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

Fatigue, Schedules, Sleep, and Sleepiness in U.S. Commercial Pilots During COVID-19

cOViD-19 has had a significant impact on the aviation industry. While reduced flying capacity may intuitively translate to reduced fatigue risk by way of fewer flights and duty hours, the actual impact of the pandemic on pilot fatigue is unknown. methods: We surveyed U.S. commercial airline pilots in late 2020 (N = 669) and early 2021 (N = 156) to assess the impact of COViD-19 on schedules and fatigue during the pandemic. results: Overall, pilots reported reduced flight and duty hours compared to prepandemic. Average sleep on workdays was slightly shorter in late 2020 (6.87 ± 1.14 h) and recovered to prepandemic levels in early 2021 (6.95 ± 1.11 h). Similarly, the frequency of sleepiness on days off and in-flight increased in late 2020, with 54% of pilots reporting an increase in in-flight sleepiness, then returned to prepandemic levels in early 2021. the use of in-flight sleepiness countermeasures remained the same across assessed time points. Pilots highlighted several factors which impacted their sleep and job performance, including limited access to nutritional food during duty days and layovers, reduced access to exercise facilities during layovers, increased stress due to job insecurity and health concerns, increased distractions and workload, and changes to scheduling. discussion: Despite a reduction in flights and duty days, COViD-19 led to increased sleepiness on days off and in flight, potentially due to the negative impact of lack of access to essential needs and heightened stress on sleep. Operators need to monitor the change in these COViD-19 related risks as the industry returns to full service

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

Implementing a Sleep Health Education and Sleep Disorders Screening Program in Fire Departments

The lost productivity from fatigue adds something like $2,000 per worker per year to an organization's overall costs. The human and financial burden of fatigue has prompted specialists to develop fatigue risk management plans, which have been implemented with success in industries like aviation, manufacturing, and first responders. We'll explore the common risk factors for fatigue and delve into successful programs from major players in the American marketplace, and provide actionable recommendations for change within your organization to prevent fatigue and encourage greater holistic wellness among your workers. Learning Objectives - Explain the causes and effects of the fatigue problem - Illustrate the difference between physical and chronic sleep-related fatigue - Explore fatigue management case studies from aviation, manufacturing, and warehousing - Demonstrate fatigue conclusions from research conducted at NASA - Answer common questions on fatigue management - Share recommendations from our experts on creating a fatigue management plan

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

A Summary Of: Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments

Sleep loss and circadian misalignment contribute to a meaningful proportion of operational accidents and incidents. Countermeasures and work scheduling designs aimed at mitigating fatigue are typically evaluated in controlled laboratory environments, but the effectiveness of translating such strategies to operational environments can be challenging to assess. This manuscript summarizes an approach for collecting sleep, circadian, fatigue, and performance data in a complex operational environment. We studied 44 airline pilots over 34 days while they flew a fixed schedule, which included a baseline data collection with 5 days of mid-morning flights, four early flights, four high-workload mid-day flights, and four late flights that landed after midnight. Each work block was separated by 3-4 days of rest. To assess sleep, participants wore a wrist-worn research-validated activity monitor continuously and completed daily sleep diaries. To assess the circadian phase, pilots were asked to collect all urine produced in four or eight hourly bins during the 24 h after each duty block for the assessment of 6-sulfatoxymelatonin (aMT6s), which is a biomarker of the circadian rhythm. To assess subjective fatigue and objective performance, participants were provided with a touchscreen device used to complete the Samn-Perelli Fatigue Scale and Psychomotor Vigilance Task (PVT) during and after each flight, and at wake-time, mid-day, and bedtime. Using these methods, it was found that sleep duration was reduced during early starts and late finishes relative to baseline. Circadian phase shifted according to duty schedule, but there was a wide range in the aMT6s peak between individuals on each schedule. PVT performance was worse on the early, high-workload, and late schedules relative to baseline. Overall, the combination of these methods was practical and effective for assessing the influence of sleep loss and circadian phase on fatigue and performance in a complex operational environment

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

Controlled Rest (CR) refers to a short, unscheduled, voluntary nap opportunity taken by pilots on the flight deck as a countermeasure to unanticipated fatigue 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 (accounting for multiple CR attempts on 23 flights) estimated by actigraphy to have successfully achieved sleep. Average sleep duration during successful rest periods was estimated as 31.7 ± 12.2 min. CR was more frequent on 2-pilot (69%, n = 83) vs. \u3e2-pilot flights (23%, n = 27); return (60%, n = 71) vs. outbound flights (33%, n = 39); night (55%, n = 76) vs. day flights (34%, n = 34); and \u3c10 h (63%, n = 80) vs. \u3e10 h duration flights (27%, n = 30) (all p ≤ 0.001). There was no significant difference for direction of travel (eastbound: 51%, n = 57; westbound: 40%, n = 44; p = .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 on flights with 2-pilot crews (\u3c10 h duration) and nighttime flights returning to base. Future studies are required to determine the generalizability of these results to other airlines

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

Exercising Caution Upon Waking–Can Exercise Reduce Sleep Inertia?

Sleep inertia, the transitional state of reduced alertness and impaired cognitive performance upon waking, is a safety risk for on-call personnel who can be required to perform critical tasks soon after waking. Sleep inertia countermeasures have previously been investigated; however, none have successfully dissipated sleep inertia within the first 15 min following waking. During this time, on-call personnel could already be driving, providing advice, or performing other safety-critical tasks. Exercise has not yet been investigated as a sleep inertia countermeasure but has the potential to stimulate the key physiological mechanisms that occur upon waking, including changes in cerebral blood flow, the cortisol awakening response, and increases in core body temperature. Here, we examine these physiological processes and hypothesize how exercise can stimulate them, positioning exercise as an effective sleep inertia countermeasure. We then propose key considerations for research investigating the efficacy of exercise as a sleep inertia countermeasure, including the need to determine the intensity and duration of exercise required to reduce sleep inertia, as well as testing the effectiveness of exercise across a range of conditions in which the severity of sleep inertia may vary. Finally, practical considerations are identified, including the recommendation that qualitative field-based research be conducted with on-call personnel to determine the potential constraints in utilizing exercise as a sleep inertia countermeasure in real-world scenarios

Stability of the timing of food intake at daily and monthly timescales in young adults

Cross-sectional observations have shown that the timing of eating may be important for health-related outcomes. Here we examined the stability of eating timing, using both clock hour and relative circadian time, across one semester (n = 14) at daily and monthly time-scales. At three time points ~ 1 month apart, circadian phase was determined during an overnight in-laboratory visit and eating was photographically recorded for one week to assess timing and composition. Day-to-day stability was measured using the Composite Phase Deviation (deviation from a perfectly regular pattern) and intraclass correlation coefficients (ICC) were used to determine individual stability across months (weekly average compared across months). Day-to-day clock timing of caloric events had poor stability within individuals (~ 3-h variation; ICC = 0.12–0.34). The timing of eating was stable across months (~ 1-h variation, ICCs ranging from 0.54–0.63), but less stable across months when measured relative to circadian timing (ICC = 0.33–0.41). Our findings suggest that though day-to-day variability in the timing of eating has poor stability, the timing of eating measured for a week is stable across months within individuals. This indicates two relevant timescales: a monthly timescale with more stability in eating timing than a daily timescale. Thus, a single day’s food documentation may not represent habitual (longer timescale) patterns