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Sleep during layovers of different lengths after long-haul flying across multiple time zones in different geographic directions

Introduction: Long-haul pilots experience high levels of fatigue and circadian disruption due to long work hours and trans-meridian travel. The aim of this study was to characterize sleep timing and duration during layovers of different lengths after crossing multiple time zones. Methods: All pilots flying long-haul operations from a single airline were eligible to participate. While following their normal work schedule within airline operations, pilots collected data for ~2 weeks including at least two long-haul rotations, with rest days and layovers. Participants wore an Actiwach (Phillips Respironics) throughout the entire study period and completed a sleep diary (at bedtime and upon waking up). Based on the data, we categorized layovers as follows: layover type 1: 34 h after crossing five time zones in westward direction; layover type 2: of 34 h, no time zone change; layover type 3: 55 h after crossing six time zones in eastward direction. Each flight left the home base at the same time of day (23:00) and the flight duration was between 10.5 and 12 hrs. We calculated descriptive statistics for each category. Results. Forty-four long-haul pilots participated in the study (5 female; mean age 44.25 ± 10.06 yrs; mean flight hours 9834.3 ± 5334.1 hrs). We found that for layover type 1, the mean sleep duration (h) per 24 h was 6.90 (±1.04), mean sleep efficiency (%) was 81.08 (±10.89) and mean Wake After Sleep Onset (WASO, min) was 33.23 (±20.42); for layover type 2, the mean sleep duration (h) per 24 h was 6.91 (±1.06), mean sleep efficiency (%) was 81.71 (±6.80), and mean WASO (min) was 30.10 (±11.00); for layover type 3, the mean sleep duration (h) was 7.07 (±1.32), mean sleep efficiency (%) was 83.93 (±6.04), and mean WAS (min) was 36.94 (±17.95). Conclusion: Our preliminary analyses showed that sleep duration and sleep efficiency were similar for the layovers of same length regardless time zone change. Additional analyses will be conducted to investigate sleep on additional layovers of different lengths and the effects of sleep obtained during layover on the performance and alertness on the return flights.

long-haul↗

Variations in Sleep and Performance by Duty Start Time in Short Haul Operations

Prior studies have confirmed that commercial airline pilots experience circadian phase shifts and short sleep duration following travel with layovers in different time zones. Few studies have examined the impact of early and late starts on the sleep and circadian phase of airline pilots who return to their domicile after each duty period. We recruited 44 pilots (4 female) from a short-haul commercial airline to participate in a study examining sleep and circadian phase over four duty schedules (baseline, early starts, mid-day starts, late starts). Each duty schedule was five days long, separated by three rest days. Participants completed the rosters in the same order. Sleep outcomes were estimated using wrist-borne actigraphy (Actiware Software, Respironics, Bend, OR) and daily sleep diaries. Thirteen participants volunteered to collect urine samples for the assessment of 6-sulfatoxymelatonin (aMT6s). Urine samples were collected in four-hourly bins during the day and eight-hourly bins during sleep episodes, for 24 hours immediately following each experimental duty schedule. The aMT6s results were fit to a cosine in order to obtain the acrophase to estimate circadian phase. Univariate statistics were calculated for acrophase changes, schedule start times and sleep times. All statistical analyses were computed using SAS software (Cary, IN).

fatigue↗

Variation in Sleep Duration and Circadian Phase by Duty Start Time Among Short-Haul Commercial Airline Pilots

Prior studies have confirmed that commercial airline pilots experience circadian phase shifts and short sleep duration following travel with layovers in different time zones. Few studies have examined the impact of early and late starts on the sleep and circadian phase of airline pilots who return to their domicile after each duty period. We recruited 44 pilots (4 female) from a short-haul commercial airline to participate in a study examining sleep and circadian phase over four duty schedules (baseline, early starts, mid-day starts, late starts). Each duty schedule was five days long, separated by three rest days. Participants completed the rosters in the same order. Sleep outcomes were estimated using wrist-borne actigraphy (Actiware Software, Respironics, Bend, OR) and daily sleep diaries. Thirteen participants volunteered to collect urine samples for the assessment of 6-sulfatoxymelatonin (aMT6s). Urine samples were collected in four hourly bins during the day and eight-hourly bins during sleep episodes, for 24 hours immediately following each experimental duty schedule. The aMT6s results were fit to a cosine in order to obtain the acrophase to estimate circadian phase. Univariate statistics were calculated for acrophase changes, schedule start times and sleep times. All statistical analyses were computed using SAS software (Cary, IN).The mean duty start times varied as expected (baseline 10:17 [ 3:50], early starts 5:24 [ 0:30], mid-day starts 13:52 [ 1:20], late starts 16:33 [ 1:33]). Actigraphy-derived sleep duration varied between schedule types, with the shortest average sleep durations occurring during the early starts and night duty. Mean circadian phase was similar during each schedule type (baseline 26:14 [ 3:22], early starts 25:29 [2:13], mid-day starts 26:20 [ 3:16], late starts 25:49 [ 4:28]), but there were wide inter-individual differences in phase shifting from the beginning to the end of the study, with phase shifts ranging from a 5.98 hour phase advance to an 11.34 hour phase delay. Our preliminary findings suggest that early and late starts are associated with reduced sleep duration. The dispersion in inter-individual differences in circadian phase across shifting duty schedules should be further evaluated to determine how schedule-induced phase shifts may affect operational performance.

