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NASA NTRS1993

Age, circadian rhythms, and sleep loss in flight crews

Age-related changes in trip-induced sleep loss, personality, and the preduty temperature rhythm were analyzed in crews from various flight operations. Eveningness decreased with age. The minimum of the baseline temperature rhythm occurred earlier with age. The amplitude of the baseline temperature rhythm declined with age. Average daily percentage sleep loss during trips increased with age. Among crewmembers flying longhaul flight operations, subjects aged 50-60 averaged 3.5 times more sleep loss per day than subjects aged 20-30. These studies support previous findings that evening types and subjects with later peaking temperature rhythms adapt better to shift work and time zone changes. Age and circadian type may be important considerations for duty schedules and fatigue countermeasures.

Gander, Philippa H.↗

NASA NTRS1994

Fatigue in operational settings: Examples from the aviation environment

The need for 24-h operations creates nonstandard and altered work schedules that can lead to cumulative sleep loss and circadian disruption. These factors can lead to fatigue and sleepiness and affect performance and productivity on the job. The approach, research, and results of the NASA Ames Fatigue Countermeasures Program are described to illustrate one attempt to address these issues in the aviation environment. The scientific and operational relevance of these factors is discussed, and provocative issues for future research are presented.

Rosekind, Mark R.↗

NASA NTRS1996

Managing fatigue in operational settings. 1: Physiological considerations and countermeasures

The authors consider three aspects of managing fatigue in the workplace. They provide a brief overview of important scientific findings related to sleep and circadian physiology that establish the psychobiological foundation of fatigue. Their major focus is on the relevance of these findings to operational settings. In addition, they provide examples to describe practical fatigue countermeasures that can be used in operational settings.

Review, Tutorial↗

NASA NTRS2019

The Benefits of Napping for Safety & How Quickly Can the Brain Wake-Up from Sleep?

Fatigue is a hazard that must be managed within 24-hour safety-critical operations. Napping is the best known countermeasure to fatigue caused by sleep-loss and circadian misalignment. This presentation will: define fatigue; discuss ways to make the most of a nap opportunity; highlight the benefits of napping, including two case studies from workplace settings; outline the challenges in implementing napping in the workplace; and walk through examples to demonstrate that not all naps are equal when it comes to benefits to alertness and performance. The second half of the presentation will focus on sleep inertia, that is, the brief period of impaired alertness and performance experienced after waking from sleep. The factors contributing to and caused by sleep inertia will be discussed, along with countermeasures to reduce the impact of sleep inertia on alertness and performance.

Hilditch, Cassie J.↗

NASA NTRS2019

The Prevalence of Controlled Rest as a Countermeasure to Sleepiness on the Flight Deck

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.

sleepiness↗

NASA NTRS2015

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

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, distracting background noise, unexpected and variable mission schedules, unfavorable thermal control, unusual sleep environment with schedules that impinge on pre‐sleep periods.

Scheuring, R. A.↗

NASA NTRS2011

Prescribed Travel Schedules for Fatigue Management

The NASA Fatigue Management Team is developing recommendations for managing fatigue during travel and for shift work operations, as Clinical Practice Guidelines for the Management of Circadian Desynchrony in ISS Operations. The Guidelines provide the International Space Station (ISS ) flight surgeons and other operational clinicians with evidence-based recommendations for mitigating fatigue and other factors related to sleep loss and circadian desynchronization. As much international travel is involved both before and after flight, the guidelines provide recommendations for: pre-flight training, in-flight operations, and post-flight rehabilitation. The objective of is to standardize the process by which care is provided to crewmembers, ground controllers, and other support personnel such as trainers, when overseas travel or schedule shifting is required. Proper scheduling of countermeasures - light, darkness, melatonin, diet, exercise, and medications - is the cornerstone for facilitating circadian adaptation, improving sleep, enhancing alertness, and optimizing performance. The Guidelines provide, among other things, prescribed travel schedules that outline the specific implementation of these mitigation strategies. Each travel schedule offers evidence based protocols for properly using the NASA identified countermeasures for fatigue. This presentation will describe the travel implementation schedules and how these can be used to alleviate the effects of jet lag and/or schedule shifts.

