two States of Sleep

eye movement)

and mental

sleep

(stages

activity

slowed

1 and 2); deep

sleep

REM (rapid eye movement)

Physiological
An active

and mental
brain

activity

(dreaming)in

sleep

(stages

sleep
increased

a paralyzed

body

Fatigue

It is widely

believed

that sleep is a time when

then re-engage

upon

awakening.

process

which

the brain

during

and quiet,

but are never

non-rapid

eye movement,

states

are as different

During
breathing

NREM

activity

sleep

during

may take

REM

occurring

NREM

to wake

for 10-15
sleep

minutes.

is associated

bursts

of rapid

eye movements

REM

sleep,

the major

REM

sleep,

individuals

motor

Program

and the body

is a highly
between

complex
periods

shut off and

physiological
of extreme

of two distinct

eye movement,

and mental
NREM

stages

3 and 4.

sleep.

activities
sleep

states:
These

activity
NREM,

or

two sleep

This phenomenon
with an extremely
(probably

of the body

can often provide

detailed

10

sleep,

to feel groggy,

sleepy,

is called

inertia.

brain

are paralyzed.
reports

an individual
and perhaps

that is dreaming,

the activity

with

very little mental

this deep
sleep

rate and

into four stages,

is usually

during

active

following

slow (e.g., heart

is divided

3 and 4. There

If awakened

up and then continue

muscles

Countermeasures

as they are from wakefulness.

regular).

during

stages

the brain

is composed

or rapid

physiological

and become

sleep
alternate

Sleep

and REM,

sleep,

sometime

disoriented

and body
off."

from each other

rate slow

the deepest

"shut

Actually,

3 and 4)

of the dream);
If awakened

of their dreams.

and with
during
during

Sleep Architecture:

NREM

and REM alternate

Most deep

NREM/REM

throughout

each

Cycle

sleep

period

sleep occurs in the first half of the sleep period

REM periods

are longer

and more regular

later in the

sleep period

Fatigue

Over
about

the course

60 minutes

90-minute
sleep

cycle

(i.e., NREM

are shorter
the sleep
is spent

early

of a typical
of NREM

repeats
stages

sleep

Overall,

in NREM

stage

NREM

followed

itself throughout
3 and 4) occurs

in the night

period.

night,

by about
a typical

25%

sleep

30 minutes

sleep

period.

in the first third

and then become

about

and REM

of sleep

2.

11

longer

occur

Program

of REM
However,
more

in REM

in a cycle,

of the night,

and occur

time is spent

Countermeasures

sleep.
most

and REM
regularly

sleep

with
This
deep
periods
later

and about

in
50%

Histogram

of Normal Sleep

Wake

REM

Stage

Stage 2

Stage 3

Stage 4

2400

0100

0200

0300

0400

0500

0600

0700

Time
Fatigue Countermeasures Program

This _:raph portrays

sleep architecture

a typical

discussed

and NREM

alternating

of the sleep

period;

throughout
and REM

night

of sleep

on the previous
the period;

periods

for a normal

slide:

becoming

sleep period.

12

REM

most

deep

longer

adult.

(indicated
sleep

It exemplifies
by darkened

occurring

and more

regular

the
bars)

in the first half

later

in the

Sleep Physiology
Amount

and structure

of sleep

changes

over the life span

Sleep becomes less deep, more disrupted, and total nocturnal sleep decreases
Daily percentage sleep loss is 3.5 times greater in long-haul Night crewmembers
aged 50-60 than in those aged 20-30

Quantity

vs quality

of sleep

Getting 8hr of disrupted sleep can have effects similar to too little sleep
After sleep loss, sleep is deeper rather than longer

Fatigue

The amount
increased

and structure

age, sleep

of sleep

becomes

more disrupted
(awakenings
It is not that older individuals
obtain

a consolidated

changes
flight

is reflected

crewmembers

during

aged

trip schedules

The quality
individual.

of sleep

of times,

of sleep
is a sleep

causes

disorder

both legs twitching

each

leg twitch,

occur

during

one sleep

awakenings

that sleep
have
might

commonly
by sleeping

demonstrated

NREM

period.

stages
sleep

The

held belief
a number

that following

3 and 4), rather

somewhat

longer,

loss 3.5 times

greater

tens or

may feel as if only a few hours

reasons

for disrupted

sleep
during

sleep"

A for further

8 hours

equal

deprivation,

than extended.

13

brief

unaware

lost.

sleep

feature

sleep,

With

awakenings

can

of the twitches

or

sleep.
has to "'make

Scientific

recovery

there

one or

information).

of this fragmented

recovery

During

but the most notable

involves

loss, an individual

to those

from

For example,

that

of these

can be completely
after

sleep,

disorders.

Hundreds

is that after sleep

sleep

part

Long-haul

is disrupted

briefly.

sleeper

of hours

sleep

This normal

study.

of sleep but the sleep

(see appendix

and tired even

of age.

These

an

leg movements

sleep

and

in restoring

to physical

is awakened

With

of sleep

diverse

light)

decreases.

a NASA

the individual

are many

"periodic

but feel sleepy

Another

8 hours

noise,

throughout

as 50 years

as the quantity

awakening,

There

sleep

from

years.

the life span.

of nocturnal
sleep decreases.
that with age, our ability to

finding

percentage

20-30

Program

3 and 4 disappears)

as early

had a daily

obtains

the sleeper

over

stages

aged

can be as critical

(e.g.,

called

starting

50--60

then upon

were obtained.

environmental

NREM

of nocturnal

in a recent

than those

If an individual

hundreds

period

in individuals

process

profoundly

(most

increase),
and the total amount
need less sleep, but it appears

and continuous

can be seen

of the aging

change

less deep

Countermeasures

laboratory

is deeper

up"

studies

(more

an individual

is the increase

in deep

sleep.

Sleep Physiology
Effects

of alcohol

Suppresses

REM, leads to withdrawal effects and more disrupted sleep

Short-haul

pilots increase consumption threefold on trips

Can interact with sleep loss to increase sleepiness

Effects

of medications

Can delay sleep onset, disrupt sleep structure, alter total sleep time

Effects

of environmental

Noise, temperature,

factors

light, etc. may interfere with good sleep

Fatigue Countermeasures

Alcohol
couple

has a profound

of glasses

can essentially

of wine

eliminate

effect

on the usual

or a couple

of beers

all of the REM

This can lead to subsequent

alcohol

period,

including

sleep

fragmentation.

aid in the United

States

is alcohol.

relaxation

and the ability

effects

on the subsequent

pilots

increased

home

consumption.

their

after long duty

onset

before
sleepy

impairment
There
counter,

are many

medications,
sleep time.

Environmental

factors

or high temperatures,
quality

of sleep.

environmental

factors

half of the

segments

have

found

major

that short-haul

trips compared

with

to unwind

and to promote

duty day.

used

used to

guidelines
Alcohol

sleep

also interacts

individual

performance

(non-sleeping

affect

sleep.

sleep

support,

on sleep

pill),

Depending

onset,

disrupt

may also interfere

and a variety

With FAA

severe

alcohol
period.

who is

and alertness

consumption.

medications

they may delay

FAR

A sleep-deprived

more

alcohol

that can adversely

flight

for the subsequent

with sleepiness.

often

study

during

within

the most widely

it will generally

threefold

multiple

than

variations),

although

One NASA

used alcohol

will demonstrate

following

sleep.

more

in the second

Unfortunately,
Ironically,

consumption

wake-up

fashion

After

individual

effects

to fall asleep,

days that included

an early

in a synergistic
already

alcohol

The pilots

cycle.

in the first half of a sleep

withdrawal

sleep

disruptive

(with

sleep

sleep

promote

sleep

Program

of other
NASA

in on-board

14

both prescribed
on the specific

the sleep

wish good
factors

action

structure,

sleep.

can decrease

has examined

and over-the-

Noise,

or alter

light,

the quantity

the effects

crew rest facilities.

of these

of

total

low
and

Sleep Physiology
Sleep disorders

can disturb

sleep and waking

alertness

Sleep problems can be diagnosed and treated by sleep-disorder

Sleeping

specialists

pills

Some help you fall asleep, stay asleep, which may improve your waking alertness
Some alter sleep structure, create dependency,

have carryover effects that

may decrease waking alertness and performance

Only recommended

at the prescribed dose for short periods of time

May have potentially serious side effects

Fatigue Countermeasures

There

are physical

alertness
apnea.)
occur

sleep

and performance.
These

sleep

and treated

Appendix

sleeping

subsequent

unaware

by accredited

pills alter

carryover

effects

medications
Many

sleeping

taken

except

in waking
structure

that decrease

typically
under

means

falling

alertness
alertness

the lowest

can have potentially

the care and guidance

existence.

information

serious

asleep
create

waking
as sleep

function,

and yet

problems

can be

specialists

about

sleeping

and staying

and clinics.
pills.

asleep,
However,

drug dependence,

and performance.

Some

with
many
and have

Proper

use of these

and that for only a few days.

side-effects,

of a physician.

15

Sleep

and performance.

dose,

such

on waking

sleep disorders

dramatically,

waking
taking

and impair

examples,

effects

of their

general

pills may facilitate

sleep

pills

some

sleep

A for some

profound

essentially

improvements

sleeping

can have

effectively

A also provides

prescription

that can disturb

(See Appendix

disorders

with the sleeper

diagnosed

disorders

Program

and none

should

be

Sleep is a Vital Physiological

Sleep

loss is additive

Sleep

loss leads

Consequen

and results

to increased

Function

in a cumulative

sleep

debt

sleepiness

ces of sleepiness

Decreased physical and mental performance

Decreased positive and increased negative mood
Increased vulnerability to performance decrements

Fatigue Countermeasures

Like food and water, sleep is a physiological

need vital to human survival

Program

and critical to

human existence.
Sleep loss can be additive and can result in a cumulative sleep debt. Estimates
suggest that in the United States, most people get 1-1.5 hours less sleep than they need. During a
regular 5-day work week a typical individual might accumulate a ?.5-hour sleep debt, equal to a full
night of sleep loss, going into a weekend.
In today's society, many individuals actively attend to
their nutrition and exercise to promote good health. Unfortunately,
the first physiological
need that
suffers when individuals are faced with everyday pressures and demands is sleep. Losing sleep
becomes a way of squeezing more hours and minutes into the day, which demonstrates
a lack of
concern for meeting this vital physiological
need.
Sleep loss leads to increased waking sleepiness. Many people equate sleepiness with
being lazy or acknowledge
it only humorously.
Sleepiness can have severe consequences
for us
as individuals and as a society. Sleepiness can degrade essentially every aspect of human
performance.
Sleep loss and sleepiness can decrease physical, psychomotor,
and mental
performance,
and can increase negative mood and decrease positive mood. Therefore, a principal
consequence
of sleepiness is an increased vulnerability to performance
decrements.
It is important
to consider this as a performance
vulnerability because, like the effects of alcohol on performance
and memory, sleepiness can lead to a reduced safety margin and an increased potential for
operational incidents and accidents. Sleep loss and sleepiness resulting from extended duty or
altered work/rest schedules have been suggested as contributory factors in many accidents and
catastrophes.
As individuals, many people put themselves at personal
sleepy, sometimes experiencing
a near incident or an actual accident.
Sleep loss can result in a cumulative

sleep debt and waking

risk by driving when too

sleepiness.

Sleepiness

should

be taken seriously. Its profound effects on waking performance,

mood, and alertness can create a
vulnerability
to operational
incidents and accidents.
That vulnerability can be minimized, thus
potentially

avoiding

an incident

or accident.

16

Sleepiness:

Two Distinct

Physiological
-

Lose

Underlying

Only

Components

sleepiness

sleep,

get sleepy
biological

reversed

Subjective

process

by sleep

sleepiness

How

you feel;

Can be concealed
stimulation,

what

you report
or altered

physical

by environmental

activity,

caffeine,
Fatigue

Two distinct
sleepiness

parallels

of food

or water,

by developing
brain's

components

Subjective
awake
rating

sleepiness

and alert"

an individual

conversation.
underlying

sleep

and thirst.

An individual

functions
When

like hunger

sleepy,

physiological
is physically
these

ready

factors

will report
expressed

greater

sleepy,

may affect
alertness

hunger

only sleep

assessment

rating

than is warranted),

and a
"wide

stimulation.

by an environment
or is engaged

the self-reported

from

this self-reported

such as environmental
caffeine,

the

or thirst

will reverse

on a scale

However,

met

of sleep,

of the feeling

sleepiness

by the level of physiological

17

Deprived
not been

deprived

can be concealed

has consumed

have

or eliminate

to nod off."
of factors,

sleepiness

active,

and thirst.

needs

physiologically

introspective

Program

Physiological

vital physiological

can rate current

by a variety

Countermeasures

described.

is physiologically

is an individual's

affected

need

been

Just as the only way to reduce

to "extremely

Whereas

individuals

that these

an individual

of that status.

can be strongly

(usually

of hunger

when

The level of underlying

which

signals

is sleepiness.

is to eat or drink,
this vital need.

have

vital physiological

the brain

feelings

signal

self-report

other

of sleepiness

etc.

of sleepiness

they do not affect

sleepiness.

in

in a lively
the

Subjective vs Physiological
Sleep and Alertness
It can be difficult
and alertness,
The good

to reliably

especially

estimate

your own sleep

if you are already

sleepy

news:

Tendency to overestimate time to fall asleep and underestimate

total sleep time

It may not be as bad as you think

The bad news:

Tendency to report greater alertness than indicated by physiological

measures

It may be worse than you think

Fatigue Countermeasures

It is usually
waking

alertness,

Overall,
it takes

there

Generally,

likely

people
experiences

to be sleepier

faster

a bad night

than they report

their

own sleep

of sleep,

longer

or their

or experience.

18

how long

to physiological
than they think.

So

it may not be as bad as it seemed.

to subjectively

measures.

overestimate

time, relative

and sleep

is for individuals

by physiological

to subjectively

e total sleep

fall asleep

estimate

sleepy.

for _,,dividuals

and underestim:

the tendency

alert than is indicated

to reliably

if they are already

is a tendency

an individual

However,

for most individuals

especially

to fall asleep

measures.
when

difficult

Program

That

rate themselves

is, most

individuals

as more
are more

Factors

Affecting

Sleepiness

Prior sleep/wakefulness
Circadian

phase

Age
Medical

conditions

Medications
Alcohol
Environmental/work

conditions
Fatigue

These
could

factors

have

be considerations

been

demonstrated

in worsening

to affect

or improving

19

waking
sleepiness.

CoJntermeasures

sleepiness

Program

and therefore

Sleepiness

In a usual 24-hour
increased

sleepiness:

Performance
during

day, there are two times of

3-5

a.m. and 3-5

and alertness

p.m.

can be affected

a 2 a.m. to 6 a.m. window

Fatigue Countermeasures

We are physiologically
usual

24-hour

period.

performance,

The period

and alertness.

The other period

experienced

programmed
3-5

During

of increased

an afternoon

for two periods

A.M. is a circadian

sleep periods or naps because the brain

increased opportunity
for sleep.
Performance

and alertness

from 2 A.M. until 6 A.M.

between

2 P.M. and 4 PM.

is roughly

of sleepiness.

provides

can be decreased

For some,

the afternoon

This highlights

3-5

These

some

20

sleepiness

in a

low point for temperature,

this time, the brain triggers

sleepiness

wave

of maximal

Program

P.M.

sleep

Most individuals

windows

have

can be used to schedule

a period of maximal

during the nocturnal

window

and sleepiness.

sleepiness

window,

of sleepiness

of the differences

and an

which

may occur

among

individuals.

is

Fatigue

Factors

in Flight Operations:

Circadian

Rhythms

Fatigue Countermeasures

This second
how they

apply

physiological

section

provides

to fatigue,
factor

basic

information

jet lag, and shift work.

that affects

fatigue

in flight

21

about

circadian

Circadian
operations.

rhythms

Program

rhythms

_,4

and

are the second

Circadian
Circa

= about;

A circadian

clock

= day

in the

brain

coordinates

Sleep/wake

Performance

Temperature

Hormones

Digestion

Etc.

Without
the

dies

Rhythms

any

timing

biological

information

day

is about

from
25

daily

the

cycles:

environment,

hours

Fatigue Countem_asures

Over

evolutionary

the Earth's
biological

clock

the beginning
which

there

expedient

When

people

to live "days"

long someone's
circadian

even

develop

"days"

The circadian
Many
must

synchronized

each

circadian

appropriately,

longer

than

25-hour

as long as 50 hours

be capable

since

environment

in

and services.

equally

medical

The

at any time of

diagnosis

and

all possible

time cues have

been

or specially

designed

apartments),

24 hours.