Flynn-Evans, Erin↗

Schedule Factors Associated with the Use of Controlled Rest in a Long-Haul Airline

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. Forty-four pilots wore actiwatches and filled in an application-based sleep/work diary for approximately 2 weeks. After merging sleep diary, actigraphy, and schedule data, complete records were analyzed from 240 flights. Sleep was estimated during CR intervals using the Philips Actiware 6.0.9 (Bend, OR) software with wake threshold set to medium. Timing of sleep periods and flight schedules were analyzed relative to home-base time. A mixed-effects binary logistics regression was used to analyze the impact of schedule factors on CR. Preliminary analyses revealed that CR was taken on 45% (n=107) of flights. Average sleep duration within these rest periods was estimated as 24.8 ± 16.1 minutes. CR was more frequent on return flights (arriving at home-base; 58%, n=69) vs. outbound flights (departing from home-base, 31%, n=38; p<0.001). There was no difference for direction of travel (eastbound: 49%, n= 56; westbound: 40%, n= 44; northbound/southbound: 50%, n=7; p=0.272). CR was more frequent on 2-pilot flights (62%, n=81) compared to augmented crew flights (24%, n=26; p<0.001). Of note, 21% (n=23) of augmented flights contained both CR and Bunk Rest. CR was more frequent on flights <10h duration (<10h: 59%, n=78; >10h: 27%, n=29; p<0.001). Flights departing between 12:00h-19:59h (25%, n=23; p<0.026) had the lowest frequency of CR. Data from this airline show that CR is most commonly used as a countermeasure to sleepiness on return, unaugmented, <10h duration, and nighttime flights. The direction of travel did not influence the use of CR. Future studies are required to determine generalizability of these results to other airlines.

Hilditch, Cassie↗

Mitigating fatigue on the flight deck: how is controlled rest used in practice?

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. Forty-four pilots wore actiwatches and filled in an application-based sleep/work diary for approximately 2 weeks resulting in complete records from 239 flights. Timing of sleep periods and flight schedules were analyzed relative to home-base time. 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. CR was taken on 46% (n=110) of flights, with 80% (n=106/133) of all CR attempts estimated by actigraphy to have successfully achieved sleep. Average sleep duration during successful rest periods was estimated as 31.7 ± 12.2 minutes. CR was more frequent on return (60%, n=71) vs. outbound flights (33%, n=39); 2-pilot (69%, n=83) vs. >2-pilot flights (23%, n=27); <10h (63%, n=80) vs. >10h duration flights (27%, n=30); and night (55%, n=76) vs. day flights (34%, n=34) (all p≤0.001). There was no significant difference for direction of travel (eastbound: 51%, n= 57; westbound: 40%, n= 44; p=0.059). Of note, 22% (n=26) of augmented flights contained both CR and bunk rest. Data from this airline show that CR is most commonly used as a countermeasure to sleepiness on flights <10h duration (2-pilot crews) and home-base nighttime flights. Future studies are required to determine the generalizability of these results to other airlines.

sleepiness↗

Changes in Alertness and Performance Over Time During Long-Haul Flying Across Multiple Time Zones

BACKGROUND: Long-haul pilots experience high levels of fatigue and circadian disruptions due to long work hours and flying over multiple time zones. The aim of this study was to describe changes in alertness and performance among flight crews during long-haul flights crossing multiple time zones. METHODS: All pilots flying long-haul operations from a single airline were eligible to participate. All participants collected data for ~2 weeks of their normal work schedule within airline operations, with at least two long-haul rotations, including rest days and layovers. Participants wore an Actiwach throughout the entire study period and completed a sleep diary (at bedtime, upon waking up and after each nap). Each participant completed a 5-min Psychomotor Vigilance Task (PVT) and a Karolinska Sleepiness Scale (KSS) pre-flight, on top-of-descent (TOD; inflight) and at the end of each flight (post-flight). Response speed (1/RT x 1000), lapses (RT > 500 ms), and alertness were assessed over time pre-flight, TOD, post-flight, using mixed-effects models with participant as a random factor. Linear models were assumed for response speed and alertness, while a negative binomial distribution was specified for lapses due to overdispersion. RESULTS: Forty-four long-haul pilots participated in the study (5 female; mean age 44.25 ± 10.06 yrs; mean flight hours 9834.3; ± 5334.1 hrs). Lapses increased post-flight relative to pre-flight (F(2, 665) = 3.67, p < 0.05). There was a main effect of response speed (F(2, 665) = 21.45, p < 0.001) with slower speed inflight and postflight compared to preflight (p < 0.001). The KSS increased over time from M = 4.02 (± 1.35) preflight to M = 5.15 (± 1.58) inflight, to M = 6.7 (± 1.51) postflight (F(2, 701) = 182.63, p < 0.001). DISCUSSION: Our preliminary analyses showed that both performance and subjective alertness worsened from the beginning to the end of a flight. Additional analyses will be conducted to investigate the changes in alertness and performance by direction of travel, sleep history, and flight timing and duration.

long-haul↗