Sleep and Circadian Rhythms in the Sky and Space

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Sleep Environment Recommendations for Future Spaceflight Vehicles

Current evidence demonstrates that astronauts experience sleep loss and circadian desynchronization during spaceflight. Ground-based evidence demonstrates that these conditions lead to reduced performance, increased risk of injuries and accidents, and short and long-term health consequences. Many of the factors contributing to these conditions relate to the habitability of the sleep environment. Noise, inadequate temperature and airflow, and inappropriate lighting and light pollution have each been associated with sleep loss and circadian misalignment during spaceflight operations and on Earth. As NASA prepares to send astronauts on long-duration, deep space missions, it is critical that the habitability of the sleep environment provide adequate mitigations for potential sleep disruptors. We conducted a comprehensive literature review summarizing optimal sleep hygiene parameters for lighting, temperature, airflow, humidity, comfort, intermittent and erratic sounds, and privacy and security in the sleep environment. We reviewed the design and use of sleep environments in a wide range of cohorts including among aquanauts, expeditioners, pilots, military personnel and ship operators. We also reviewed the specifications and sleep quality data arising from every NASA spaceflight mission, beginning with Gemini. Finally, we conducted structured interviews with individuals experienced sleeping in non-traditional spaces including oil rig workers, Navy personnel, astronauts, and expeditioners. We also interviewed the engineers responsible for the design of the sleeping quarters presently deployed on the International Space Station. We found that the optimal sleep environment is cool, dark, quiet, and is perceived as safe and private. There are wide individual differences in the preferred sleep environment; therefore modifiable sleeping compartments are necessary to ensure all crewmembers are able to select personalized configurations for optimal sleep. A sub-optimal sleep environment is tolerable for only a limited time, therefore individual sleeping quarters should be designed for long-duration missions. In a confined space, the sleep environment serves a dual purpose as a place to sleep, but also as a place for storing personal items and as a place for privacy during non-sleep times. This need for privacy during sleep and wake appears to be critically important to the psychological well-being of crewmembers on long-duration missions

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

Sleep in High Stress Occupations

High stress occupations are associated with sleep restriction, circadian misalignment and demanding workload. This presentation will provide an overview of sleep duration, circadian misalignment and fatigue countermeasures and performance outcomes during spaceflight and commercial aviation

Sleeping on Mars: A Hidden Challenge for Human Space Exploration

The purpose of this talk is to provide a general public audience with basic information about what it is like to sleep in space. Dr. Flynn-Evans will begin by highlighting how sleep is different in movies and science fiction compared to real life. She will next cover basic information about sleep and circadian rhythms, including how sleep works on earth. She will explain how people have circadian rhythms of different lengths and how the circadian clock has to be re-set each day. She will also describe how jet-lag works as an example of what happens during circadian misalignment. Dr. Flynn-Evans will also describe how sleep is different in space and will highlight the challenges that astronauts face in low-earth orbit. She will discuss how astronauts have a shorter sleep duration in space relative to on the ground and how their schedules can shift due to operational constraints. She will also describe how these issues affect alertness and performance. She will then discuss how sleep and scheduling may be different on a long-duration mission to Mars. She will discuss the differences in light and day length on earth and mars and illustrate how those differences pose significant challenges to sleep and circadian rhythms

Fatigue Monitoring in Scheduled Airline Operations

Reporting and monitoring are important facets of a comprehensive Fatigue Risk Management System. As part of efforts to reduce fatigue risks, we partnered with an international airline to study 44 (4 Female) volunteer pilots over a 4 week period that included baseline earlymiddaylate flight days and rest days off. All study procedures were approved by an IRB and participants provided written informed consent prior to beginning the study. Reduced sleep duration was associated with both early and late duties. Performance was influenced by duty timing, time of day and time awake. TLX ratings were highest for mental and effort demands, while ATC and weather were the most identified hassle factors. Melatonin analysis revealed individual variations in circadian shift over the study period. The study results highlight the value of FRMS monitoring in airline operations. Ongoing crew education should emphasize individual variation and effective mitigation strategies. Further study could focus on workload and time of day scheduling factors

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

Measurement of Visual Reaction Times Using Hand-held Mobile Devices

Modern mobile devices provide a convenient platform for collecting research data in the field. But,because the working of these devices is often cloaked behind multiple layers of proprietary system software, it can bedifficult to assess the accuracy of the data they produce, particularly in the case of timing. We have been collecting datain a simple visual reaction time experiment, as part of a fatigue testing protocol known as the Psychomotor Vigilance Test (PVT). In this protocol, subjects run a 5-minute block consisting of a sequence of trials in which a visual stimulus appears after an unpredictable variable delay. The subject is required to tap the screen as soon as possible after the appearance of the stimulus. In order to validate the reaction times reported by our program, we had subjects perform the task while a high-speed video camera recorded both the display screen, and a side view of the finger (observed in a mirror). Simple image-processing methods were applied to determine the frames in which the stimulus appeared and disappeared, and in which the finger made and broke contact with the screen. The results demonstrate a systematic delay between the initial contact by the finger and the detection of the touch by the software, having a value of 80 +- 20 milliseconds