Regardless

of how

in a time-free

an approximately

systems

which

bunkers,

becomes

environment,
cycle

however,

in many

with, for example,

the

functions.

36 hours

Some

of

of sleep.

can be thought

different

of generating

from

underground

by 14 hours

clock

from

of a

regulations.

"day"

still enforces

followed

orchestra.

in our society,

that are generally

subjective

clock

wakefulness

orchestra

caves,

However,

operations

by

in the form

a cultural

that we can and do function

live alone in environments

(deep

developed

(produced

circuitry

of the hypothalamus.

for round-the-clock

activities

hours-of-service

environment

into our neuronal

we have

pressure
many

in the physical

nucleus

assumption

underlies

excluded

they begin

cycles

hard-wired

revolution,

is ever-increasing

to many

carefully

the daily

become

in the suprachiasmatic

(but incorrect)

treatment

capable

have

of the industrial

the day or night

people

time,

rotation)

Program

of as analogous

in the body,

rhythms
of playing

the harmony

down

independently,

to the conductor
to the level

22

of individual

just as the members

their own part.

rapidly

of a symphony

degenerates

However,

cells,

are

of an

if they are not all

into cacophony.

Circadian
Pra-ITip

Rhythms

Tr_
da/1

of a DC-9 Pilot

Trip
day' 2

Trp
dw 3

Post-trip
day 1

Post-b'_
day 2

39
38
Temperature

37
36
35

140
Physical activity
(actigraphy)

105
7O
35
0
8O
6O

Fatigue

4O

(subjective)

20

30Activabon

20

(subjective)

1O 00

This figure
a 46-year-old
short-haul

DC-9

2 hours,

a number
First

Officer

using

a logbook

every

Fatigue Countermeasures

monitor

(measured

carried

in the eastern

biomedical

activity

Duty period

shows

flying

portable

Seep period

of different
before,
United

which

in which

during,
States.

he rated

these

his core body

his fatigue

measured

and after 3 days

and average

records

rhythms

To obtain

recorded

actigraphy),

and kept detailed

circadian

heart

and mood,

simultaneously

of scheduled

temperature,

level of physical

2 minutes.

including

in

commercial

data, the pilot wore

rate every

of all his activities,

Program

He also

subjective

including

when

being

asleep.

activation,
and how well

he slept.
Vertical
was flying
maintained

shaded

bars

during

their normal

This figure

temperature

before

he awakened.
activity.

cyclic

variation

heart

rate closely

times

when

feature

a minimum

in the setpoint
paralleled

his daily

of the circadian

the end of the day the pilot felt more

temperature

sleep

period,

and reported

23

he

rhythm.

is envisaged

system.

In general,

activity.

less activation.

The

to rise well

of increased

which

in the level of physical

fatigued

Since
the trip

and began

is not the result

clock,

of the temperature-regulating

the changes

during

and to the environment.

rise in temperature

the action

rhythms

of the circadian

during

This spontaneous
It reflects

his circadian

to one another

an important

reached

the pilot reported

at night,

relationships

illustrates

pilot's
physical

indicate

the day and sleeping

to drive

changes

in

As expected,

by

Circadian
The

circadian

Bright

clock

is synchronized

- In the middle

advances

Work/rest

day are known

types

by the German

light

lux) affects

have

(more

been

clock

2500

in the subjective

exposure

in the middle

3. Light

exposure

in the subjective
a circadian

that the clock

morning

would

with an innate

period

exposure

be advanced
achieve

of 23 hours

There
social
which

day depends
is some

factors,

environment

light is generally

they affect

the clock

that the human

a delay

the eye.

cycles.

effect.

circadian

An appropriate

cycles.

to a 24-hour
exposure

are intended

day

to sunlight

to synchronize

a clock

of 1 hour per day, in other

examples

The

is reasonably

circadian

of 25 hours

Conversely,

These

have

of different

circadian

schedule.

time cues
remain

period

resetting.

combination

the work/rest

that constitute

subsequent

less than 500

cycles

subsequent

two

factors.

words,

an

to illustrate

(also known as "entrainment").

Clearly, however,
they
life, synchronization
of an individual's
circadian
clock to

on a complex

evidence

including

with an innate

require

from

day has minimal

delays

evening.

pathway

by light/dark

advances

by 1 hour per day.

the mechanism
of synchronization
are highly simplistic.
In everyday
a 24-hour

indoor

evening

would

Currently,

lux--normal

morning

every

"time-givers.'"

neural

clock

it to a 24-hour

light and social

of a direct

circadian

synchronize

to bright

the necessary

to sunlight

which

meaning

of the subjective

clock

the human

exposure

by means

exposure

appropriate

time cues

term "zeitgebers,"
identified:

1. Light

every

dock

the environment,

synchronization
of the circadian
clock
and can be summarized
as follows.

To synchronize

Program

clock

interaction

2. Light

requires

delays the circadian

environmental

than about

the circadian

principle
behind
well understood

Fatigue Countermeasures

the circadian

is recei _'ed from

The specific

of zeitgebers
Bright

social

information

to run slow.

by:

schedules

Regular

tends

daily

of the day has little effect

- In the evening

timing

(reset)

light (sunlight)

- In the morning

Unless

Rhythms

clock

However,

not yet been

unknown.
24

zeitgeber

inputs.

may be synchronized
the specific

identified,

aspects

by certain
of the social

and the mechanisms

by

Circadian

The circadian

clock

environmental

Rhythms

cannot

adapt immediately

time or to a duty/rest

to a new

schedule

change

Fatigue Countermeasures

We cannot,
However,

as yet, reset

It may take days

one transmeridian
have

1-2 days

flight.

Thus,

at each

adapt

to yet another
rotating

few days),

circadian

easily

Europe.

performance
This approach

to normal

rotations

if ever,

daytime

is generally
engendered
schedule

fully adapted

on their

rapid

the hours

are examined

25

sleep

of work

layovers.

on their

have
hours

is minimal,

of work

to
for

every

and workers
common

1-2 weeks),

work/rest

next
trying

developed

is more

every

at least

schedule

then means

This approach

usually

transmeridian

to one work/rest

(changing

after

crews

time during

to work

pattern

progressively,

in the United

another

approaches

to a given

by the slow adaptation

changes

back

rotations

days off.

(changing
to improve

watches.

time zone

flight

and nighttime

going

to any one work/rest

preferred

to local

Two different

With

to a new

operations,

they operate

activity

shift workers,

time to synchronize

are thus expected

and duty/rest

long-haul

before

schedule.

day-active

has more

The problems
zones

are rarely,

adaptation

to synchronize

fully synchronized

shift workers.

slower

clock

destination

of rotating

at will, as we do our wrist

J_

countermeasures.

commercial

become

work/rest

to being

With

circadian

layover

back

In the case

scheduling
revert

rhythms

for all rhythms

During

shift workers

they switch

days off.

to weeks

flight.

they seldom

Similarly,
before

our circadian

this is the aim of most circadian

Program

schedule.

in

the
Sleep

and

until the next day off.

States.
of circadian
in the following

rhythms
slides.

to new time

Shift Work
Night

work:

awake

any schedule

and active

Requires

when

overriding

pre-programs
Creates

they

would

the circadian

daytime

conflict

that requires

activity

between

someone

nownally
clock

to be

be asleep

which

and nighttime

environmental

sleep

synchronizers:

- Work/rest schedules
- Day/night cycles
- Day-oriented
People

society

switch

back

to daytime

activity

on days

off

Fatigue Countermeasures

The basic

problem

the circadian
The work/rest
However,

society

at best,

the circadian

current

work/rest
days

zation

off.

schedule.

The conflicting
operations

relative

(associated
factors).

to somehow

override

instability

with weather,

orientation.

Thus,

adapted

to their

revert

to being

can result

in chronic

and persistent

day-active

on

desynchroni-

internal

systems.
of shift work
of the duty/rest

mechanical

26

and our predominantly

diurnal

are only partially

to the environment,

typical

cycle

its usual

shift workers

orientation

physiological

environment

by the day-to-day

usually

most

changing

the day/night
toward

of shift workers

different

zeitgeber

from

it back

In addition,

clock

among

people

us for daytime activity and nighttime

sleep.
the clock of the shift worker to some extent.

inputs
push

rhythms

of the circadian

of unpredictability
other operational

zeitgeber

continually

This continuously

desynchronization

aviation

is that it requires

clock, which pre-programs

schedule
itself may reset

the competing

day-oriented

their

with shift work

Program

is further
cycles

problems,

confounded

in

and by the element

system

delays,

and

Jet Lag
Abrupt

change

in environmental

The circadian

Gradual

clock

and

Different

time:

is out of step with the environment

uneven

adaptation

physiological

functions

of different

circadian

rhythms:

are out of step with one another

Fatigue Countermeasures

Crossing

time zones

encountered

by flight

produces

crews.

an additional

The circadian

new environmental

time.

quickly,

on the tightness

depending

interactions

with other

Circadian

During

commercial

one time zone

sequences
to the clock,

for their
which

resynchronizes

of their coupling
functions,

circadian

operations,
clocks

flights

is buffeted

back

present

disruption

in different

27

adjust

more

to a
or less

and on their

at its own rate.

Thus,

clock out of step with the local

are out of step with one another.
rarely

synchronized

continuously

and forth

only gradually

to the clock

crewmembers

to become

(_

regularly

functions

each adapting

not only is the circadian

physiological
functions

long-haul

of transmeridian

clock

rhythms

physiological

after a transmeridian
flight,
zeitgebers,
but also different

zeitgeber

Program

and unable

changing

stay long enough

to local time.
zeitgeber

to stabilize.

Rapid

signals

in

Symptoms

of Shift Work and Jet Lag

Disturbed

sleep

Increased

waking

Decreased
Increased

(inability

(work-time)

physical
reports

More negative

to fall asleep

or stay asleep)

sleepiness

or mental

performance

of fatigue

mood

Gastrointestinal

problems
Fatigue

Recent

overviews

of studies

with shift workers

indicate

Coun_,_'11easures

that 60%

Program

of them

have

complaints,
whereas
only 20% of day workers have similar complaints;
75%
workers experience
sleepiness
on every shift, and 20% report falling asleep.
Shift

workers

leave,

more

health

complaints

frequent

gastrointestinal
day workers.
including
often

(particularly

visits to health

than day workers.

disorders,

These

circadian

accompany

rotating

including

symptoms
desynchronosis

shift workers)

care

facilities

Night
general

probably

have

at the work

shift workers
stomach

result

28

have

higher

discomfort
domestic

of night

incidence

site, and more

of sick
general

incidences

and ulcers,

from the interaction

and the increased

shift work.

a higher

of

than do

of several

and social

sleep

factors,

stresses

that

Factors Affecting Circadian Adaptation

Takes

longer

after

Faster
with

the

more

a westward

progressively

biological

day

Different

duty

is usually

people

to adapt

zones

flight

later

"Evening-types"

Ability

time

are crossed

(delay

direction)

times

longer

or

because

than

the

24 hours

adapt

at different

rates

adapt

faster

"morning-types"

decreases

than

with

age
Fatigue Countermeasures

Circadian

adaptation

in flight

crews

after

transmeridian

flights

Program

has been

examined

in

only a few studies.

Klein
flying
after

and colleagues

skills

a westward

eastward

flight

A joint

study

(the German

pilots tested

(as passengers)

conducted

Medicine

during eastward

Aerospace

in an F-104

crossing

rhythm

eight

study

during the first layover

crossing

zones.

eight

In the same
of daytime

San Francisco)
A NASA

Establishment)
simulator

found

were

that

less impaired

time zones

than after

the return

Norwegian

Air Force

Institution

become

more

declines.
aged

Daily

across

crewmembers

than

of sleep

flight

trips was less disturbed

after eastward
flight

as more
crossing

and

flights.

sleep of long-haul

who scored

of

P-3 aircraft

flights

after

crossing

evening-type
eight

crews
westward

eight

time

showed

time zones

lower

(Tokyo-

morning-types.

of the effects

percentage

than

Orion

Adaptation

after westward

by NASA,

after an eastward

did more

operating

nine time zones.

international

to nine time zones

morning-type

50--60

of 9 crewmembers

coordinated

sleepiness

study

flights

of scheduled

study,

than

and the Royal

adaptation

to local time was faster

In an international
flights

by NASA

examined
and westward

the temperature

crews

fighter

flight.

Aviation

levels

at the DLR

of 12 German

of aging

found

and the amplitude

sleep

among

of their

loss during

long-haul

that as flight

crews

circadian

trips was 3.5 times

crews

29

aged

20-30.

get older,

temperature
greater

among

they
rhythm
long-haul

Fatigue

Factors

in Flight Operations:

Effect of
Flight Operations
Fatigue Countermeasures

The previous
fatigue.
fatigue.

This

two sections

section

identifies

dealt with the principal

how flight

operations

30

physiological

Program

factors

play a role in creating

that create
flight

crew

Effect of Flight Operations

Flight operations

are not always

to a regular sleep/wake

conducive

schedule

Fatigue Countermeasures

Certain
changes
usual

kinds

of flight

(and therefore
sleep/wake

conducive

schedules.

to regular

operations

minimal

However,

sleep/wake

occur

circadian

during

the day, involve

disruption),
it is very clear

schedules.

31

minimal

and may have

that many

Program

(_

time-zone

a minimal

flight

operations

effect

on

are not

Effect of Flight Operations

Duty at unusual
cycle,

or changing

or time-zone

Conflict

crossings

between

in the day/night

can lead to:

duty schedules,

environmental/local
Continuous

times

time,

circadian

and body time

disruption

Fabgue Counten'neasures

Flight

operations

occurring
time-zone
basi_

effects:

The body's
occurs

between

circadian
time

programming

night

flying

can occur.
cause

clock

effects

opposition

nighttime,

time

or local)

ways:

first, by

and body

time;

just as sleep

continuously,

between

resetting

of incomplete

adaptation.
resetting

32

The

clock's

first case

natural

day hours

is in opposition

during

daytime.

The second

resulting

from successive

continuous

day and night

to be constantly

of continuously

time zones).

during

time changes

to adjust

(in the case of unusual/

to the circadian

for wakefulness

of required

alternation

can also lead to symptoms

on the specific

with environmental

programming

is required

Continual

the circadian

time (environmental

is in direct

during

clock's

the body

in two main

disruption.

occurs due to the wide range

east/east-west
flights.
When

factors

or local time (in the case of changing

for sleep

to the circadian

and circadian

external

can conflict

schedules)
because

sleep

or changing
times in the day/night
cycle, and second, by requiring
Either of these, and especially
the two combined,
can have two

conflict

and continuous

changing

can affect

at unusual
changes.

Program

circadian

schedules,

itself.
There

the circadian

for sleep

Successive
clock

west-

disruption
or duty,

time-zone

is currently

case

can

changes

no information

in flight operations.

Effect of Flight Operations

Extended

duty

periods

Prolonged

wakefulness

Fatigue

Boredom/complacency

from

Restricted

continuous

time

- Cumulative

operations

available

sleep

for

sleep

debt

Fatigue

An obvious
An extended
sleep,

contributor
duty period

and can involve

continuous
a passive
opportunity
emerge

(i.e., the person

In many
constraints.
scheduled

flight

of relatively

factors
may

operations,

If an individual's
sleep opportunity,

loss is a prolonged
fatigue

Other

to increase

events

When

in highly

the likelihood

factors

Program

of continuous

wakefulness

fatigue

and complacency.
rare

period

by extending

disruption.

are boredom

(e.g.,

for these

can create

circadian

operations
monitor

to sleep

Countermeasures

wakefulness.

and decreasing

that can emerge

a human

automated

for physiological

is acting
aircraft),

in
only as

there

is an

sleepiness

to

by a variety

of

fall sleep).
the time available
physiological

for sleep

timing

then a cumulative

33

is restricted

for sleep

does not coincide

sleep debt can result.

with the

Fatigue

Signs and Symptoms

Forgetful

Fixated

Poor decisions

Apathetic

Slowed
Reduced

reaction

time

Lethargic
Bad mood

vigilance

Poor communication

Nodding

Fatigue

34

off

Countermeasures

Program

Common
Misconceptions

Fatigue Countermeasures

There
commonly
information

are many

misconceptions

held misconceptions
previously

presented

about

fatigue

will be presented
and additional

35

in flight

operations.

and then addressed

scientific

data.

