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All sourcesNASA NTRSDOE OSTI
NASA NTRSDate not supplied

Comparison Between Continuous and Intermittent Actigraphy Outcomes During Long-Duration Missions

INTRODUCTION Historically, astronauts have worn actigraphy watches continuously throughout their missions. This has enabled reliable sleep estimation and comparisons between sleep and other outcomes and mission activities such as the arrival of a visiting vehicle. However in late 2020, astronauts were scheduled to wear an actiwatch for one 2-week period every two months, substantially decreasing availability of data. Our aim was to compare sleep and mission events between data collected continuously and data collected intermittently to identify any differences. METHODS Crewmembers (n = 19) who volunteered for the NASA Standard Measures protocol between January 2019 and March 2022 were provided with actiwatches (Phillips, Respironics, Bend OR) that they wore either continuously (C; n = 9) or for two weeks every two months while in space (2W; n = 10). We used crew schedules to identify mission events that were asynchronous with actigraphy. We further compared sleep outcomes (sleep duration, wake after sleep onset [WASO], sleep efficiency) between the C and 2W actigraphy collection. RESULTS In the 2W group, sleep data was not available for 52% of EVAs, 67% of visiting vehicle events, and 67% of commander turnovers. Average sleep duration for the 2W group (M = 6.91, ± 1.24 SD) was significantly lower compared to the C group (7.51 ± 1.08, p < .01). Sleep efficiency was better for those in the C group (90.56 ± 5.19) than for those in the 2W group (87.02 ± 6.47 p < .01). There were no significant differences in WASO (C = 26.66 ±12.99; 2W = 32.38 ± 18.83). DISCUSSION Continuous actigraphy data collection yields different sleep outcomes compared to intermittent data collection. In addition, many mission events were not captured with intermittent data collection. Our findings support the use of continuous actigraphy data collection.

fatigue↗
NASA NTRS2011

Identification of Cardiometabolic Vulnerabilities Caused by Effects of Synergistic Stressors that are Commonly Encountered During Space Missions

Microgravity is a physiologically challenging state even when at rest. Astronauts experience additional physical and mental stresses, such as prolonged exertion, sleep loss and circadian misalignment, that could impact cardiovascular function. The main goals of this four year NASA project are to characterize the independent and synergistic effects on cardiovascular and immune function of: (1) circadian misalignment; (2) sleep loss; and (3) varied physical and mental stressors, mimicking some of the synergistic stressors experienced by astronauts. Sixteen healthy volunteers, aged 35-55 years, will be studied with standardized behavioral stressors occurring across all circadian phases, both with and without accruing sleep loss, achieved via two 11-day "forced desynchrony" protocols performed in each subject (randomized, within-subject design), where wake periods are advanced 4-h each "day" (i.e. recurring 20-h "days"). One protocol permits 8.33 h sleep opportunity per 20-h "day" (=10 h sleep per 24-h), and the other permits 5 h sleep per 20-h "day" (=6 h sleep per 24-h; matching the reported sleep duration of astronauts). In both protocols, subjects will perform a standardized stress battery including a cognitively challenging task; bicycle exercise, and passive 60deg head up tilt. Outcome variables include blood pressure, heart rate, arrhythmia frequency, cardiac vagal tone (from heart rate variability), sympathetic activity (catecholamines), and endothelial function. Additional measures of cardiac function (echocardiography), responses to a passive 80deg head up tilt, maximal oxygen uptake, and immune function will be assessed at the beginning and at the end of each protocol (i.e., without and with sleep loss, and before and after circadian misalignment). We hope to identify the relative impact on cardiovascular risk markers of varied behavioural stressors while subjects experience circadian misalignment and sleep loss, mimicking some of the synergistic stressors experienced by astronauts. Supported by NASANNX1 OAR 1 OG.

Ruger, M.↗
NASA NTRS2014

Fatigue in U.S. Astronauts Onboard the International Space Station: Environmental Factors, Operational Impacts, and Implementation of Countermeasures