Whitmire, Alexandra↗

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 NTRS2014

Behavioral Health and Performance at NASA JSC: Recent Successes and Future Plan for BHP Research and Operations

The Behavioral Health and Performance discipline at NASA Johnson Space Center is organized into two distinct Divisions (Biomedical Research and Environmental Science Division and Space and Clinical Operations Division) but is integrated and interrelated in its day‐to‐day work. Ongoing operations supporting NASA's spaceflight goals benefit from the research portfolios that address risks to mission success. Similarly, these research portfolios are informed by operations to ensure investigations stay relevant given the dynamic environment of spaceflight. There are many success stories that can be presented where initial work begun as a BHP Research project, and funded through the Human Research Program, was fully implemented in operations or addressed an operational need. Examples include improving effectiveness of the debriefings used within Mission Control by the Mission Operations Directorate and countermeasures for fatigue management. There is also ongoing collaboration with research and operations for developing selection methods for future generation astronauts, and to enhance and inform the current family support function. The objective of this panel is to provide examples of recent success stories, describe areas where close collaboration is benefitting ongoing research and operations, and summarize how this will come together as NASA plans for the one year ISS mission - a unique opportunity for both BHP operations and research to learn more about preparing and supporting crewmembers for extended missions in space. The proposed panel will be comprised of six presentations, each describing a unique aspect of research or operations and the benefits to current and future spaceflight.

Leveton, L. B.↗

NASA NTRS2015

Daytime Cognitive Performance in Response to Sunlight or Fluorescent Light Controlling for Sleep Duration

Light is the primary synchronizer of the human circadian rhythm and also has acute alerting effects. Our study involves and comparing the alertness, performance and sleep of participants in the NASA Ames Sustainability Base, which uses sunlight as its primary light source, to in a traditional office building which uses overhead florescent lighting and varying exposure to natural light. The purpose of this study is to determine whether the use of natural lighting as a primary light source improves daytime cognitive function and promotes nighttime sleep. Participants from the Sustainability Base will be matched by gender and age to individuals working in other NASA buildings. In a prior study we found no differences in performance between those working in the Sustainability Base and those working in other buildings. Unexpectedly, we found that the average sleep duration among participants in both buildings was short, which likely obscured our ability to detect a difference the effect of light exposure on alertness. Given that such sleep deprivation has negative effects on cognitive performance, in this iteration of the study we are asking the participants to maintain a regular schedule with eight hours in bed each night in order to control for the effect of self-selected sleep restriction. Over the course of one week, we will ask the participants to wear actiwatches continuously, complete a psychomotor vigilance task (PVT) and digit symbol substitution task (DSST) three times per day, and keep daily sleepwork diaries. We hope that this study will provide data to support the idea that natural lighting and green architectural design are optimal to enhance healthy nighttime sleep patterns and daytime cognitive performance.

cognitive performance↗

NASA NTRSDate not supplied

Sleep, Sleepiness, and Performance Across Three In-Flight Bunk Rest Opportunities

Introduction: Airline pilots are required to take a rest break in a bunk during long-haul flights in an effort to reduce sleepiness during critical phases of flight. It is unclear, however, whether each rest break affords equal opportunity for sleep. We aimed to characterize sleep, sleepiness, and performance outcomes across three in-flight rest breaks during long-haul flights. Methods: Thirty-seven pilots wore actiwatches and completed sleep diaries for approximately two weeks while flying a variety of long-haul routes (n=126 flights). Self-reported in-flight bunk rest (BR) periods were used to set rest intervals and sleep was estimated within these intervals using actigraphy software (wake threshold set to medium). Pilots provided Karolinska Sleepiness Scale ratings (KSS) and performed a 5-minute psychomotor vigilance task (PVT) before landing. A linear mixed-effects model with participant included as a random effect and allowed to vary by intercept was used to assess differences between BR opportunities. Results : The majority (97%, n=122) of bunk rest periods contained sleep (as estimated by actigraphy). The mean (+/- standard deviation) sleep duration for the first, middle, and third BR opportunity was 152.8 (69.7), 149.2 (44.1), 125.2 (44.9) minutes, respectively. There was a significant effect of BR opportunity for sleep duration (F2,54 = 3.747, p=.03) and KSS (F2,44 = 7.869, p=.001). Bonferroni adjusted planned pairwise contrasts revealed that pilots using the third BR obtained significantly less sleep than in the first BR (p=.029). KSS ratings prior to landing were higher for the third BR compared to both the first (p=.001) and middle BR (p=.017). There were no significant differences for PVT speed or lapses (all p>05). Conclusion: These results suggest that the last rest break is associated with shorter sleep, lower alertness, and no differences in performance relative to the other rest breaks. Further analysis is required to determine whether the higher KSS ratings following the third rest break are associated with sleep inertia, or whether other factors may be involved.