Program

Several
using

the

Common Misconceptions
"Scheduled

rest period

NASA short-haul

allows

for required

sleep"

field study

The average layover was 12.5 hours long

Pilots slept about 1hour less per night on trips than at home

However, pilots had to wake up for duty more than 1 hr earlier than normal

- They could not fall asleep earlier to compensate for the early wake-up

Sleep laboratory
-

finding

It is very ditficult to fall asleep earlier than usual, except

when cumulative sleep debt overcomes circadian factors
Fatigue

The problem
impossible,

with having

to fall asleep

the duty schedule

circadian
as there
when

onset

and one of them

the "biological
is easier
staying
build

day"
longer,

which

allows

more

been

clock

time

asleep,

Just

are also times

maintenance

In addition,

because

than 24 hours,

to sleep

for the homeostatic

The

bedtime.

there
"wake

to be longer

Going

if not
when

or motivation.

labeled

bedtime.

tends

earlier.

(even

than the habitual

for falling
have

than to go to sleep

to compensate

of discipline

the habitual

by the circadian

is that it is very difficult,

before

earlier

cycle
times

Program

it

later also means

"sleep

pressure"

to

up.

An example
study,

asleep

occurs just before

later

usual

a question

falling
These

than

the night

in the circadian

unlikely.

dictated

to go to sleep
awake

opposes

times

is very

early

It is not simply

effectively

are preferred

sleep

zones,"

permits).

clock

to get up earlier

sufficiently

Countermeasures

which

12.5 hours.

of the phenomena

examined

44 pilots

Yet, despite

8 or more

hours

The pilots

had to wake

not fall asleep

of sleep,
earlier

described

above

in the DC-9

and the B-737.

the fact that 12.5 hours

pilots

slept about

up for duty more

to compensate

is from

1 hour

than

The

earlier

wake-up.

short-haul

average

an adequate

less per night

1 hour

for the early

36

seems

a NASA

amount

field

layover

was

of time for

on trips than at home.

than usual,

and they could

Common
"Scheduled

Misconceptions

rest period

NASA

long-haul

allows

field study

for required

sleep"

conclusions

- The circadian system influenced the timing and duration of sleep

(very similar to subjects living with no environmental

time cues)

- There was a clear preference for sleeping during the local night
-

The circadian system could not synchronize

to the duty/rest pattem and time-zone changes

Physiologically,
is usually

the time available

less than duration

for sleep

of layover
Fatigue Countermeasures

The information
demonstrates

on this slide is based

the misconception

examined

29 pilots

5-9

The

days.

hours,
episodes

24.9

hours.

follow

long-haul

changes

This NASA

field study

confirms

changes

and non-24-hour

zone

addition,
hours

a 24-hour

of duty followed

This forced
the bi-circadian
increasing
cycle

(twice

during

which

effect

layover.

Third,

the patterns
can result

on how

per cycle)

sleep normally
much

from repeatedly

This is longer

could

rhythm

of

no longer

and rest.

cannot

experienced

in sleep

napping
occurs

rhythms
eating

clock

of 24.8

two sleep

here is that the average

clock

of work

keep

by long-haul

with the average

has a number

peaks

sleep flight

availability

layover

usually

up with the timeflight

duty/rest

crews.

pattern

In
of 10

layover.

with local

the circadian

of meal

cycles

is impossible

were

The study
that lasted

free-running

the circadian
hours

for sleep.

trip patterns

to 25.7 hours.

than the usual

of time,

desynchronization

and may or may not coincide

major

cycle

the risk of inadvertent

was extended

that the circadian

by a 25-hour

internal

finding

that also

by an average

A provocative

and irregular

duty/rest

sleep/wake

followed

There

and longer

that after a period

time-zone

four

of 35.1 hours.

pilots

cycle

study

is available

400) during

10.3 hours,
cycle

long-haul

rest period

except

per layover.

circadian

It suggests

the many

was

rest/duty

for these

24-hour

series

duty period

11.5 hr of sleep)

rhythm

than the usual

(each

in an average

(total

temperature

that the entire

in B-747s

average

resulting

on a NASA

Program

in-flight

of important

tendency

can occur

in the cockpit.

Second,

consequences.
in-flight,

The interplay

crewmembers
in digestive

function

and during

at inappropriate
37

of these

are able
layovers.

times

thus

the part of the circadian

may or may not be contained

night.

First,

to obtain

within
factors

a layover,
will have

en route

and on

may or may not coincide

Gastrointestinal

in the circadian

cycle.

a
with

problems

Sleep Loss in Different Flight Operations

Long-haul

Overnight cargo

Short-haul

T
Average sleep
duration (hr)

Pre-trip

Trip

Post-trip
Fatigue

This graph
during

trips.

demonstrates
Three

types

that in each flight

of commercial

flight

operation
operations

Countermeasures

studied,

sleep

are portrayed

Program

loss occurred
on this graph:

short-haul,
long-haul,
and overnight
cargo. The average hours of sleep obtained
pretrip are portrayed
for each flight operation
on the left. The middle three bars indicate
the reduced

sleep

obtained,

The bars

on the right display

principal

finding

will engender

on average,
the average

is that in most cases

sleep

in each type of operation

loss during

amount

any of these

trip schedules.

38

of sleep
three

obtained
types

during

a trip schedule.

posttrip.

of flight

The

operations

Common
"1 know

Misconceptions

how tired

l am"

"I've lost sleep before

"I'm motivated

and I did just fine"

enough

Why

to just push through

not?

It is difficult to reliably estimate

alertness a nd performance

your own

FaUgue Countermeasures

One widely
alertness

is that individuals

and performance.

professional
combat

held belief

or having

the physiological

individuals
performance.

(especially

Many

previous

people

experience

consequences
sleepy

The following

individuals)

it"

can accurately

believe

and reliably

that being

motivated,

with sleep deprivation

of sleep

loss.

As previously

do not reliably

data from a long-haul

39

pilot

Program

estimate
illustrate

estimate

their

well-trained,

prepares

them

and
to

presented,
their

alertness

the point.

and

Subjective

vs Physiological

Sleepiness

Terme/Alert
SSS

scale (mm)
100

+..++%

4,
i
i

7
20

15
MSLT room
(rain)

lO

(mean=

10.5;

major s_ep episode

2 3 4 5 6 7 8 9 10

11

12 13 14

15 16

17

18

19 20 21

22

Local Time {hr)

Sasaki et aL, 1986

Fatigue CountermeasuresProgram

These

data

and waking
asked

were

obtained

sleepiness

during

to rate his overall

it measured

is called
of falling

the more

alert the individual,

Measurements

asleep:

of brain,

half a second.

eye,

their

immediately,

score

their
of studies

are sleep deprived

will fall asleep
less often

score

his MSLT

in the twilight

and the level of physiological

pilot

The letter
The bottom

di,'ectly
This

was approaching

scores

under

A.

demonstrates
sleepiness.

the twilight

zone

sleepy.

will occur;
if it does at all.
asleep

dark room.

to
If they

If they fall asleep

This test has been

deprivation.

disorder

that causes

opportunity.

(SSS = Stanford
the point

half of the graph

used in

Individuals
waking

This MSLT

zone,

when

who

sleepiness
score

of 5 or

are portrayed

the pilot repo_ ted his

the pilot reported

between

reporting

Scale)

his MSLT

and on subsequent

the discrepancy
Although

Sleepiness

portrays

At this time (when

scores.
being

MSLT

tests,

the self-report

peak

levels

and a high level of physiological

40

for
by

zone".

A indicates

the twilight

alert.

standard

of falling

in a quiet,

and sleep

every

having

sleepiness

onset

to occur,

the speed
very

very

simultaneously

sleep

onset

to fall asleep

a sleep

on almost

in the "'twilight

sleepiness

is approaching

zone.

the sooner

patients

sleep

This pilot was

the test defines

can quantify

or who have

to as being

of alertness.

the point

activity
20 minutes

crews.

and is a laboratory

it will take for sleep

sleep-disorder

experimentally

subjective

score

(MSLT)

the individual,

layover

The test of physiological

Essentially,

is 0 and they are considered

on the top half of the graph.

B indicates

Test

is 20 and they are considered

involving

is referred

level

have

on this test in 5 minutes

The pilot's
greatest

and muscle

flight

the day while

sleepiness.

Latency

the longer

that examined

long-haul

throughout

sleepiness.

the sleepier

Individuals

do not fall asleep,

thousands

Sleep

of physiological

study

in international

test of physiological

the Multiple

evaluation

collaborative

level of sleepiness

the speed

within

layovers

with an objective

sleepiness
objective

in a NASA

The letter
most alert),
it is clearly

of sleepiness

of alertness,
sleepiness.

this

Common Misconceptions
"The
"There
"One

is a quick
cure

answer

fix, a magic

will work

is simple..."
bullet"

for everyone,

all aircraft,

all flight

schedules"

Why not?
Sleep

and circadian

People

physiology

are complex

are not the same

Different

flight

schedules

present

different

demands

Fatigue Countermeasures

A misconception

that must be dispelled

the fatigue,

jet lag, sleep

loss, circadian

operations.

The previous

sections

physiological
operations.
response

to these

The idea
latest

systems

"cure"

physiological

disruption,

have

effects

that there

of effects

are not the same,

is a "'magic

and sleepiness

demonstrated

and the diversity

Also, people

is that there

clearly
created

and the range

Program

bullet"

that will cure

engendered

by flight

the complexities

of the

by the range

of flight

of individual

differences

in

must also be considered.

is no magic

for jet lag.

Be skeptical

information

previously

bullet

should

and weigh
presented.

41

be remembered
the claims

whenever

in consideration

assessing
of the

the

Alertness
Management
Strategies
Fatigue Countem)easures

42

Program

Important
The following

Considerations

recommendations

are intended

to help you apply what is currently

Tailor

known

them to your own needs

The best effects

strategies

may result

rather

from

than relying

combining

on a single

multiple

strategy

Fatigue Countermeasures

It will be continually
recommendations
activities.
effectiveness

You should
may

result

that the following

be tailored

experiment

in the context

The best effects

individual

emphasized

and should

with different

strategies

of your own physiology

from

strategies

to an individual's

combining

strategies

strategy.

43

are only

particular

needs

and evaluate

and specific
rather

Program

flight

and

their
operations.

than relying

on an

Alertness
Preventive
Used

duty

sleep

and on layovers

loss, and circadian

Operational
Used

Strategies

strategies

before

fatigue,

Management

to reduce

adverse

disruption

during

to maintain

alertness

and

before

operations

performance

Fatigue

Preventive
maximize

flight

of

strategies

in flight

The following

effects

is an approach

to differentiating

alertness

Countermeasures

management

Program

strategies.

strategies
focus on the underlying
physiology
by attempting
to manage and
sleep and promote circadian
adaptation.
These strategies
are used at home

a trip or during

help to maintain
the underlying

a layover.

alertness
physiological

operations.

Primarily,

underlying

physiological

Operational

strategies

and performance.
mechanisms,

these

short-term

These
but focus

strategies

sleepiness.

44

are in-flight

strategies
more

measures

do not necessarily
on managing

help to conceal

fatigue

or attenuate

that
affect
during

Preventive Strategies:
Sleep Scheduling and Quantity
At home
-

Get the best sleep possible

before starting

a trip

On a trip
-

Try to get at least as much sleep per 24 hours

as you would

in a normal

24-hour

period at home

Trust your own physiology

-

If you feel sleepy and circumstances

If you wake spontaneously

to sleep within

15-30

permit, then sleep

and cannot

minutes,

go back

then get up
Fatigue Countermeasures

Prior

sleep loss can be a significant

symptoms.
more

That

difficulty

regarding
individual
during

is, individuals
than those

sleep

as possible.

before

trip schedules.
layover
sleep,

should

of sleep

information

with flight

expect

is to begin

jet lag

a trip can experience

the previous

loss associated

debt,

the amount

sleepiness

factors

should

to trust your
as a clear

operations.

at least

An

that the it will only worsen

a trip schedule

as sleep-

I and preferably

2 days

own physiology.

sleep

time.

Instead

sleep during

at home.

Knowing

available

that

windows

message

45

period

to return

for

take the

the sleepiness,

take a

will be discussed
to sleep

is that if your

If you awaken

wakefulness,

to stay awake,

of fighting

of that sleep

then sleep.

get up. You can force

struggling

you are unable

The principal

that you are sleepy,

to sleep,

The length

spontaneously

loss during

these opportunities.

When
sleep.

by sleep

at least as much

24 hours

the physiologically

to maximize

sign to get some

are characterized

to obtain

a normal

will diminish

then get out of bed.

signals

operations

attempt

during

be made

if after awakening

to return

should

typically

nap or a longer

minutes,

most flight

Individuals

and other

attempts

Learn

clear

previously,

as they would

circadian

Also,

Maximize

before

Consider

recommendation

of subsequent

departure.

As indicated

brief

sleep

a trip with a sleep

The

deprived

are well rested.

debt and the expected

who begins

in the severity

who are sleep

who

the trip schedule.

satiated

factor

Program

brain

within

soon.
15-30

is giving

you

and you are alert and unable

but you cannot

force

sleep.

Preventive
Strategic
Before

Strategies:
Napping

duty

A nap can acutely

If immediately
If you

before

sleep

longer

a duty

period,

limit nap to 45 minutes

for you to become

can be longer

at other

A nap will decrease

before

alertness

too long and go into deep

it may take
Nap

improve

a duty period;

sleep,
fully awake

times

the length
some

of continuous

sleep

is better

wakefulness
than

none

Fatigue Countermeasures

An extensive
improving

scientific

subsequent

napping

close

sleep (stages

literature

alertness

to a duty period
3 and 4).

clearly

is to minimize

If awakened

sleepy,

inertia.

Therefore,

or disoriented
if taking

a nap before

for 10-15

minutes

or less will decrease

the chances

A brief nap can be an important

When
be longer.

much

better

you nap

at times

In this case,

least one NREM/REM

Strategic
subsequent

napping
alertness

flight operations,
countermeasure.

sleep,

minutes.
of having

sleep

than

of going

an individual
limiting

significant

the length

than none

2 hours

of naps in

consideration

This phenomenon

other than immediately

a nap longer

important

a duty period,

way to decrease

to get some

the effectiveness

One

the chances

out of deep

groggy,

It is usually

demonstrates

and performance.

Program

into deep

when
NREM

may continue
is called

its duration
amounts

sleep
to 45

of deep

of continuous

to feel

sleep.

wakefulness.

at all.

before
is likely

a duty period,

then the nap can

to get an individual

through

cycle.
can be an extremely
and performance.

"NASA

naps"

have

effective
Some

been

countermeasure

individuals

demonstrated

46

in improving

call these "power"

to be an effective

naps.
acute

In
fatigue

at

Preventive Strategies:
Good Sleep Habits
Keep a regular sleep/wake
Develop

and practice

Use bedroom
If hungry,
Avoid

schedule;

a regular

only for sleep;

protect sleep time

pre-sleep

routine

avoid work, worry, exercise

eat a light snack; do not eat or drink heavily

alcohol

or caffeine

Use physical/mental

before

techniques

in 30 minutes,

as needed to fall asleep

get out of bed

Fatigue

The following
good

sleep

as much

recommendations

habits.

They

as possible.

other

responsibilities.

mind

and body

condition
sleep.

apply

before

A regularly

pre-sleep

relaxation

trips,

of the bed with activities

to bed hungry

can delay

falling

sleep,

for the stomach

is busy digesting

snack

or have

quantity

should

a small

be avoided

Caffeine

consumption

should

sleep
routine

before

for maintaining

sleep

and wake

time protected
can be used

schedule

and minimize
to teach

your

A set of cues can be established

be used anywhere
in the bedroom

and anytime

before

and to prevent

to

going

to

the association

and sleep.

asleep.

food.

Eating

If hungry

of something

immediately

Program

important

pre-sleep

to relaxation

Countermeasures

a regular

try to keep

work or worry

contrary

keep

and fall asleep.

and can then

to avoid

considered

First,

practiced

that it is time to relax

It is important

Going

are generally

to everyone.

At home

bedtime

going to bed

relaxation

If you don't fall asleep

before

to drink.

going

a heavy

at bedtime,

As previously

to bed because

also be limited.

meal also can disrupt

or thirsty

Caffeine

mentioned,

of disruptive

in coffee,

eat a light
alcohol

effects

on sleep.

tea, and colas

can prevent

sleep onset and disrupt subsequent

sleep.
Some individuals
are sensitive
to the caffeine
in
chocolate,
and even a chocolate
dessert after dinner is enough to interfere
with their sleep.
Many

mild pain relievers

also contain

Be sure to stop caffeine

A variety
onset

and good

any skills,
applications,
trying

of mental

these

sleep.

caffeine;

several

and physical
Appendix

techniques

essentially

to fall asleep.

relaxation

intake

hours
relaxation

B describes

can be practiced;
anywhere.