Since 2000, US astronauts have been supporting missions up to a six month duration on the International Space Station (ISS). Crewmembers have experienced fatigue for reasons similar to military deployments. Astronauts experience psychological stressors such as heavy workloads, extended duty periods, circadian misalignment, inadequate/ineffective sleep, and loss of the environmental cues of a gravity environment. Complicating the psychological stressors are environmental factors; distracting background noise, unexpected and variable mission schedules, unfavorable thermal control, elevated CO2 levels, and an unusual sleep environment with schedules that impinge on pre‐sleep periods. Physiological contributors to poor sleep and fatigue include a cephalad fluid shift and back pain. Restful sleep is further challenged due to a lack of gravity‐related proprioceptive cues and need for restraints. The term "space fog" has been used by astronauts to describe a phenomenon of forgetfulness, slowed reaction time and transient confusion while trying to complete tasks. There is a distinct temporal correlation with arrival on the Space Station and the onset of slowed cognitive skills and a spontaneous resolution that may take up to 6 weeks. The Genesis of this phenomenon may be chronic fatigue secondary to transitioning from a planar environment to a 360deg microgravity perspective. Recently, countermeasures to improve sleep duration and quality in astronauts on the ISS have been instituted with moderate degrees of success as measured by self‐reaction time (psychomotor vigilance task testing), actigraphy, and subjective reports. Judicious use of stimulants and hypnotics, light therapy, controlled sleep periods and sleep shifting and reducing ambient CO2 levels are a few of the most promising countermeasures being used in space to improve sleep and reduce fatigue.

Scheuring, R. A.↗
NASA NTRS2019

Fatigue and Fatigue Countermeasures

Sleep can play an important role in alleviating health disparities, as inadequate sleep is associated with serious, adverse health conditions including cardiovascular disease, diabetes, obesity, cancer, and premature mortality. Nonetheless, dissemination of sleep health interventions targeted towards health disparities populations remains limited. Social workers and social work students serve populations designated as health disparities populations and are in an optimal position to promote sleep health among their underserved clients. However, social work students lack the specific training and resources necessary to promote healthy sleep practices among their clients. In fact, bachelors, master's, and doctoral social work programs in the United States do not incorporate any sleep health training as part of their curriculum. To improve public health through the promotion of healthy sleep practices among underserved populations, we propose to equip social work students, through an online learning module, with the knowledge and resources necessary to promote healthy sleep practices among their clients in underserved communities. In order to maximize effectiveness and reach, this proposal employs: (1) a collaborative team of sleep medicine and social work professionals; and (2) an ideal university environment with sophisticated eLearning capabilities that has one of the largest social work programs in the state of Florida.

fatigue countermeasure↗
NASA NTRS2019

Controlled Rest: Profile of Use, Challenges, and Best Practices

Despite the introduction of flight, duty, and rest time regulations to reduce the risk of sleepiness, airline pilots often encounter elevated sleepiness during flight. To combat this sleepiness, in some instances, pilots can take a short nap on the flight deck (controlled rest) to improve their alertness. Little is known, however, as to when and how often this countermeasure is used operationally. Methods: Forty-four pilots from a European carrier wore actiwatches and filled in an electronic sleep and work diary for approximately 2 weeks resulting in data from 239 flights. Self-reported in-flight rest periods were used to set rest intervals and sleep was estimated within these intervals using Philips Actiware 6.0.9. Wake threshold selection was set to medium; sleep threshold detection algorithm was set to 10 immobile minutes at sleep onset and sleep end. Timing of sleep periods was analyzed relative to home base time. Results: Preliminary analyses showed that controlled rest was taken on 46% (n=110) of flights. On 23 flights (10%) pilots reported taking two controlled rest periods. Sleep, as estimated by actigraphy, was achieved during 80% (n=106) of controlled rest periods. The mean sleep duration was 32 (± 12) minutes estimated within successful controlled rest periods. Approximately two-thirds (67.5%, n=81) of all rest periods were initiated during home base time night (0000h-0800h). On 11% (n=26) of flights, pilots also reported taking bunk rest (longer rest period in a designated sleeping facility).Conclusion:This study shows that controlled rest is commonly used as a countermeasure to sleepiness on the flight deck. Further analysis is required to determine what other factors contribute to the decision to take controlled rest, and how effective it is in reducing sleepiness on the flight deck.

Hilditch, Cassie J.↗
NASA NTRS1996

Crew Factors in Flight Operations 7: Psychophysiological Responses to Overnight Cargo Operations