sleepiness↗

NASA NTRS2011

Cognitive Behavioral Training and Education for Spaceflight Operations

Cognitive behavioral-training (CBT) is an evidence-based practice commonly used to help treat insomnia, and is part of NASA's countermeasure regimen for Fatigue Management. CBT addresses the life style and habits of individuals that are maladaptive to managing stress and fatigue. This includes addressing learned behavioral responses that may cause stress and lead to an increased sense of fatigue. While the initial cause of onset of fatigue in the individual may be no longer present, the perception and engrained anticipation of fatigue persist and cause an exaggerated state of tension. CBT combined with relaxation training allows the individual to unlearn the maladaptive beliefs and behaviors and replace them with routines and techniques that allow cognitive restructuring and resultant relief from stress. CBT allows for elimination in individuals of unwanted ruminating thoughts and anticipatory anxiety by, for example, training the individuals to practice stressful situations in a relaxed state. As a result of CBT, relaxation can be accomplished in many ways, such as progressive muscle relaxation, meditation and guided imagery. CBT is not therapy, but rather the synthesis of behavioral countermeasures. CBT utilizes progressive relaxation as a means of reinforcing educational and cognitive countermeasures. These countermeasures include: masking, elimination of distracting thoughts, anxiety control, split attention, cognitive restructuring and other advanced psychological techniques.

Moonmaw, Ronald↗

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 NTRSDate not supplied

Space Transport and Fatigue

Space travel presents numerous challenges to fatigue management. Fatigue in space results from many of the same challenges that shiftworkers face on Earth, including inadequate sleep, circadian misalignment, and elevated workload. However, spaceflight also presents unique challenges including circadian misalignment due to non-24- hour light-dark cycles, erratic work schedules due to operational constraints, a microgravity sleep environment, constraints to habitat design, and an isolated and confined living environment. These challenges can be mitigated with fatigue management strategies and countermeasures specifically targeted for space travel. Those strategies can include light interventions, advanced scheduling tools, improved habitat design, and pharmacological countermeasures. What is needed is a future-facing approach to most effectively manage the challenges that may arise as advancements in space travel continue to develop at a rapid pace.

sleep deprivation and performance↗

NASA NTRSDate not supplied

Space Transport and Fatigue

sleep deprivation and performance↗

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 NTRS1992

Alertness management in two-person long-haul flight operations

Long-haul flight operations involve cumulative sleep loss, circadian disruption, and extended and irregular duty schedules. These factors reduce pilot alertness and performance on the flightdeck. Conceptually and operationally, alertness management in flight operations can be divided into preventive strategies and operational countermeasures. Preventive strategies are utilized prior to a duty period to mitigate or reduce the effects of sleep loss, circadian disruption and fatigue during subsequent flight operations. Operational countermeasures are used during operations as acute techniques for maintaining performance and alertness. Results from previous NASA Ames field studies document the sleep loss and circadian disruption in three-person long-haul flying and illustrate the application of preventive strategies and operational countermeasures. One strategy that can be used in both a preventive and operational manner is strategic napping. The application and effectiveness of strategic napping in long-haul operations will be discussed. Finally, long-haul flying in two-person highly automated aircraft capable of extended range operations will create new challenges to maintaining pilot alertness and performance. Alertness management issues in this flight environment will be explored.

Rosekind, M. R.↗

NASA NTRS2019

Controlled Rest on the Flight Deck: Profile of Use, Challenges, and Best Practices

Managing fatigue in 24/7 operations is complex; fatigue and performance degradation can have health and safety consequences for the workers and can have economic and community consequences. We will present new findings on sleep, circadian misalignment, and performance in operational personnel. The presentations will shed light on how sleep and circadian misalignment affect workers' performance, safety, and health across multiple operations, and their application in fatigue risk management.As part of this symposium, I will discuss how pilots can use short naps (controlled rest) as a countermeasure to elevated sleepiness in-flight. My presentation will describe how and when controlled rest is used operationally and outline best practice guidelines for maximizing the benefits while managing the associated risks.

aviation↗