Instead,

read the label for ingredient

before

If unable

get out of bed

planned

techniques
some

of these

are proven

to promote

techniques

in more

then they can be used

to fall asleep
and engage

and sleep.
47

information.

bedtime.

detail.

in a wide range

in 30 minutes,

in some

sleep

activity

don't

Like

of

lie in bed

conducive

to

Preventive Strategies:
Good Sleep Habits
Sleep

environment

- Dark room (if necessary,

use mask, heavy curtains)

- Quiet room (turn off phone,

- Comfortable

temperature

- Comfortable

sleep surface

use earplugs)

Lifestyle
- Exercise

regularly

- Eat a balanced

(but not too near bedtime)

diet
Fatigue Countermeasures

Program

l._isruptive environmental
factors should be minimized.
Sleep in a dark, quiet,
temperature-controlled
room, and on a comfortable sleep surface.
Lzt,oratory studies suggest that regular exercisers may have increased amounts of
NREM ..;rages 3 and 4. However, exercising too close to bedtime can disrupt subsequent
sleep. Although physically tiring, exercise elevates heart and breathing rates, and is
generally activating physiologically.
Usually, it is not possible to immediately wind
down and fall asleep after exercise. A balanced diet and regular exercise are critical
components for overall good health.

48

Operational
"...each

required

flight

duty must remain

seat belt fastened
landing,
What

Strategies
crewmember

at the assigned
duty station with
while the aircraft is taking off or

and while

it is en route"

can you do in your

Engage

Do something

Stretch

on flight deck

(FAR requirement)

cockpit

in conversations

with

that involves

seat?

others

physical

action

Fatigue Countermeasures

Operational
remain

seated

challenge

breaks

at their

because

according
possible,

countermeasures
assigned

and while

conversations

duty stations

one of the most

to the earliest
engage

are challenged

seated

with others

activity,

remain

with their

successful

sleep-deprivation

in physical

even

as active

by FARs

technique
experiments,

that require

for combating
is physical

as possible--even

49

don't

to

This poses

sleepiness,
activity.

Take

writing

"(_"

crewmembers

seat belts fastened.

if it is only stretching.

and be sure to participate;

Program

Whenever

regular

helps.

stretch

Engage

just nod and listen.

in

Operational
Strategic
- Use

caffeine

caffeine

- Don't

consumption

to acutely

use it when

(e.g.,

Strategies

increase

already

alert

start of duty or after

-Avoid

caffeine

Be sensible

near

alertness

a nap)

bedtime

about nutrition

and stay hydrated

Fatigue

Caffeine,

a stimulant,

can be consumed

It is best not to continually

determine
period

the potential

of sleepiness

for example,
Though

affected

will usually
Therefore,

take
sleep

bedtime

Be sensible
Obviously,
Try

(e.g.,

to carry

flight

by several
15-30

minutes

on layover.

nutrition.

operations
cockpit

Whenever

can interfere

snacks

increase

and after a trip.

using

it when

already

and then last for up to 3-4

could

caffeine

hours.

interfere

far enough

alert,

after a nap.

food intake),

a flight

Instead,

a specific

or immediately

size, previous

consumption

alertness.

with

in advance

of a

be active.
possible,

maintain

with regularly

as needed.

humidity

Avoid

throughout

Stop caffeine

Program

be used to combat

duty period

effect

caffeine

so that it will no longer

about

P_M.).

(e.g., body

to take

during,

could

a daytime

variables

to acutely

before,

caffeine

AaVI. or 3-5

consuming

appropriate

Between
reduced
dehydrated.

3-5

caffeine

when

just beginning

continually

subsequent
planned

when

consume

periods

strategically

Countemleasures

Drink

and caffeine

50

plenty

a balanced

scheduled,
of fluids

(a diuretic),

diet.

balanced

meals.

and stay hydrated.

it is easy

to become

Operational
Planned

brief

- NASNFAA

long-haul

study showed

alertness
- Planned

nap during

Strategies

improved

that vigilance

in duration

- One crewmember

at a time

non-augmented

napping

Controlled

Rest

nap

portion of cruise

- Up to 40 minutes

Cockpit

and physiological

after a brief, in-flight

for low-workload

-Three-person

flights

flights

is no__.tt
currently
on the Flight

sanctioned;

Deck

under

review
Fatigue

It must
sanctioned.
flight

be emphasized
A recent

nap in improving

reviewing

Controlled

operational

strategy

flight

that controlled

NASA/FAA
subsequent

study

alertness

Rest on the Flight

that directly

rest on the flight

demonstrated

reduces

A planned

the physiological

operations.

51

Countermeasures

Program

deck is NOT

the effectiveness

and performance.

Deck.

by FAA

currently
of a brief

As a result,

brief

in-flight

sleepiness

in-

the FAA

nap would

is

engendered

be an
by

Future Considerations
Bright

light

- Facilitates rapid circadian adaptation and promotes alertness

- Provocative laboratory findings
- Operational effectiveness still being demonstrated
Pharmacologic

agents

- Continuing search for agents that safely and effectively promote

sleep and maintain alertness and performance during wakefulness
- Melatonin
Facilitates rapid circadian adaptation and promotes sleep
Studies to demonstrate operational effectiveness currently underway
Fatigue Countermeasures

Several

potential

their possible
Bright

application

Two

the appropriate

to three
phase

an 8- to 12-hour
bright

There

sleep

These agents
wakefulness.
Recent
a useful
example,

search

suggest

aid).

clock

However,

it is not controlled

no guarantee

of content,

cycle
clock.

for three
Separate

alertness

from

Watch

for

agents
sleep

melatonin
cautions

52

days

its effects

that safely

at

may facilitate

on the circadian

and effectively

during

wakefulness.

and stimulants

may be useful
sedative
associated

and Drug Administration,

or effectiveness.

circadian

lux) administered

effect.

and performance

are known

by the Food

rapid

successive

alerting

and that it demonstrates

there

dosage,

to facilitate

pills to promote

that the hormone

of the circadian
sleep

studies

for pharmacologic

both sleeping

of development.

light (i.e., 2,500-10,000

an independent

and help to maintain

include

studies

adaptation

of bright

of the temperature

is a continuing

promote

in laboratory

hours

also can have

stages

environments.

shown

shift of the circadian

light

are at various

to operational

light has been

adaptation.

clock,

countermeasures

Program

to promote

for facilitating

effects

(i.e., may be

with melatonin.
and therefore

For
there

is

Future Considerations
Exercise
-

Research on animals suggests exercise may facilitate circadian adaptation;

applications in humans being studied

Diet
-

Recent scientilic study demonstrated that the Jet Lag Diet

did not help adjustment after multiple time-zone changes

However, the use of dietary countermeasures

"Anchor

deserves more research

sleep"

Obtaining a portion of layover sleep during your usual home sleep lime

Difficult to predict the anchor sleep "window"

- Currently no demonstration

of operational effectiveness
Fatigue Countermeasures

Exercise
applications
Recent
effective

demonstrated

in humans

are being

scientific

sleep

after multiple

circadian

flight

currently

countermeasures

to think

However,

potential
additional

demonstrated

the usual

to predict

bullet"

Individuals

adaptation

in animals,

that the "Jet Lag

Diet"

and

is not

the home
system,

for eliminating

by flight

sleep
sleep

period

can be determined

window

for two reasons:

and 2) circadian

should

countermeasures

the fatigue,

operations.

and evaluated

their fatigue

strategies

home

resynchronization

the window.

but may produce

they are managing

may provide

clearly

shifts

engendered

not only be ineffective,

currently.

when

be developed

their effectiveness.

studied

in the circadian

segments

circadian

adaptation.

it is difficult
differences

is no one "magic

disruption

to facilitate

have

may be useful

However,

1) the individual

There

studies

in facilitating

Anchor
reliably.

has been

Program

in operational

be wary
a false
when,

of unproved
sense

are currently
alertness

53

loss, and circadian

being

that potential

environments
"'cures."

of security

in fact, they

for overall

sleep

It will be critical

to demonstrate

These

by causing

"cures"

may

individuals

are not.
evaluated,

management

and in the future

in flight

operations.

If You Remember
Physiological

Improve

current

Sleepiness

People

There

mechanisms

situation

can have

are different

is no one simple

find out what

works

underlie

tailor

now

consequences

this

answer

m take

information

m these

to your

messages

it seriously

own

needs

are recommendations;

for you

Fa_gue

The critical

Else...

fatigue

m do it yourself

severe

--

Nothing

to take home...

54

Countermeasures

Program

APPENDIX
BRIEF

INTRODUCTION

TO SLEEP

Physical
There are several
wakefulness.

physical

Two examples

of these medical
These

sleep apnea

that illustrate

relate

to a sleep problem

situations).

disorder

specialists,

waking

difficulties,

It is imperative

be used to accurately
so that individuals

excessive

PILLS

sleepiness

why it is important

to know

about

during

the existence

myoclonus.
conditions

consequences
sufferer

during

that can disrupt

wakefulness.

and may produce

(e.g., high blood pressure,

that health

care professionals,

determine

the cause

receive

SLEEPING

sleep and cause

physiological

of the individual

AND

Disorders

and nocturnal

of sleep disorders,

the knowledge

not typically

sleep in many

Sleep

that can disturb

of sleep and can have subsequent

can exist without

would

disorders

are described

disorders:

are only two examples

and quality

Sleep

sleep

DISORDERS

appropriate

Sleep

waking

morning

disorders

difficulties

headaches,

especially

accredited

of sleep disturbances

and effective

the quantity
often
that one
fighting
sleep-

or the related

treatment.

Apnea

The sleep apnea syndrome

(SAS)

is a sleep disorder

at the same time. Apnea (a = not, pnea = breathing)

Essentially,

apneic individuals

in which

individuals

cannot sleep and breathe

is a pause in the regular pattern of breathing.

fall asleep and then periodically

stop breathing.

When this occurs,

little

or no oxygen is available to the brain or body. Usually, when the oxygen level in the blood drops below
a certain level and carbon dioxide levels rise, the brain arouses the individual who then begins to breathe
again. This awakening
breathing.
to breathe

is often associated

with a gasp for air or a snore as the individual

resumes

Depending
on the severity of the disorder, this cycle of pauses in breathing and awakening
can continue throughout the sleep period. Sleep apnea is a potentially lethal disorder--if
the

brain does not respond during an apnea, death can occur. There are two aspects of apneic episodes that
affect the severity of the disorder: the duration of the apnea and the frequency (the number that occur
during a given
from

sleep period).

hundreds

of times across

per hour,

whereas

during an average
Many

Most apnea episodes

15 sec up to 2 or 3 rain in duration.

physical

a sleep period.

in a severe

usually last under 30 sec, though they can range

Apneas

may occur

only a few times per hour of sleep

or

In a very mild case, there may be only 5 or 10 apnea episodes

case there may be 50 to 80 per hour of sleep

(i.e., 300 or 400 episodes

sleep period).

and behavioral

problems

can be caused

by sleep apnea,

for example,

excessive

sleepiness
and cardiovascular
difficulties
such as hypertension.
Currently,
sleep-disorder
specialists
believe that a combination
of frequent arousals from sleep (which also results in little or no deep sleep)
and the oxygen
sleep

deprivation

is an important

factor

someone

with sleep apnea

episodes,

and therefore

are completely
or problems

unaware
staying

lead to excessive

sleepiness

in how refreshed

and alert an individual

may sleep 8 hours,

the quality

the sleep could

because

wakefulness.

of excessive

They may have

sleepiness,
55

feels

be disturbed

of sleep can be very poor. Very

that they have the disorder.

awake

during

Remember,
after sleep.

high blood

of

So, although

300 or 400 times

often individuals

but they often

the quality
by apnea

with sleep apnea

pressure

do not relate

during

the day

this to a sleep

problem.Thus,evenpersonswho areawakenedhundredsof
breathing
partner

may awaken

the next morning

is the first to notice

duration,

may become

Epidemiologic
apnea

the repeated

suggest

that 3-4%

on the definition

with age. The textbook

high blood

pressure,

meetings,

reading,

sleep apnea

in breathing

that can cause

of the general

used).

during

because

of disturbed

Frequently,

sleep and, depending

people

awake

a movie

to snore,

and 10-15%

of the disorder

case is an overweight,

staying

a car, watching

of the nose),

a bed
on their

during

of sleep apnea.

worsen

of sleep apnea (both the duratie

Another

caution

and its severity

snoring

are a variety

to

sleep whiic

in
to

problems

symptom

pills,

of apnea

has

unrelated

septa (i.e., physical

sleeping

:_nd frequency

appear

of reasons

is also a primary

is that alcohol,

had sleep

male who snores,

the day (e.g., fighting

colds, deviated

However,

of males

middle-aged

or TV). There

for example,

and allergies.

with the occurrence

the severity

a night

population

The occurrence

sleep apnea

and has problems

driving

with the structure

pauses

times

of what has happened.

quite concerned.

studies

(depending

increase

and be unaware

associated

and sleep loss can

events).

A number of options are available to effectively

trea .ae sleep apnea syndrome.
The treatment usually
depends
on the severity of the disorder and can range from losing weight, to the continuous
administration

of oxygen

evaluated

during

sleep,

by an appropriate

physician.

to surgery.

health

care professional.

Also, there are now sleep-disorder

diagnoses,

and prescribe

American

Sleep

treatments.

Diselders

apnea

is an example

heart and blood

completely

pressure

unaware

pathological

of a medical

during

and treated by qualified

medical
treatment
of the disorder.
Myoclonus

These

specialists,

or Periodic

States

clinics

and yet every

using

suffer

problem,

the approaches

from

currently

a personal
make

(accredited

by the

university

excessive

a disorder

and

can be

that can cause

should

accepted

and

sleepiness,

An individual

sleep apnea

be

evaluations,
full diagnos,,ic

in many

wakefulness.

night

Like any medical

clinics

that provide

sleep and cause

during

sleep apnea

i_rst consult

are located

that can disturb

about

sleep-disorder

sleep-disorder

the United

and other difficulties

the daytime.

should

who perform

are also specialized

disorder

concerned

An individual

throughout

of sleep disorders.
the country.

problems,

that someone

specialists

of the sleep disturbances

sleepiness

Nocturnal

There

Association)

treatment
services ior the range
community
hospitals throughout
Sleep

It is critical

be e _:duated

for successful

Leg Movements

Another physical sleep disorder that can disturb the quality of sleep is nocturnal myoclonus,
or periodic
leg movements
during sleep. This disorder is characterized
by a twitching
(or muscular contraction)
of
the lower
twitch).

leg muscles
The twitch

during

can occur

episodes

across

Periodic

leg movements

sleep (though
There

constitute

of non-restorative

disorder that can go unrecognized

often noticed
important

can be several

a sleep disorder

in the lower

300 times

sleep,

because

awakening

Again,

unrefreshed,
of multiple

any given

twitch

someone

also
in periodic

slee[, period.

is usually

could be getting

associated
8 hr of

This poor quality sleep can translate

tired, sleepy,

etc. This is another sleep

leg movements

and one that is

kicks during sleep!).

and treated by a knowledgeable

56

0.5 sec, and appear

during

each muscular

with the periodic

first by a bed partner (often the recipient

that the disorder be diagnosed

twitches

with awakenings.

by the individual

legs, the arms could

last only about

hundred

or a shift from deep to light sleep.

sleep but have that sleep interrupted

into complaints

found

in one leg or both, typically

the sleep period.

with either an awakening

typically

physician

Again, it is very

or accredited

sleep-

disorderspecialist.Althoughnot life-threateninglike sleepapnea,periodiclegmovementsduringsleep

canresultin excessivedaytimesleepiness.

Medications
Alcohol
The most widely
materials,

used self-treatment

alcohol

wine can totally

sleep period,

for disturbed

is a very potent
suppress

REM

withdrawal

poor,

disrupted

sleep,

its disruptive

sleep.

sleep

sleep is alcohol.

suppressant.

More

As noted

can be seen, including

Although

alcohol

awakenings,

is often used to unwind,

on the subsequent

During

a REM
relax,

sleep will outweigh

in the presentation

than a couple

sleep in the first half of a sleep period.

effects

effects

REM

of beers

or glasses

the second

rebound,

half of the

and generally,

and promote

its usefulness

of

the ability

in promoting

very

to get to
the onset

of sleep.