To document the psychophysiological effects of flying overnight cargo operations, 41 B-727 crew members (average age 38 yr) were monitored before, during, and after one of two typical 8-day trip patterns. During daytime layovers, the average sleep episode was 3 hr (41%) shorter than nighttime sleeps and was rated as lighter, less restorative, and poorer overall. Sleep was frequently split into several episodes and totaled 1.2 hr less per 24 hr than on pretrip days. Each trip pattern included a night off, which was an effective countermeasure against the accumulating sleep debt. The organization of sleep during daytime layovers reflected the interaction of duty timing with circadian physiology. The circadian temperature rhythm did not adapt completely to the inverted wake-rest schedule on duty days, being delayed by about 3 hr. Highest subjective fatigue and lowest activation occurred around the time of the temperature minimum. On duty days, reports of headaches increased by 400%, of congested nose by 200%, and of burning eyes by 900%. Crew members also reported eating more snacks. Compared with daytime short-haul air-transport operations, the overnight cargo trips included fewer duty and flight hours, and had longer layovers. Overnight cargo crews also averaged 5.4 yr younger than their daytime short-haul counterparts. On trips, both groups lost a comparable amount of sleep per 24 hr, but the overnight cargo crews had shorter individual sleep episodes and more broken sleep. These data clearly demonstrate that overnight cargo operations, like other night work, involve physiological disruption not found in comparable daytime operations.

Gander, Philippa H.↗
NASA NTRS1991

Light as a chronobiologic countermeasure for long-duration space operations

Long-duration space missions require adaptation to work-rest schedules which are substantially shifted with respect to earth. Astronauts are expected to work in two-shift operations and the environmental synchronizers (zeitgebers) in a spacecraft differ significantly from those on earth. A study on circadian rhythms, sleep, and performance was conducted by exposing four subjects to 6 deg head-down tilt bedrest (to simulate the effects of the weightless condition) and imposing a 12-h shift (6 h delay per day for two days). Bright light was tested in a cross-over design as a countermeasure for achieving faster resynchronization and regaining stable conditions for sleep and circadian rhythmicity. Data collection included objective sleep recording, temperature, heart rate, and excretion of hormones and electrolytes as well as performance and responses to questionnaires. Even without a shift in the sleep-wake cycle, the sleep quantity, circadian amplitudes and 24 h means decreased in many functions under bedrest conditions. During the shift days, sleepiness and fatigue increased, and alertness decreased. However, sleep quantity was regained, and resynchronization was completed within seven days after the shift for almost all functions, irrespective of whether light was administered during day-time or night-time hours. The time of day of light exposure surprisingly appeared not to have a discriminatory effect on the resynchronization speed under shift and bedrest conditions. The results indicate that simulated weightlessness alters circadian rhythms and sleep, and that schedule changes induce additional physiological disruption with decreased subjective alertness and increased fatigue. Because of their operational implications, these phenomena deserve additional investigation.

Samel, Alexander↗
NASA NTRS1997

Research on the Effects of Fatigue within the Corporate/Business Aircraft Environment

In 1980, responding to a Congressional request, NASA Ames Research Center created a program to examine whether 'there is a safety problem of uncertain magnitude, due to transmeridian flying and a potential problem due to fatigue in association with various factors found in air transport operations.' The NASA Ames Fatigue/Jet Lag Program was created to collect systematic, scientific information on fatigue, sleep, circadian rhythms, and performance in flight operations. Three Program goals were established and continue to guide research efforts to: (1) determine the extent of fatigue, sleep loss, and circadian disruption in flight operations; (2) determine the impact of these factors on flight crew performance; (3) develop and evaluate countermeasures to mitigate the adverse effects of these factors and maximize flight crew performance and alertness. Since 1980, studies have been conducted in a variety of aviation environments, in controlled laboratory environments, as well as in a full-mission flight simulation. Early studies included investigations of short-haul, long-haul, and overnight cargo flight crews. In 1991, the name of the program was changed to the Fatigue Countermeasures Program to provide a greater emphasis on the development and evaluation of countermeasures. More recent work has examined the effects of planned cockpit rest as an operational countermeasure and provided analyses of the pertinent sleep/duty factors preceding an aviation accident at Guantanamo Bay, Cuba. The Short-Haul study examined the extent of sleep loss, circadian disruption, and fatigue engendered by flying commercial short-haul air transport operations (flight legs less than eight hours). This was one of the first field studies conducted by the NASA program and provided unique insight into the physiological and subjective effects of flying commercial short-haul operations. It demonstrated that a range of measures could be obtained in an operational environment without disturbing the regular performance of duties. The Long-Haul study examined how long-haul flight crews organized their sleep during a variety of international trip patterns and examined how duty requirements, local time, and the circadian system affected the timing, duration, and quality of sleep. Duty requirements and local time can be viewed as external/environmental constraints on time available for sleep, while the internal circadian system is a major physiological modulator of sleep duration and quality. The Overnight Cargo study documented the psychophysiological effects of flying overnight cargo operations. The data collected clearly demonstrated that overnight cargo operations, like other night work, involve physiological disruption not found in comparable daytime operations.