Sleeping

Pills
CAUTION

The other
sleeping
periods

widely

used

available

over-the-counter,

be used

information
their effects.

provided

are several

important

purpose

of a sleep medication

helping

to maintain

therapeutic

effect

only

without

only

There

to treating

sleep

by prescription
prescriptions,

under

in many

the supervision

here

is intended

characteristics
should

is prescription

So the optimal

sleeping

overseas

can be obtained

locations.

Sleeping

physician.

only

to give a basic

understanding

of sleeping

pills that should

be considered.

frequent

sleep,

either

by facilitating

or long awakenings).

of its use (i.e., sleep should

pill should

States

of a knowledgeable

be to promote

sleep (e.g., reducing

for the duration

in the United

the first). The improvement

in sleep should be associated
alertness, better mood) and, at the very least, the sleeping
function.

disturbances

pills. The use of prescription

sleeping
pills close to and during duty
is not medically
allowed.
However,
it is acknowledged
that many

medications
should

approach

promote

about

The primary

sleep onset

It should

be as good

pills

The

maintain

or by
this positive

on the fifth night

of use as on

with waking benefits (e.g., increased

medication
should not impair waking

sleep

and improve

subsequent

waking

function.

A very important
consensus
statement (from physicians,
sleep-disorder
specialists,
etc.) recommends
that the safest and most beneficial
use of sleeping pills is obtained when they are taken for short
periods

of time and at the lowest

effective

dose.

In the past, some of the most widely used prescription

sleeping pills were in a class of drugs
barbiturates.
These include medications
such as pentobarbital
and seconal. Scientific
studies
laboratories

have shown

that the barbiturates

often lose their effectiveness

to promote

called
in sleep

sleep within

7-10 days and can create tolerance to, and dependence

on, the medication.
It is important
to keep in
mind that barbiturates
have been found to be factors in accidental
or intentional
drug overdose. The
barbiturates
NREM

are also potent

and REM

REM

sleep, creating

sleep suppressants
fragmented

and, like alcohol,

and poor quality

57

sleep.

can disrupt
Eventually,

the regular

cycle of

these medications

can

actuallycreateaninsomniaproblemcalleddrug-dependent
insomnia.Only aftercarefultaperingoff and
eventualwithdrawalof the medicationcansleepreturnto a morenormalpattern.As prescribing
physicianshavelearnedmoreaboutthesesleeplaboratoryfindingsregardingbarbiturates,their use
asa primarysleepingmedicationhasrapidly declined,andtheyarerarelyusedtoday.
Today,the mostwidely prescribedsleepingpills (oftencalledsedative/hypnotic
medications)arein a
classof drugscalledthe benzodiazepines.
Therearethreethatarecommonlyprescribed:Halcion
(triazolam),Restoril(temazepam),
and Dalmane
(flurazepam).
Sleep-laboratory
tests of these three
medications
usually

show

that they promc.'.

considered

intentionally
effects.

,Jleep over many

safer than the barbiturates

overdose

The benzodiazepines,
benzodiazepines

nights

because,

in sleep-disturbed

generally,

with them and they can be more easily

like all medications,

do not suppress

REM

are not without

sleep,

it is more difficult

started

and stopped

their adverse

they can suppress

There

are properties

The primary

factor

individual's

body.

the benzodiazepines
by a knowledgeable

of these

that distinguish

three benzodiazepines

Halcion

that is, the amount

is a short-acting

to accidentally

the

3 and 4 (the deep

are widely
physician.

their effects

(about

or

negative

Although

sleep stages

used

from one another.

of time the drug continues

benzodiazepine

are

suggest that the benzodiazepines

too rapidly, may cause a rebound

In spite of these considerations,

sleeping pills when prescribed

is their half-life,

They

with fewer

side-effects.

NREM

sleep that occurs in the first third to half of the sleep period). Reports
can have side effects that affect short-term
memory and, if withdrawn
anxiety or insomnia.
as safe and effective

patients.

to work in an

2--4 hr) that helps

to promote

sleep

onset but is no longer active by the middle to end of a sleep period. In sleep laboratory
studies, Halcion
has been shown to effectively
improve nocturnal
sleep and to be associated
with improved
daytime
alertness. There have been several scientific studies that showed Halcion to be effective for travelers
using

it as an aid to improve

medium-acting
longer

active

effectively

by the morning

promotes

several

nights,

effects

that carry

administration,
wakefulness.
overseas.
Recently,
attention

sleep on trips that involve

benzodiazepine

(about

8 hr) that helps

awakening.

sleep onset

the long half-life

Dalmane

and maintains
results

over to wakefulness.

multiple

is a long-acting

sleep throughout

in an accumulation
Laboratory

time-zone

to maintain

sleep

changes.

Restoril

throughout

a night

benzodiazepine
the night.

of the medication

studies

have shown

(about

However,

is a
and is no
100 hr) that

if used over

in the body that can have

that after several

nights

of

the build-up of Dalmane metabolites

can be associated
with increased
sleepiness
during
It should be noted that the specific formulations
of these medications
can be different

For example,

Restoril

obtained

in the United

a new prescription
sleep medication,
as a safe and effective
sleep aid.

Ambien

Kingdom

has a half-life

(a non-benzodiazepine),

of 5-6 hr.
has been receiving

The main message is that the benzodiazepines

can be used effectively
to help get to sleep and stay
asleep. They have different properties
that should dictate the appropriate
use of the medications
for
different

people

in different

circumstances.

only be used under the care and guidance

Finally,

all of these are prescription

of a qualified

58

and knowledgeable

medications

physician.

that should

Note
The information
provided
here is intended
only to provide
examples
of sleep
disorders
and some of the medications
used to promote
sleep. You should not use
this information
about

your

indicated,

circadian

readings
rhythms,

sleep

sleep

diagnosis,

out by contacting

medicate,

potential

accredited

evaluation,
general

to diagnose,

health,

and

a local

clinics
treatment

university

in appendix
and sleep

or treat

disorders,
and

yourself.

or medication,

sleep-disorder

for the range

or community

E suggest

other

disorders.

59

If you have
see your

specialists

any questions
physician.

are available

of sleep

disorders.

hospital

for a referral.

sources

of information

Seek
about

As
for

them
The
sleep,

APPENDIX
BRIEF

Flight

operations

can involve

of flight operations,
demonstrated

INTRODUCTION

many

that these

hectic

to the perceived

demands

become

physically

others

a layover

tense,

and relax

can significantly

by these

the subsequent

sleep period

factors.

Scientific
some

important

(see appendix

studies

in which

when

they

used to relax

A). However,

Outside

have

health.

individuals

situations

is sometimes

events.

and mental

differently:
are many

off duty. This is especially

alcohol

and stressful

physical

of situations

and so on. There

mentioned,

SKILLS

responsibilities,

an individual's

and challenges

As previously

disrupt

significant

can affect

will worry,

after coming

sleep period.

RELAXATION

lives also are affected

"life stresses"

respond

to "unwind"

schedules,

people's

TO

People
will

pilots need

are preparing

for

after duty, but it

there

are alternatives

to alcohol. Many people use exercise, hobbies, and many other strategies
to physically
and mentally
relax. This section is not intended to cover the full range of those options; entire books have been
written on the subjects of stress management
introduce
some information
about relaxation
promote

sleep.

Relaxation

skills can be powerful

any situation
tiveness

or environment.

demonstrated

headaches)

to decreasing

are a wide variety

Some

relaxation

phrases,
muscle,

mentally

Examples

focusing

of techniques

training.

Meditation

phrase

(individually

guided

imagery;

images

associated

individual
heavy

good

(e.g., tensing

and their effec(e.g., tension

sleep.

and effectively

(i.e., involve

focusing

and relaxing

and physical

tested

problems

in almost

used by many

the mind,

the major

components

individuals.

internally

muscle

repeating

groups

(e.g., after tensing

of the

and relaxing

on the relaxation).
that are primarily

chosen),

an individual
focuses

cognitive

chooses

include

relaxation

and focusing

with the experience.

of techniques
relaxation.

standardized
chest

physical

physical

relaxation

meditation,

methods

on deep

relaxation.

Positive

a specific,

relaxing

scene

Autogenic

training

involves

on each of the major

positive

and involves

muscle

imagery,

sitting

quietly,

imagery

and is guided

groups

often

begins

through

repeating

standard

of the body

and autogenic
repeating

with

the pleasant
phrases

as an

(e.g., "my right hand is

and warm").

Examples
muscle

cognitive

both cognitive

is one of the oldest

cognitively

to promoting

and mental

scientifically

from eliminating

skills that are practiced

are primarily

are primarily

physical

skills have been

areas,

and anxiety

of relaxation

most involve

for promoting

relaxation

different

worry

techniques

etc.), others
though

techniques

Many

in many

There

body),

and relaxation
skills. However,
it is intended to briefly
skills that may be useful in your efforts to relax and

Yoga

movements

breathing,

relaxation

and chest. During

that involve

more physical

is also a very old method

and a cognitive
through

the deep breathing

deep

action

for relaxing

component.
breathing

include

Rather

yoga,

the body
than short

deep breathing,
and mind;
breaths

uses long, slow breaths

a word or phrase

associated

tensing

and relaxing

of the muscles,

starting

at the head and neck

it involves

primarily

a set of

involving

that use both the abdomen

with relaxation

mind and facilitate a deeper state of relaxation.

Progressive
muscle relaxation
received much attention and is effectively
used in a wide range of applications.
systematic

and progressive

is used to focus

the

is a technique
that has
It involves the
and moving

all the way to

61

thetoes.Themind focuseson thedifferencebetweenthetensionandthe relaxationassociatedwith the

releaseof themuscle.
It is importantto think of theseasrelaxationskills. As skills,theycanbetaught,learned,andpracticed.
Practiceis critical! Too often peopletry to quickly learnsometechniqueandthenuseit in effortsto
relaxthenexttime theyare in a highly stressful situation. Usually it does not work and the individual
decides

that the technique,

mastered

should

and relaxation

it be applied,

skills in general,

and even

then it should

usefulness
in different
situations. Eventually,
relaxation
on a regular basis and incorporated
as a daily activity.
There

are many

resources

different

ways to learn relaxation

are available.

skill. An external

It is often

source

useful

are ineffective.

be gradually

skills and today

book, tape)

after a skill has been

for its effectiveness

skills are most effective

to first read about

(e.g., instructor,

Only

tested

many

they are practiced

commercially

a technique

that guides

when

produced

and a description

an individual

and

of the specific

through

a particular

technique
can be useful in learning the skill and in focusing attention on the relaxation.
Eventually,
it is
important to internalize
and memorize the specifics of the skill. Once learned very well, an individual
should be able to use his or her favorite, most effective
relaxation
skills in different situations and
environments,
Relaxation

without

having

to rely on an external

skills can be a powerful

mind, and promote

practice, and enjoy

source

to help relax.

tool to help individuals

good sleep. If you decide

learning to relax.

to try some

reduce

physical

tension,

of these new skills,

focus

and relax the

keep an open mind,

Note
There

are many

range

of techniques,

many local
physicians,

or stress

(e.g.,

accredited

management.

Recommended

H. (1976).

should

Do some

practitioners

are recommended

The relaxation

made

a wide

be wary!

for further

list of available

be available

reading
resources

to be sure
the services

on relaxation

Today,

at your local community

that

(e.g.,

reputable

and instruction.

skills and stress

but it does provide

response.

New

York,

library,

some

college

guidance
library,

for a
or

Englewood

C.E. (1977).
Cliffs,

NY: Avon Books.

relaxation

How to sleep better:

NJ: Prentice-Hall,

training:

A drug-free

A manual

program

for helping

for overcoming

Inc.

Farquhar, J.W. (1978). The American

way of life need not be hazardous
Stanford, CA: Stanford Alumni Association.
62

regarding

Please

checking

are providing

and Borkovec,
T.D. (1973). Progressive
Champaign,
IL: Research Press.

T.J. and Thoresen,

insomnia.

techniques.

or licensed)

books

claims
to relaxation.

Readings

Bernstein,
D.A.
professions.
Coates,

management

references

unsubstantiated

and approaches

facilities,
hospitals,
and licensed health care providers
nurses,
social workers)
provide
classes
on relaxation

This is not an inclusive

starting point. These

bookstores.

Benson,

and

devices,

health care
psychologists,

skills

The following

outrageous

to your health.

APPENDIX
NASA

AMES

Relevant

NASA

from
This appendix
(TMs)

FATIGUE

comprises

the operational

from the Fatigue

Countermeasures

Gander,

P.H., Graeber,

R.C.,

COUNTERMEASURES

Technical

the "Crew

Foushee,

Memoranda

Factors

Operational

in Flight

summaries

PROGRAM

Summaries

Operations"

of five relevant

Series

NASA

Technical

Memoranda

Program.

H.C., Lauber,

J.K., and Connell,

L.J.

(in press). Crew factors

in flight operations:
II. Psychophysiological
responses
to short-haul
air transport
operations.
(NASA Technical
Memorandum).
Moffett
Field,

CA: National

Graeber,

R.C. (Ed.)

wakefulness
Moffett
Gander,

Aeronautics

(1986).

R.C. (1994).

Crew factors

in flight

IV. Sleep

Technical

and Space

K.B., Connell,

................................................

operations:

(NASA

Aeronautics

R., Gregory,

Administration

in flight

aircrews.

CA: National

P.H., Barnes,

Graeber,

Crew factors

in international

Field,

and Space

L.J., Miller,
operations

and

Memorandum

Administration
D.L.,

No. 88231).

...................................

P.H., Graeber,

in flight

R.C.,

operations:

M.R.,

Spinweber,
Effects

VI: Psychophysiological

(NASA
Aeronautics

infuencing

K.B. (1991).

R.C.,

Dinges,

cockpit

D.F.,

K.A. (1994).

sleep timing and subjective

Connell,

rest on crew performance

Technical
and Space

L.J., Rountree,

Crew factors

Memorandum
Administration

inflight

sleep
.............

74

M.S.,
operations

and alertness

No. 108839).

72

Crew factors

long-haul flight crews. (NASA Technical Memorandum

Field, CA: National Aeronautics and Space Administration

and Gillen,

of planned

operations.
National

Graeber,
C.L.,

L.J, and Gregory,

VIII. Factors

quality in commercial
No. 103852). Moffett
Rosekind,

Connell,

68

and

responses
to helicopter
operations.
(NASA Technical
Memorandum
No. 108838).
Moffett Field, CA: National Aeronautics
and Space Administration
...................................
Gander,

65

Moffett

IX:

in long-haul
Field,

CA:

..................................................................

77

63

Crew

Gander,

Factors

P.H., Graeber,

flight

R.C.,

operations:

(NASA Technical
Administration.

Operational

Foushee,

H.C., Lauber,

responses

Memorandum).

Field,

is the second

on flight crews,

To document
patterns.

Moffett

agreed

74 pilots from

to short-haul

CA: National

Responses

L.J. (in press).

air transport

Aeronautics

Crew factors

in

operations.

and Space

percent

The population

14.6 yr) and averaged

before,

was experienced

68.6 hr of flying

per month

presents

analyses

are

air transport

and after 3-day

States

or 4-day

trip

and data were collected

of the pilots who had been

studied

scientific

short-haul

during,

of the United

of flight

This overview

The supporting

of flying commercial

were monitored

effects

of these effects.

of the major findings.

on the East Coast

the year. Eighty-five

and psychological

significance

effects

two airlines

took place

to participate.

experience

and Connell,

in a series on the physiological

and on the operational

the psychophysiological

All flights

throughout

J.K.,

II. Psychophysiological

comprehensive
review and interpretation
described
in detail in the rest of the text.

operations,

II: Psychophysiological
Transport
Operations

Overview

This report
operations

in Flight
Operations
to Short-Haul
Air

awarded

(average

the trips selected

age 41.3 yr, average

in all categories

for study

airline

of aviation.

Subjects wore a portable biomedical

monitor which recorded core-body
temperature,
heart rate, and
wrist activity every 2 min. They also rated their fatigue and mood every 2 hr while awake, and recorded
sleep episodes,
naps, showers, exercise, duty times, food and fluid intake, voidings, cigarettes,
medications,
and medical symptoms
in a daily logbook. A background
questionnaire
was administered
which

included

inventories.
operational

basic demographic

A cockpit

observer

accompanied

sleep and life-style

the crews

habits,

on the flight

and four personality

deck and kept a detailed

log of

events.

The trips studied

were

pilots in predominantly

selected

daytime

long duty days with multiple

hr which

information,

included,

and evening

flight

on average,

than 12 hr. The mean

to provide

rest-period

segments

information
operations.
(average

on the upper
Common

range

features

5.5 per day). Daily

of fatigue

were early

as defined

report

duty durations

4.5 hr of flight time. One third of all duty periods

duration,

experienced

by the pilots in their daily

times and

averaged

studied

by
10.6

were longer

logs, was

12.5 hr. The

mean rest-period
duration calculated
from the last wheels-on
of one duty day to the first wheels-off
the next duty day was significantly
longer (14.0 hr). Overnight
layovers after successive
duty days
occurred

progressively

On trip nights,
less, and waking
lighter

and poorer

earlier

subjects
about

across

reported

most
taking

1.4 hr earlier

overall,

and reported

of

trips.
about

12 rain longer

than on pretrip
significantly

sleep restriction
results in more rapid sleep onset
latencies and more frequent
awakenings
reported

nights.

They

to fall asleep,
also rated

more awakenings.

sleeping

about

1.2 hr

their sleep on trips as

In contrast,

in the laboratory,

and more consolidated

sleep. The longer sleep
by pilots on trips may reflect the commonly
reported
65

needto "spin down" aftercomingoff

ments.

duty and the disruptive

effects of sleeping in unfamiliar
environtrips was reported not only as shorter but also as more disturbed,

The fact that sleep during

suggests
mood

that the effects

may be greater

The effects
comparisons
layovers,
Positive

of this sleep restriction

than those reported

of duty demands

of ratings
fatigue

made

for either

pretrip

during

affect

as highest

or posttrip.

in laboratory

on subjective

pretrip,

and negative

affect was rated

on subsequent

were rated
during

Posttrip

as highest

flight

recovery

after awakening,

was indicated

before

As expected,

sleep.

relationships

were found

and mood during

in these ratings.

layovers.

The use of tobacco

significantly
occurred

activation
between

did not change

the opposite
duration,

seen in the

and posttrip.

During

affect and activation

fatigue

ratings

by return

of fatigue

levels

daily

time-of-day

been because

associated

of sleep restriction.

even though

values

variation.

or flight hours

were consumed

morning,

layovers,

their highest

on trip days relative

and alcohol

in the early

levels

and

as lowest.

were higher

than

to baseline,

the

of activation. Significant
time-of-day
variations
Fatigue and negative affect were low in the first

to reach

This may well have

more caffeine

primarily

showed

the timing,

performance,

are most clearly

during

and positive

segments,

and rose thereafter

sleepiness,

with similar

and mood

segments,

lowest negative affect ratings, and the highest levels

were found in fatigue, negative affect, and activation.
three ratings

studies

fatigue
flight

daytime

No significant

in a duty period

of the high levels

to pretrip

days.

caffeine

wake-up

and the fatigue

of individual

and posttrip

on trips. Additional

with the earlier

in the final rating

times

variability

However,

consumption
on trips, and also

around the time of the mid-afternoon

peak in physiological
sleepiness.
The urge to fall asleep at this
peak time would increase progressively
with the accumulating
sleep debt across trip days. The
additional
going

alcohol

to sleep.

Although

The common

alcohol

can adversely

consumption

may be assumed
practice

may facilitate

affect

of using alcohol

falling

subsequent

in the use of medications,

asleep,

waking

meals

72 pilots

rates during
during

to relax before

and performance.

of reports

of medical

of exercise

sleep is not recommended.

disruptive
There

effects

on sleep which

were no significant

symptoms

sessions

off duty and before

between

reported

changes

trip days and

was no different

on trip

and timing of meals on trip days was not significantly

different from pretrip or posttrip
more snacks were eaten, and they were eaten earlier, on trip days. This suggests that

on trip days may have been

Heart

after coming

it has well-documented

alertness

or in the number

pretrip or posttrip days. Similarly,

the number
days than on pretrip or posttrip days.
The number
days. However,

to have occurred

takeoff,

589 flight

smaller

descent,

segments.

or less filling

and landing
Increases

than meals

were compared

in heart

on pretrip

or posttrip

with values

rate were greater

during

during

days.

mid-cruise

descent

for

and landing

for the pilot flying. The difference

between flying and not flying during descent was greater for first
officers than for captains. Heart-rate
increases
were greater during takeoff and descent under instrument

flight conditions

of segments

flown

A number
this study.

than under visual

per day should

of ways

First, since

of reducing

flight conditions.

On the basis

of similar

findings,

the number

be regulated.
fatigue

daily duty durations

during

short-haul

air-transport

were more than twice

operations

as long as daily

are suggested

flight

durations,

by
and

since about one third of all duty periods were longer than 12 hr, it would seem reasonable
to limit duty
hours in addition to, !i_ght hours in short-haul
operations.
There may also be some advantage
to
66

definingthe restperiodmoreprecisely,sincesignificantvariabilityis possiblewithin thepresent

systemof definitionby contractnegotiation.Second,the practiceof requiringearlyreporttimes
makesit moredifficult for pilotsto obtainadequatesleep,evenduringrelativelylong layovers.
This is becausecircadianrhythmsimpedefalling sleepearlierthanusual,exceptaftermajorsleeploss.
Third, in thetrips studied,duty beganprogressivelyearlieracrossthe daysof thetrip. Becauseof the
difficulty of falling asleepearlier,this hasthe effectof progressivelyshorteningthetime availablefor
sleepacrossthedaysof the trip. In addition,becausetheinnate"physiologicalday" determinedby the
circadiansystemis longerthan24hr, it adaptsmorereadilyto scheduledelaysthanto advances.Thus,
wherepossible,successivedutydaysshouldbeginprogressivelylater.Fourth,thewidespreaduseof
alcoholasa meansof relaxingbeforegoingto sleephasdeleteriouseffectson subsequent
sleep.It thus
seemslikely thatthe quality of sleepon trips couldbeimprovedin manycasesby providingpilotswith
informationon alternativerelaxationtechniqueswhichhavebeenwell-testedin thetreatmentof sleep
disorders.

67

International

Cooperative

Study

of Air Crew

Layover

Sleep

Graeber,
R.C. (Ed.) (1986). Crew factors
in flight operations:
IV. Sleep and wakefulness
international
aircrews.
(NASA Technical
Memorandum
No. 88231). Moffett Field,
Aeronautics

and Space

Operational

multiple

Administration.

Overview

The major
crews

goals

time zones

were studied

basic findings
used by crew
Westward

of this research

were to examine

and, if necessary,
during

to suggest

the first layover

can be best described

members

to obtain

There

was clear evidence

westward

the second

(LHR-SFO,

During

indicated

the same amount

fewer

Nevertheless,

on the following

as at homebase.

across

Flight
The

to strategies

home.

The strategy
the coming

of taking

night flight

nap will help reduce

strategies

latter part of flight

crews

during

temperature

occurring

layovers

flights.

Following

during

the early
day's

The same findings

better

departure

morning

pattern

hours.

of increasing

successfully

attempted

held for the one group

was seen in

to take a preflight
of subjects

difference

of wakefulness.

Recent

research

suggests

performance

deficits.

period
schedule

flight suggest

potential
emphasizes
circadian

that alertness

tt_ rise. Therefore,

night and take advantage

the potential
rhythms.

certain

of the circadian

aspect

of

of time of the

results

obtained

improves

as the circadian

schedules

may be more

rise in alertness

in view of
that such a

A second

importance

Additional

nap

whose

was that their

important

to the crew members'

return

drowsiness

appears

with this flight

rate begin

in local

layover

and avoid

and heart

faster

sleep quality.

after a westward

drowsiness

the eastward

fell asleep

the late afternoon

25 hr instead of the usual 48 hr. The only major

the first afternoon
after arrival.

with its prolonged

to cope

generally

reported

seen during

Most crew members

a nap before

in relation

subjects

continued
to increase during the remainder
of the
some adaptation
of sleep to the new time zone as

day, the previous

for testing.

in-flight

they facilitate a nap before

part of the flight.

during

than after eastward

Some even

usually

drowsiness
was already

for duty that afternoon.

layover lasted approximately

preflight nap occurred
during

68

with respect
flight

less sleep difficulties

with baseline,

in alertness

awakenings

who were available

in preparation

in body

the return

SFO-NRT)

In comparison

the next day, the increase

by even

experienced

FRA-SFO,

individuals
was not observed.
Instead,
wake span. By the second night, there

some

such sleep.

seven to nine time zones.

and discussed

operating

with flights

all subjects went to bed soon after arrival. During the first night, sleep
good quality and not unduly disturbed
except for increased
wakefulness

half of the night.

and slept essentially

planning

associated

for improving

crossing

of flight direction

sleep before

that crew members

flights

the westward
flights almost
appeared to be of generally

crews

in sleep

recommendations

after long flights

in terms

sufficient

the changes

Flights

following

during

in
CA: National

during

from

rhythms
desirable
the latter

if

EastwardFlights
Sleeppatternsweremuchmorevariableandfragmentedaftereastwardnightflights (NRT-SFO,
SFO-LHR,SFO-FRA)than afterwestwardflights acrossanequivalentnumberof time zones.There
appearsto havebeena powerfulinfluencewhichfractionatedsleep,probablydependentonthe
difficulty whichindividualsexperiencedin shorteningtheirday.Furthermore,the consequences
of
sleeppatternfragmentationwerereflectedin subsequent
measuresof daytimedrowsiness.
Manycrewmemberswent to bedassoonaspossibleafterarrival andfell asleepmorequickly than
observedduringbaselinebut slepta relativelyshortamountof time evenaftera longovernightflight.
Subjectstendedto awakespontaneously
ata time correspondingto thelatemorningof their hometime.
Overall,this strategycanbebeneficial;however,theonsetof thenextmajorsleepvariedconsiderably
amongindividuals,with somecrewmembersfromeachairlinedelayingsleepuntil it coincidedwith
their usualbedtimeathome.Similar wide-rangingdifferenceswereseenin the secondnight's sleep
andinterveningsleeps.In spiteof a high degreeof variability, sleepdurationwasusuallyshorterthan
baselineandsubjectivelyworse.
Giventheusualimportanceattributedby flight crewsto obtaining"good" sleepimmediately
beforea flight, thesedatasuggestthattheir chanceof doingsocouldbe substantiallyimprovedby
adheringto a morestructuredsleepschedule.In orderto optimizesleepduringaneastwardlayoverof
24 hr or multiplesthereof.It wouldbeimportantto limit sleepimmediatelyafterarrival andprolongthe
subsequent
wakefulperiodto endaroundthenormallocal time for sleep.This processwould increase
the likelihoodthatthesleepimmediatelyprecedingthenextduty periodwouldbe of adequateduration
for theseoperations.It appearsthatpropersleepschedulingduringthefirst 24 hr is mostcritical and
thatcrewmembersshoulddevelopthedisciplineto terminatesleepeventhoughtheycouldsleep
longer.
Severalsubjectsattemptedthestrategyof trying to maintaina sleepschedulebasedon hometime.
For theschedulesunderstudy,this practicewouldappearto belessdesirablesinceit would producea
substantiallyshortersleepspanimmediatelybeforedeparture;however,this approachcould not be
adequatelyevaluateddueto therelativelysmallnumberof subjectswhousedit.
Unlesslayoversleepis arrangedin a satisfactorymannerby anappropriatesleep-wakestrategy,
increaseddrowsinessis likely to occurduringthe subsequent
long-haulflight. Otherresearchsuggests
thatunderacceptable
operationalcircumstances.
Limited durationnapscanbea helpfulstrategyto
providerefreshmentandimprovealertnessfor a usefulperiodof time.Althoughwe donot havethe
appropriatedatato addressthis issuedirectly,flight decknappingcouldbe animportantstrategyif
operationallyfeasible.
IndividualFactors
While thesubjectsasa wholedid not exhibitserioussleepproblems,certainindividualcrew
membersdid experiencesomedifficulty. Furtherinvestigationof thesedatais requiredbeforeany
clarifying statementcanbe maderegardingthefactorsresponsiblefor this situation.Suchwork is
currentlyunderway.

69

Age is oneindividualfactorwhich appearsto havebeenimportantin this study.Olderpersonstend

to experiencemoredifficulties obtainingundisturbedsleep,andthis wasseenin theaircrewduring
baselineandlayoverrecordings.Lessrestfulsleepis a featureof growingolderandbeginsto affect
individualsin middleage.Surprisinglylittle is knownaboutthe natureandprevalenceof lessrestful
sleepoverthis importantspanof life, but thedataobtainedfrom theseflight crews has highlighted the
need for normative

data in a similar

age group

of individuals

who are usually

involved

in highly

skilled

and responsible
occupations.
These data are now being collected
and may be helpful in understanding
why some individuals
in this age group have difficulty
in adapting to unusual hours of work and rest.
This issue may be relevant

to the practice

of occupational

medicine.

Finally, in one group of pilots, preliminary

analyses suggest that other individual
factors may
contribute
to the crew member's
response
to layover sleep requirements.
Although
this evidence
is
currently

limited

to differences

in daytime

sleepiness

in morning-

underscores
the potential usefulness
of factors related
individual reactions
to multiple time zone flights.

versus

to personality

evening-type

and lifestyle

individuals,

as predictors

it

of

Study Limitations
Although

these results

have direct implications

the context of several limitations

inherent
uncomplicated
trip patterns were studied.

for air carrier

operations,

they must be viewed

within

in the study design. Most important

is the fact that relatively
All but one of these trips involved
an immediate
return to the

home time zone after the layover. The primary data were obtained from crew members during the first
layover stay following an initial outbound
flight. One group of subjects provided additional
data upon
return to homebase.

At present, such trips are not typical of most international

flight crew duty schedules,
involve multiple flight segments and layovers in different time zones before return home;
the trips under examination
Although

represent

the alterations

an important

type of schedule

in sleep were not considered

which

is becoming

to be of operational

which usually
nevertheless,
more prevalent.

significance

in the present

schedules,
it is nevertheless
possible that the pattern of disturbed
sleep would lead to cumulative
sleep
loss if the schedule were longer or if complete
recovery of sleep were not attained before the next trip.
The latter possibility
some

subjects,

all flights

though

occurred

influences,
operational

is supported,

Secondly,
as a whole.

this may have also been

during

particularly
factor.

late summer

the length

the relatively
In this regard,

along

layover

at a sleep laboratory

Finally,
baseline

other dimensions

70

a potentially

data immediately

of daylight

limited

due to other factors

or early

sample

fall, which

versus

related
of crew

more serious
preceding

which

differed

us to examine

member_

problem

with staying
suggest

seasonal

in age and possibly

Third,

at a crew hotel. However,

that sleep-wake

for one airline,

Furthermore,

of the flight crew population

of their participation.

stems from the difficulty

the trip. Except

in

may also be an important

considerably

nature

sleep was reduced

such as early rising.

did not permit

darkness,

to the voluntary

may not be equated

groups

that baseline

sizes may not be representative

it is clear that the groups

differed

from two participating

these two conditions.

at least in part, by the observation

patterns

differ

we experienced

baseline

may have
spending

sleep log results

little under

in obtaining

data could only be

obtained
these

whenever

the volunteers

measurements

relating

to baseline

were available

often preceded

or followed

sleep must be tempered

following

by the realization

nights immediately
prior to flight might have differed
and may have been confounded
by the residual effect
preceding

trip involved

Regardless
consistency
and airline
spectrum

an eastward

of these interpretative

among

the different

operational
of long-haul

practices.

non-flying

or more.

that the actual

Thus,

days.

Consequently,

any conclusions

sleep obtained

during

the

from that measured

in the homebase
laboratory
of the previous flight schedule, particularly
if the

flight direction.
issues,

the data revealed

flight crew samples

Consequently,

crew members

at least three

the trip by a week

despite

a high degree
significant

of similarity

differences

it is likely that the overall

results

and

in culture,
apply

age,

to a wide

and carriers.

71

Crew Factors

Gander,

P.H., Barnes,

in Flight

Operations
to Helicopter

R., Gregory,

Vh Psychophysiological
Operations

K.B., Connell,

L.J., Miller,

D.L.,

Responses

and Graeber,

R.C.

(1994).

Crew

factors
in flight operations
VI: Psychophysiological
responses
to helicopter
operations.
(NASA
Technical
Memorandum
No. 108838). Moffett Field, CA: National Aeronautics
and Space
Administration.