Neri, David F.↗
NASA NTRS1999

Aging and space flight: findings from the University of Pittsburgh

For more than a decade, the Sleep and Chronobiology Center (SCC) at the University of Pittsburgh has received funding from the National Institute on Aging (NIA), the National Institute of Mental Health (NIMH) and the National Aeronautics and Space Administration (NASA) in order to study the sleep and circadian rhythms of healthy older people, as well as the sleep and circadian rhythms of astronauts and cosmonauts. We have always been struck by the strong synergism between the two endeavors. What happens to the sleep and circadian rhythms of people removed from the terrestrial time cues of Earth is in many ways similar to what happens to people who are advancing in years. Most obviously, sleep is shorter and sleep depth is reduced, but there are also more subtle similarities between the two situations, both in circadian rhythms and in sleep, and in the adaptive strategies needed to enhance 24h zeitgebers.

STS-78 Shuttle Project↗
NASA NTRSDate not supplied

Controlled Rest: Investigating the Use of an In-Flight Sleepiness Countermeasure

INTRODUCTION: Sleepiness is commonly reported amongst commercial airline pilots and is recognized as a safety risk due to its impact on performance. Controlled Rest (CR) refers to a short, voluntary nap opportunity taken by pilots on the flight deck as a countermeasure to unanticipated sleepiness in flight. This study explores the profile of CR use in a long-haul commercial airline. METHODS: Forty-four pilots filled in an application-based sleep/work diary and wore actiwatches for approximately 2 weeks. Complete data sets from 239 flights including sleep diaries, actigraphy, and schedules were merged and analyzed. Sleep diary entries were used to set CR intervals in the actigraphy software, which was then used to predict sleep within these intervals. All time-stamps of sleep periods and flight schedules were adjusted for home-base time of the pilots. Pearson Correlations were used to assess the influence of pilot demographics on CR use. A mixed-effects logistic regression was used to analyze the impact of schedule factors on CR. RESULTS: Pilots reported taking CR on 46% (n=110) of observed flights. Average CR attempt duration was 43.1 ± 11.0 minutes. Eighty-percent (n=106/133) of all CR attempts were estimated by actigraphy to have successfully achieved sleep with an average sleep duration during successful rest periods of 31.7 ± 12.2 minutes. Captains reported taking CR on 38% of flights (n=39/102), compared to First Officers reporting 52% (n=71/137) of flights with CR (p=0.131). Age, experience, BMI, and sleep need were not associated with the percentage of flights with CR (all p>0.244). The following schedule factors were associated with a higher frequency of CR: night (55%, n=76) vs. day flights (34%, n=34); <10h (63%, n=80) vs. >10h duration flights (27%, n=30); return (60%, n=71) vs. outbound flights (33%, n=39); and 2-pilot (69%, n=83) vs. >2-pilot flights (23%, n=27) (all p≤0.001). There was a trend for more CR on eastbound flights, but this was not significant (eastbound: 51%, n= 57; westbound: 40%, n= 44; p=0.059). Of note, 22% (n=26) of augmented flights (>2-pilots) contained both CR and Bunk Rest (in a designated rest facility). DISCUSSION: Data from this airline show that pilots commonly use CR to mitigate sleepiness in-flight, especially on flights <10h duration and during home-base nighttime flights. Future studies are required to determine generalizability of these results to other airlines.

sleepiness↗
NASA NTRS2011

Fatigue Management in Spaceflight Operations

Sleep loss and fatigue remain an issue for crewmembers working on the International Space Station, and the ground crews who support them. Schedule shifts on the ISS are required for conducting mission operations. These shifts lead to tasks being performed during the biological night, and sleep scheduled during the biological day, for flight crews and the ground teams who support them. Other stressors have been recognized as hindering sleep in space; these include workload, thinking about upcoming tasks, environmental factors, and inadequate day/night cues. It is unknown if and how other factors such as microgravity, carbon dioxide levels, or increased radiation, may also play a part. Efforts are underway to standardize and provide care for crewmembers, ground controllers and other support personnel. Through collaborations between research and operations, evidenced-based clinical practice guidelines are being developed to equip flight surgeons with the tools and processes needed for treating circadian desynchrony (and subsequent sleep loss) caused by jet lag and shift work. The proper implementation of countermeasures such as schedules, lighting protocols, and cognitive behavioral education can hasten phase shifting, enhance sleep and optimize performance. This panel will focus on Fatigue Management in Spaceflight Operations. Speakers will present on research-based recommendations and technologies aimed at mitigating sleep loss, circadian desynchronization and fatigue on-orbit. Gaps in current mitigations and future recommendations will also be discussed.

Whitmire, Alexandra↗