Operational

Overview

This report

is the sixth in a series on the physiological

and psychological

effects

of flight

operations
on flight crews, and on the operational
significance
of these effects. This section
a comprehensive
review of the major findings and their significance.
The rest of the volume
the complete

scientific

Thirty-two

description

helicopter

presents
contains

of the work.

pilots (average

age 34 yr) were studied

before,

during,

and after 4- to 5-day

trips providing
support services from Aberdeen,
Scotland,
to rigs in the North Sea oil fields. Duty days
began and ended in Aberdeen.
Half the trips studied took place in winter/spring,
and the other half in
summer/autumn.
continuously
quality,

Heart

rate, rectal

temperature,

by means

of portable

biomedical

food and fluid intake,

medications

and activity
monitors.

taken,

of the nondominant
Subjects

and medical

kept daily

symptoms.

wrist were monitored

logs of sleep

They also rated

and mood every 2 hr while awake. For every segment flown, they rated their workload
Bedford Scale) for each phase of flight, and rated five different environmental
factors
influence

workload,

useless);

and weather

on a 5-point

scale

that is, functioning

on-duty

subjects

time 0725

local time), they averaged

to fall asleep

mechanisms

controlling
averaged

about

ness. Sleep
typical

was rated

during

were required

earlier

duty-related

reported

shown

overall

from sleep

more

activities

they came

fatigue

(on a modified
assumed to

from perfect

aids, and air-traffic

to

control

and sleep loss. Fatigue

(each

mornings

(average

1437

almost

17 hr.

of the physiological

for the early wake-ups,

and deeper

in the amount

days than on pretrip

and negative

early

that averaged

and to progressively

the start of on-duty

improvement

than on pretrip

is due to properties

than on trip nights

loss. Delaying

on posttrip

at home

on trips than on pretrip.

to accumulate

posttrip

1.5 hr earlier

to compensate

times

In the laboratory,

1 hr per

daytime

posttrip

than pretrip,

(by 1.5-2

days, suggesting
to maintain

and

increase

of sleep pilots

affect were higher,

the end of trip days than by the end of pretrip days. The inability
the end of trip days was exacerbated
by early on-duty times.

72

scale

off duty relatively

layovers

bedtime

50 min less sleep per night

as better

site, letdown

up about

were thus unable

would be expected to produce a significant

and should be given serious consideration.
Pilots

to wake

than the habitual

Subjects

has been

recovery

the landing

(on a 5-point

and

to very unfavorable).

local time). Although

sleep.

night of sleep restriction

systems

only 6.4 hr of sleep during

The inability
therefore

for landing,

from very favorable

On trip mornings,
(average

conditions

of the aircraft

timing

their fatigue

sleepi-

are able to obtain,

a cumulative

and activation
subjective

as is

hr on average)

effect

lower,

activation

by
by

of

Pilotsdrank42%morecaffeineon trip daysthanon pretripandposttripdays.More caffeinewas

consumedin the earlymorning,in association
with theearlywake-ups,andalsoaroundthe time of the
mid-afternoonpeakin physiologicalsleepiness.
The urgeto fall asleepatthistime would increaseas
the sleepdebtaccumulatedacrosstrip days.
Thereweretwiceasmanycomplaintsof headaches
on trips asathome.Reportsof backpain
increasedtwelvefold,andreportsof burningeyesincreasedfourfold. Helicopterpilotswerethreetimes
morelikely toreportheadaches,
andfive timesmorelikely to reportbackpainthanwerepilotsof fixedwing aircrafton short-haulcommercialflights. Thephysicalenvironmenton thehelicopterflight deck
wasprobablyanimportantfactor.Studiesof thesameoperations,conductedin parallel,demonstrated
thatpilotsoftenhadskin temperatures
outsidethe rangeof thermalcomfort,andthatvibrationlevelsin
all of thehelicoptersstudiedexceededthe "reducedcomfort" boundarydefinedby the International
StandardsOrganization(I.S.O.263).The longerpilotsremainedon duty,themorenegativetheir mood
became.This situationcould be improvedwith betterseatdesign,includingbetterisolationof the seat
from floor vibration,andbetterflight-deckventilation.
Thepredominantenvironmentalfactorsaffectingsubjectiveworkloadassessments
weredifferent
different

phases

useless)

of flight.

had a significant

aircraft

maintenance,

phases

of flight.

approach.

effect

thereby

Landing

However,

better letdown

The quality

of the aircraft

during

preflight,

minimizing

weather

the effect

aids. The quality

taxi, climb,

failures,

was the major

of adverse

workload ratings during landing. These findings

aids, and air-traffic
control can reduce subjective

(rated

on a 5-point

and cruise.

Paying

influencing

on workload

site and air-traffic

workload

was reduced
control

confirm that improvements

workload during descent,

scale

from perfect

particular

might be one way of reducing

factor

weather

of the landing

systems

attention

to

during

these

workload

ratings

during

with better

had a significant

for

to

descent

landing
effect

and

sites and
on

in landing sites, letdown

approach,
and landing.

73

Crew

Factors

Sleep

in Flight

Timing

and

Operations

Subjective
Long-Haul

Gander,

P.H., Graeber,

R.C.,

Connell,

operations:
VIII. Factors
haul flight crews. (NASA
Aeronautics

Operational

Commercial

Crews

L.J, and Gregory,

K.B. (1991).

Crew factors

and subjective
No. 103852).

inflight

sleep quality in commercial

Moffett Field, CA: National

Iong-

Overview
is the eighth

in a series

scientific

description

their sleep during

on physiological

of the work.

a variety

The aim of this study

of international

and local time can be viewed

the circadian

system

Self-reports

is a major

and psychological

effects

of flight operations

significance
of these effects. The Operational
Overview
findings and their significance.
The rest of this volume

of sleep (and nap)

timing

is a
contains

the

how flight crews

and to elucidate

how duty

(measured
by the rhythm of body temperature)
and subjectively
rated sleep quality. Duty require-

as environmental

physiological

was to document

trip patterns,

requirements,
local time, and the circadian
system
influence
the choice of sleep times, sleep duration,
ments

Influencing

in

and Space Administration.

This report

organize

Factors

Quality

Flight

influencing
sleep timing
Technical Memorandum

on flight crews, and the operational

comprehensive
review _of the major
complete

VIII:

Sleep

constraints

modulator

on the time available

of sleep quality

and sleep quality,

for sleep, while

and duration.

and continuous

records

of rectal

temperature
were collected
from 29 male flight crew members (average age 52 yr) during scheduled
B-747 commercial
long-haul
operations. Data from four different trip patterns were combined.
Sleep/wake
were followed
episodes.

patterns
by layovers

The average

5.7 hr sleep/7.4
layover
being

on these trips were complex.

of about

pattern

hr wake/5.8

hr sleep.

were not significantly

of better quality,

improved

longer

system

increased,
appeared

episodes than on second-sleep

was high, e.g., after eastward
typically
woke

went to sleep sooner

up either about

Otherwise,
preceding

The timing

falling

reinforcing
to have

in the layover

strongly

influenced

there

durations
asleep

were typically

However,

and deeper

influence

naps)

lasted

about

sleep.

episodes

were rated

Sleep-quality

on the timing

sleep

19 hr wake/

first-sleeps

of allowing

10.3 hr and

two subject-defined
was

of the first- and second-sleep

the importance

a greater

duty periods

(disregarding

of wakefulness.

adequate

in a

as

ratings
time for sleep.

and duration

of first-sleep

episodes in the layover, except when that level of accumulated

sleep debt
flights crossing five or more time zones. In such cases, crew members
after arriving

at the layover

onsets

and generally

by the amount

seemed
coincided

destination,

during

the local afternoon,

a nap) or 3 hr later (if they reported

tended to delay going

minimum.

of second-sleep

obtained

74

The average
episodes

2 hr later (if they reported

crew members
the temperature

which

and wakefulness

with less difficulty

as sleep duration

The circadian

24.8 hr during

of sleep

On average,

to sleep until the local night and/or

to be related

primarily

with local night.

of time remaining

to the amount

The duration

in the layover.

and

a sleep episode).
until the hours

of sleep already

of second-sleeps

was

For both first- and second-sleeps,

the circadiantime of sleeponsetwasalsoa significantpredictorof sleepduration.Longersleep

episodesbeganearlierwith respectto theminimumof thecircadiantemperaturecycle.
In summary,therelativeimportanceof duty requirements,
localtime,andthecircadiansystemin
determiningsleeptiming andquality wasdifferentfor first- andsecond-sleep
episodesin a layoverand
wasrelatedto specificflight schedules.
Nevertheless,
therewereclearlypreferredtimesfor sleepwithin
the layover,determinedby the circadianmodulationof sleeppropensityandthefactorsdriving the
preferenceto sleepduringthelocalnight(noise,light, mealavailability,etc.).
Flight andduty-timeregulationscanbeinterpretedasa meansof ensuringthatreasonable
minimum restperiodsarerespected.
Therehasbeena tendencyon thepart of regulatoryauthoritiesto
view theentiretime off duty asbeingtime availablefor sleep,despiteanecdotalevidencethattheeaseof
falling asleepandthe ability to remainasleepwerenot constantthroughoutthelayover.This study
clearlydocumentsthatin scheduledcommerciallong-hauloperations,therearephysiologicallyand
environmentallydeterminedpreferredsleeptimeswithin a layover,i.e.,the timeavailablefor sleepis
lessthanthe time off duty.
Evidencefromthis andotherstudiessuggeststhatthetiming anddurationof the second-sleep
episodein a layoveris stronglylinkedto the amountof sleepalreadyobtainedin the layover.Particularly whenthe first-sleepis short,asis typicalaftereastwardflights crossingfive or moretime zones,it
is essentialthatthelayoverbelongenoughto permitanadequatesecond-sleep
episodeappropriately
timedwith respectto the temperaturecycleandlocaltime.The durationof anyspecificlayovershould
bedeterminedwith regardto the localarrivaltime,andthesequence
of flights precedingit in thetrip
pattern,whichinfluencesboththecumulativesleeplossandthephaseof thecircadiansystem.
Basedon polygraphicstudiesof flight crewsleepaftera singleeastwardflight crossingeightor
ninetime zones,Graeberetal. recommended
thatcrewmembersshouldlimit sleepimmediatelyafter
arrival andprolongthe subsequent
wakeperiodto endaroundthenormallocal time for sleep.This is
intendedto improvethe quality of thesubsequent
sleepepisode,in keepingwith the anecdotalreport
thatflight crewsconsiderit importantto havea goodsleepimmediatelybeforea flight. Their study
lookedonly atsleepduringthe first (24 hr) layoverof a trip sequence.
The presentstudysuggests
that
therecommended
strategymaynot beoptimal aftereastwardflights laterin thesequence,
whencrew
membersmayhavealreadyaccumulated
animportantsleepdebt,andwhenthepositionof their
circadiantiming systemwould bemuchlesspredictable.
Napswerealsoreported,bothduringthe layoversandon theflight deck.Napsthatrepresented
the
first-sleepepisodein a layoverweresignificantlylonger(averageduration2.0 hr) thansubsequent
naps
in the layoveror flight-decknaps,andfollowedsignificantlylongerepisodesof wakefulness(14.7
versus5.9 and9.3hr,respectively).Suchfirst napswerenot very commonandwereassociatedwith
theacutesleepdebtimposedby overnighteastwardflightscrossingfive or moretime zones(67%)or
theprolongedwakefulnessassociated
with westwardflights crossingfive or moretime zones(25%).
Naps later in the layover tended to occur just before the next duty period and, since they reduce the
duration of continuous
wakefulness
before the next flight, may be useful as a strategy for reducing
cumulative

sleep loss.

75

Onthe flight deck,crewmemberswereobservedto benappingat least11%of the availabletime.

The averagedurationof thesenapswas46 min (range10-130min). Recentwork from our group
suggeststhata preplanned40-mintime intervalfor nappingon theflight deckcanreducesubsequent
reactiontimesandthenumberof EEG/EOGmicroeventsduringlong internationalflights. The optimal
durationof suchnapsis anactiveresearchissue.
This studyhassignificantlyenhancedour
this complex
cycle

operational

to adopt

influence

environment.

a period

different

of the circadian

understanding

The flight

of how the circadian

schedules

of the trips studied

from that of the underlying

system

circadian

was still seen in the selection

forced

pacemaker,

of sleep times

system

functions

in

the sleep/wake

although

the

and in sleep

durations,

i.e., the two systems were not completely

uncoupled.
However,
when the accumulated
sleep debt
was high, the circadian
rhythm in sleep propensity
could be overridden,
and crew members
could
fall asleep

at unusual

times

in their temperature

uncoupled

from the very complex

patterns

cycles.

The circadian

of environmental

system,

synchronizing

in turn, effectively
stimuli

experienced

by

crews.

There

are known

pacemakers,

to be differences

(2) their sensitivity

between

individuals

to environmental

in (1) the periods

synchronizers,

of their circadian

and (3) their self-selected

exposure
to social and sunlight cues in each time zone. At least some of these factors
ated with certain personality
profiles and probably all are age-dependent.
An analysis
data from 205 of the flight
the period

of the circadian

documented,
including
during the day.

crew members
pacemaker

shorter,

in our data bases concurs

shortens

less efficient

with age. Age-related

nocturnal

on the insights

to improving
education,
circadian

en route sleep
providing

system,

used to combine
knowledge
scheduling

76

gained

in this and other studies,

for flight crews

crew members

acquired
assistant.

from

flight crew members

both.

commercial

about
Second,

physiological

and schedulers

suggesting

and dynamic
algorithm.

promising
trip patterns.

system

systems

to develop

approaches
The first is
of the

technology

should

with operational

a computerized

that

sleepiness

sleep and the functioning

expert

of

are also well

physiological

we see two particularly

intemational

can modify

of the underlying

studies
in sleep

is the product of a subtle

by any simple predictive

with basic information

and how their behavior

our understanding

during

changes

sleep and increased

The timing and quality of sleep obtained by flight crews

interplay between all of these factors and cannot be captured
Based

with other

patterns

may be associof questionnaire

intelligent

be

Crew Factors

Rosekind,
Gillen,

in Flight Operations
IX: Effects of Planned Cockpit
Performance
and Alertness in Long-Haul
Operations

M.R.,

Graeber,

K.A.

(1994).

R.C., Dinges,

performance
and alertness
Moffett Field, CA: National

Operational

and on the operational

Long-haul

flight

operations

disruptions,

loss, decreased

effectiveness
response

in long-haul
Aeronautics

L.J., Rountree,

operations

M.S.,

IX: Effects

operations.
and Space

Spinweber,

of planned

(NASA Technical
Administration.

is the ninth in a series on physiological

on flight crews,

sleep

in flight

C.L., and

cockpit

rest on crew

Memorandum

No. 108839).

Overview

This report

circadian

D.F., Connell,

Crew factors

Rest on Crew

significance

often involve

and long, irregular

alertness,

and safety

rapid multiple

and decreased

and fatigue

because

time-zone

These

performance

experienced

effects

of flight operations

of these effects.

work schedules.

may be compromised

to the sleepiness

and psychological

changes,

factors

in long-haul

One natural

operations

disturbances,

in fatigue,

flight crews.

of pilot fatigue.

in long-haul

sleep

can result

cumulative

Thus, operational
compensatory

is unplanned,

spontaneous

napping and nonsanctioned

rest periods. That these activities occur is supported
by anecdotal,
observational,
and subjective
report data from a variety of sources. In response to this information
to concerns

for maintaining

flight

safety,

it was suggested

that a planned

cockpit

rest period

and

could

provide a "safety
rest period would

valve" for the fatigue and sleepiness

experienced
in long-haul
flying. The cockpit
allow a planned opportunity
to sleep, with the primary goal being to improve

subsequent

of performance

descent

levels

and alertness,

especially

during

critical

phases

of operation

such as

and landing.

This study was co-sponsored

and sanctioned
by the FAA and involved the voluntary
participation
of two commercial
airlines. The primary goal was to determine
the effectiveness
of a planned cockpit
rest period

to improve

performance

and alertness

in nonaugmented,

three-person

long-haul

operations.
Twenty-one
volunteer
pilots participated
and were randomly
assigned
(N = 12) or a no-rest group (N = 9) condition.
The rest group (RG) was allowed
period

during

the low-workload,

prearranged
rotation,
(NRG) had a 40-min
activities

during

part of a 12-day
eastbound

were studied.

with generally

procedural

and safety

not all of these

would

in long-haul

flight

choice

of rest period

going

phase

of flight over water.

this time. The four consecutive

trip pattern,

periods
workload

portion

Pilots rested

to either a rest group

a planned 40-min rest
one at a time, on a

with two crew members maintaining

the flight at all times. The no-rest group
planned control period identified
during cruise but maintained
their usual flight

night flights,

Specific
However,

cruise

flight

of flight

comparable

guidelines

be necessary

operations:
and ended

were successfully
for a general

scheduled

day flights

implemented

transpacific

trip,

and two legs were

descent;

established;

in this initial study.

implementation

that the rest period

pilot; (2) the rest periods

1 hr before
rotation

legs of a regularly

flight and duty times.

(1) it was crucial

to the landing

rest at a time with a clear planned

middle

Two legs were westbound

of planned

cockpit

was planned,

were scheduled

(3) only one crew member

(4) the rest opportunity

during

rest

with first
a low-

was scheduled

was divided

to

into an
77

initial preparationperiod
min) (these

(3 min), followed by the 40-min rest period, followed by a recovery period (20
times might be altered to reduce the overall length of the period); (5) the rest was terminated

at a preset time by a researcher,

loop; and (6) it was established

and the resting

that the captain

pilot was fully briefed before

would be notified immediately

reentering
the operational
at the first indication of

any potential anomaly. The safe and normal operation of the aircraft was given the highest
therefore, no cockpit rest procedure
or activity was allowed to interfere with this.
Several measures
effects of the planned
were conducted

period,

as well as the time taken

to determine

study

pattem
included

exercise,

There

to fall asleep

in-flight

fatigue

and the stages

Generally,

night,

significant
effects
than night flights,

quickly

(average

to sleep quantity

and flight position

that emerged
and the night

finding

emerged

There

were generally

a daily

across

flight

recordings

the rest

allowed

from

analysis

consistent

total of 124 lapses,

findings

differences

consistent

whereas

log for noting

collected

sleep periods,

in the

meals,

Questionnaire.
opportunities

that were analyzed:

the RG pilets

were able

o' ._:6_o2.n.

total sleep utr, t,, sleep

1 sleep, percent NREM stage 2 sleep, and pe.,rcent

was examined
for effects related to trip leg, r,alves of the
first officer,

second

of the physiological

sustained

legs, with significant

a generally

measures

and after

officer).

There

were two

from these analyses. The day flights had significantly

more light sleep
flights had significantly
more deep sleep than day flights. An

data. The median

show significant
increases
sec) for all 21 pilots (both
trials

during

= 5.6 min) and slept for an average

data collected

during

the NRG

usual flight activities,

four NRG pilots
several minutes to over 10 min.
for the variety

of analytical

attention/reaction

NRG showed a greater range of average responses

across
seen in the RG. After leg 1, the pilots in the NRG showed
maintained

(These

Subjective

Background

and quality

(captain,

control period. Although

instructed
to continue
total of five episodes) for periods lasting from

the performance

of sleep.

that on 93% of the rest period

they fell asleep

related

ratings,

efficiency,
sleep latency, percent NREM stage
NREM slow wave sleep. Each of these factors

interesting

sleep was obtained

sleep episodes.

etc., and the NASA

data showed

were six factors

layover

and alertness

flight and duty periods,

trip, day versus

how much

A wrist activity monitor was worn continuously

before, during,
monitor provided information
regarding
the pilots' 24-hr rest/

and was used to examine

The physiological
to sleep.

physiologically

of non-rapid-eye-movement
(NREM) sleep and its stages and rapid-eye-movement
A reaction-time/sustained-attention
task (psychomotor
vigilance task) was used to

assess performance
capability.
the trip schedule. This activity
activity

and,

were used to examine the physiological,

behavioral,
performance,
and subjective
cockpit nap. Continuous
ambulatory
recordings
of brain wave and eye movement

activity

differentiation
(REM) sleep).

priority

(a

used to examine
measure)

for the

flight legs and during in-flight trials than

a steady increase in median reaction time

by the middle

level of performance

approaches

time (a performance

40-min

fell asleep

and end of flights.

both across

and within

The RG pilots
flight legs, and did not

in reaction time. There were a total of 283 lapses (i.e., a response delay > 0.5
groups combined).
For in-flight trials, the NRG (with fewer subjects) had a
the RG had a total of 81. There

2 and 3 (after the test period)

for the NRG,

though

was an increase

this increase

in lapses

did not occur

during
during

in-flight
in-flight

trials following
the nap in the RG. Both groups had more lapses before top of descent (TOD) on nightflight leg 4 than on night leg 2. However,
the number of lapses in the NRG pilots increased
twice as
much

as in the RG pilots.

Vigilance

pilots had a level of performance

the performance
78

task demonstrated

decrement

functions

that was significantly

decrements

across

also revealed
decreased
flight

relative

that on night flights

to the RG pilots.

legs and within

flights

the NRG
Generally,

for the NRG,

whereastheRG maintainedconsistentlevelsof
nap prevented

deterioration

Changes

in brain wave

alertness/sleepiness
of the cockpit
descent

changes.

An intensive

in 78% of the NRG

in the NRG

significantly

critical

can reflect

phase

the subtle

analysis

alertness.

for the occurrence

suggest

that the planned

ways that physiological

was conducted

The period

from

to examine

1 hr before

of brain and eye movement

more

(with

and 50% of the RG. Overall,

fewer

subjects)

total microevents

The 24-hr rest/activity

the 21 subjects

patterns,

accumulated

is considered,

than the average

the rest period

in combination

the effects

TOD through

microevents

indicative

the percent

When

a total of 120 microevents

was followed

This supports

by increased

36-hr duty period

(layover

that
averaged

the

physiological

logs, demonstrated

from 4 to 22 hr and averaged

the entire

of layover

in the RG. The NRG

in the RG (2.90).

with the subjective

a sleep debt that ranged

by the ninth day of the duty cycle.

there were

and a total of 34 microevents

(6.37)

conclusion
that the sleep obtained during
alertness
in the RG relative to the NRG.

cycle)

findings

physiological
alertness. During approximately
the last 90 min of flight, each event greater
duration was scored for both the NRG and RG. There was at least one such microevent

identified
occurred

activity

physiological

was analyzed

These

performance.

and eye movement

nap on subsequent

and landing

of reduced
than 5-sec

of vigilance

performance.

that 86% of

approximately

and subsequent

sleep time is 28%. This is less than the average

9 hr
duty

33% sleep

time spent off-duty at home, hence the cumulative

sleep debt. One subject gained sleep, and two others
had no change. Further analysis demonstrated
that the cockpit nap did not significantly
alter the
cumulative

sleep debt observed

in the RG. Also, 77% of the layovers

involved

more than one sleep

episode. Generally,
there were two sleep episodes,
and if the first one was long, then the second one
was short or did not occur. Conversely,
if the first sleep episode was short, then there was almost
always

a second

to control

one that was long. This result

sleep timing

was not designed

sleep periods,
Overall,
alertness

and quantity

to examine

including
the analysis

leg 1). The results

objective

measures

the issue of layover

naps,

in long-haul

of the subjective

on night flights

indicated

sleepiness
asleep

indicated

The speed

Overall,
approaches.
circadian

the study

disruption,

performance
experienced

recently,
addressed.

demonstrated

of falling

asleep

and greater
in long-haul

the timing

ratings

than before
of alertness,

alertness

though

on

the

was demonstrated

of physiological

he or she will fall asleep).

sleep

lower

it (except

in the RG.

flight operations

to that seen in moderately

operating
of layover

that pilots reported

period

has been used as a measure

the faster

usual flight

operations.

of their level of physiological

results

Conceptually

though

has been

factors

sleep loss). This study

deprived

The speed of falling

individuals.

sleepiness
in sleep disorder patients is a sleep latency of 5 min or less.
of sleep that occurred during the control period in four NRG pilots who

to continue

are poor evaluators

ratings

were multiple

time, prior

and after the rest/control

an individual,

in the RG (5.6 rain) is comparable

diagnostic
guide for excessive
Also, there were five episodes
pilots

alertness

better

sleepiness

(i.e., the more sleepy

had been instructed

sleep periods,

that the nap did not affect the subjective

clearly

groups.

that there
circadian

flight operations,

than on day flights

The level of physiological

in both subject

demonstrated

(e.g., local time, home

provide

support

and operationally,

and fatigue

in flight

This result

operations

previous

findings

that

sleepiness.

for differentiating
methods

reinforces

fatigue

to minimize
can be divided

countermeasures

or mitigate

into two basic

the effects

into (1) preventive

of sleep loss,

strategies

and (2)
79

operationalcountermeasures.
Preventivestrategiesinvolvethoseapproaches
thatresultin morelongtermadjustmentsandeffectson underlyingphysiologicalsleepandcircadianprocesses
(e.g.,possibilitiesfor further researchincludeshiftingthe circadianphasebeforemultipletime-zone
changes,usingbrightlightsor exerciseto rapidly readjustthe circadianclock,andmaximizingthe
quantityandqualityof sleep).Thesepreventivestrategiesaffectunderlyingphysiologicalsleepneed,
sleepiness,
andcircadianphasein a long-termandchronicfashion.Operationalcountermeasures
are
focusedstrategiesfor reducingsleepinessandimprovingperformanceandalertnessduringactual
operations(e.g.,provedstrategiesincludejudicioususeof caffeine,increasedphysicalactivity,and
increasedinteraction).Theseshort-actingcountermeasures
arenot intendedto reduceunderlying
physiologicalsleepinessor a sleepdebt,but ratherto increaseperformanceandalertnessduring
operationaltasks.Oneacute,short-actingoperationalcountermeasure
thatcantemporarilyreduce
physiologicalsleepinessis napping.The plannedcockpitnapin this studyis consideredto bean
operationalcountermeasure
thatprovidedanacute,short-actingimprovementin performanceand
alertness.
It mustbeacknowledgedthateveryscientificstudyhasspecificlimitationsthatrestrictthe
generalizabilityof theresults.This studyinvolvedonly onetrip patternon a commercialairlinecarrier.
The studywasconductedon transpacificflights to utilize theopportunityof schedulingtheplanned
restperiodsduringthe low-workloadportionof cruiseoverwater.The intensephysiologicaland
performancedatacollectionoccurredduringa specificandrestrictedmiddlesegment(four consecutive
flight legs)of thetrip schedule.Therefore,the initial home-to-flight-schedule
transitionis quantified
onlywith logbookandactivity data.Also,the highestlevelsof accumulated
fatigue,which probably
occurredduringthefinal trip legs,werenot studiedexceptfor log bookandactivity data.This study
involvedB-747aircraftflown by three-person
crews;the specificapplicationof thiscountermeasure
to the two-personcockpitwasnot addressed.
Thereweretwo NASA researchers
on theflight deck
duringthein-flight datacollectionperiods.Althoughtheywereinstructedto minimizetheir interactions
andpresence,thereis noquestionthathavingtwo extraindividualsonthe flight deckmay have
potentiallyalteredtheregularflow of cockpitconversationandinteraction.It is importantto remain
cognizantof theselimitationswhenattemptsaremadeto generalizethestudyresultsto questionsthat
extendbeyondthescopeof the specificscientificissuesaddressed
here.
In conclusion,the RGpilots wereableto sleepduringtheplannedcockpitrestperiod,generally
falling asleepquickly andsleepingefficiently.This napwasassociated
with improvedperformanceand
physiologicalalertnessin theRG comparedto theNRG.The benefitsof thenapwereobserved
throughthecritical descentandlandingphasesof flight. Theconvergenceof the behavioralperformancedataandthe physiologicaldatato demonstratetheeffectiveness
of thecockpitnaplendssupport
to therobustnessof the findings.The napdid not affectlayoversleepor the overallcumulativesleep
debtdisplayedby themostof thecrewmembers.Thenapprocedures
wereimplementedwith minimal
disruptionto usualflight operations,andtherewereno reportedor identifiedconcernsregardingsafety.
The plannednapappearedto provideaneffective,acuterelieffor thefatigueandsleepiness
experien
n nonaugmented
three-person
long-haulflight operations.The strengthof the current
resultss
,rts the implementation
of planned cockpit sleep opportunities
in nonaugmented
long-haul
flight o__
each airhne
operation.
80

_tions involving
could

determine

If implemented,

three-person

crews.

the appropriate
we recommend

If planned

incorporation
that a joint

cockpit

sleep opportunities

of procedures

NASA/FAA

were sanctioned,

into its specific

follow-up

mode

study be conducted

of
within

6-12 monthsto examinehowplannedcockpitsleepopportunitieshavebeenincorporatedinto airline

procedures.
Thatstudywouldexaminehowtheprocedureswereimplementedandtheir effectiveness.
This mighttaketheform of a surveyor includesomefield datacollection.The resultsof
thatfollow-up studymight thenlendsupportfor further refinementof proceduresandfuture
implementationin otherflight environments.

81

APPENDIX
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AMES

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APPENDIX
GENERAL

Carskadon,

M.A.

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(Ed.).

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& Company.
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(1992).

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& Company.
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87

REPORT
Public

reporting

burden

gathering

and

collection

of

information,

Highway,

Suite

Davis

for

maintaining

1. AGENCY

this
the

collection
data

1204,

of

needed,

including

DOCUMENTATION
information
and

Arlington,

USE ONLY

VA

(Leave

is

estimated

completing

suggestions

lot

and

reducing

22202-4302,

and

blank)

2.

1o

to

average

reviewing

this

the

burden,
the

to

Office

of

REPORT

AND

hour

per

collection

of

Washington

response,

including

information,

Send

Headquarlers

Management

and

the

time

comments

Services,

Budget,

Paperwork

Alertness
Education

for

reviewing

instructions,

regarding

Directorate
Reduction

for

this

Project

Management
Module

Ames

Research

Moffett

SPONSf.

ORGANIZATION

H. Gander,*

NAME(S)

AND

SUPPLEMENTARY

AGENCY

this

20503

NUMBERS

Linda J. Connell,

8. PERFORMING
ORGANIZATION
REPORT NUMBER

ADDRESS(ES)

NAME(S)

AND

10.

ADDRESS(ES)

SPONSORING/MONITORING
AGENCY
REPORT
NUMBER

NASA/TM-2001-211385
DOT/FAA/AR-01-01

NOTES

Melissa Mallis, Ames Research

(650) 604-3654

DISTRIBUTION/AVAILABILITY

Center, MS 262-4,

Ames Research

Moffett Field, CA 94035-1000

Center.

STATEMENT

12b.

DISTRIBUTION

CODE

-- Unlimited

Subject Category 03
Availability: NASA CASI (301 ) 621-0390
ABSTRACT

of
Jefferson

IH-022

*San Jose State Universit_ Foundation,

13.

DC

sources,

aspect
1215

Center

,_ ;NGIMONITORING

Unclassified

Washington,

FUNDING

Field, CA 94035-1000

Point of Contact:

12a.

data

other

548-30-32

National Aeronautics
and Space Administration
Washington,
DC 20546-0001

11.

any
Reports,

in Flight Operations

Mark R. Rosekind, Philippa

and Elizabeth L. Co*
PERFORMING

existing
or

and

X:

S. AUTHOR(S)

7.

estimate

Operations

(0704-0188),

5.

in Flight Operations

searching

burden

intormation

Technical
3. REPORT
TYPEMemorandum
AND DATES COVERED

2001

SUBTITLE

Crew Factors

Approved

OMBNo.0704-0188

DATE

November
4. TITLE

Form

PAGE

(Maximum

Distribution:

Standard

200 words)

In response to a 1980 congressional

request, NASA Ames Research Center initiated a Fatigue/Jet Lag
Program to examine fatigue, sleep loss, and circadian disruption in aviation. Research has examined fatigue
in a variety of flight environments
using a range of measures (from self-report to performance
to physiological). In 1991, the program evolved into the Fatigue Countermeasures
Program, emphasizing
the development and evaluation of strategies to maintain alertness and performance
in operational settings. Over the
years, the Federal Aviation Administration
(FAA) has become a collaborative
partner in support of fatigue
research and other Program activities.
From the inception of the Program, a principal goal was to return the information
learned from research
and other Program activities to the operational
community. The objectives of this Education and Training
Module are to explain what has been learned about the physiological
mechanisms
that underlie fatigue,
demonstrate
the application of this information in flight operations, and offer some specific fatigue countermeasure recommendations.
It is intended for all segments of the aeronautics industry, including pilots, flight
attendants, managers, schedulers, safety and policy personnel, maintenance
crews, and others involved in an
operational
environment
that challenges human physiological
capabilities
because of fatigue, sleep loss, and
circadian disruption.
14. SUBJECTTERMS
Fatigue,

Circadian

rhythms,

Education

15.

NUMBER

16.

PRICE

OF PAGES

91

and training

CODE

A05
17.

SECURITY
CLASSIFICATION
OF REPORT

Unclassified
NSN

7540-01-280-5500

18.

SECURITY
CLASSIFICATION
OF THIS PAGE

19.

SECURITY
CLASSIFICATION
OF ABSTRACT

20.

LIMITATION

OF ABSTRACT

Unclassified
Standard
Prescrtbed
298-102

Form
by

ANSI

298
sta.

(Rev.

Z39-18

2-89)