Best Practices for Fatigue Risk Management in Non-Traditional Shiftwork

Fatigue risk management programs provide effective tools to mitigate fatigue among shift workers. Although such programs are effective for typical shiftwork scenarios, where individuals of equal skill level can be divided into shifts to cover 24 hour operations, traditional programs are not sufficient for managing sleep loss among individuals with unique skill sets, in occupations where non-traditional schedules are required. Such operations are prevalent at NASA and in other high stress occupations, including among airline pilots, military personnel, and expeditioners. These types of operations require fatigue risk management programs tailored to the specific requirements of the mission. Without appropriately tailored fatigue risk management, such operations can lead to an elevated risk of operational failure, disintegration of teamwork, and increased risk of accidents and incidents. In order to design schedules for such operations, schedule planners must evaluate the impact of a given operation on circadian misalignment, acute sleep loss, chronic sleep loss and sleep inertia. In addition, individual-level factors such as morningness-eveningness preference and sleep disorders should be considered. After the impact of each of these factors has been identified, scheduling teams can design schedules that meet operational requirements, while also minimizing fatigue

Risk of Performance Decrements and Adverse Health Outcomes Resulting from Sleep Loss, Circadian Desynchronization, and Work Overload

Sleep loss, circadian desynchronization, and work overload occur to some extent for ground and flight crews, prior to and during spaceflight missions. Ground evidence indicates that such risk factors may lead to performance decrements and adverse health outcomes, which could potentially compromise mission objectives. Efforts are needed to identify the environmental and mission conditions that interfere with sleep and circadian alignment, as well as individual differences in vulnerability and resiliency to sleep loss and circadian desynchronization. Specifically, this report highlights a collection of new evidence to better characterize the risk and reveals new gaps in this risk as follows: Sleep loss is apparent during spaceflight. Astronauts consistently average less sleep during spaceflight relative to on the ground. The causes of this sleep loss remain unknown, however ground-based evidence suggests that the sleep duration of astronauts is likely to lead to performance impairment and short and long-term health consequences. Further research is needed in this area in order to develop screening tools to assess individual astronaut sleep need in order to quantify the magnitude of sleep loss during spaceflight; current and planned efforts in BHP's research portfolio address this need. In addition, it is still unclear whether the conditions of spaceflight environment lead to sleep loss or whether other factors, such as work overload lead to the reduced sleep duration. Future data mining efforts and continued data collection on the ISS will help to further characterize factors contributing to sleep loss. Sleep inertia has not been evaluated during spaceflight. Ground-based studies confirm that it takes two to four hours to achieve optimal performance after waking from a sleep episode. Sleep inertia has been associated with increased accidents and reduced performance in operational environments. Sleep inertia poses considerable risk during spaceflight when emergency situations necessitate that crewmembers wake from sleep and make quick decisions. A recently completed BHP investigation assesses the effects of sleep inertia upon abrupt awakening, with and without hypnotics currently used in spaceflight; results from this investigation will help to inform strategies relative to sleep inertia effects on performance. Circadian desynchrony has been observed during spaceflight. Circadian desynchrony during spaceflight develops due to schedule constraints requiring non-24 operations or 'slam-shifts' and due to insufficient or mis-timed light exposure. In addition, circadian misalignment has been associated with reduced sleep duration and increased medication use. In ground-based studies, circadian desynchrony has been associated with significant performance impairment and increased risk of accidents when operations coincide with the circadian nadir. There is a great deal of information available on how to manage circadian misalignment, however, there are currently no easily collected biomarkers that can be used during spaceflight to determine circadian phase. Current research efforts are addressing this gap. Work overload has been documented during current spaceflight operations. NASA has established work hour guidelines that limit shift duration, however, schedule creep, where duty requirements necessitate working beyond scheduled work hours, has been reported. This observation warrants the documentation of actual work hours in order to improve planning and in order to ensure that astronauts receive adequate down time. In addition to concerns about work overload, ground based evidence suggests that work underload may be a concern during deep space missions, where torpor may develop and physically demanding workload will be exchanged for monitoring of autonomous systems. Given that increased automation is anticipated for exploration vehicles, fatigue effects in the context of such systems needs to be further understood. Performance metrics are needed to evaluate fitness-for-duty during spaceflight. Although ground-based evidence supports the notion that sleep loss, circadian desynchronization and work overload lead to performance impairment, inconsistency in the measures used to evaluate performance during spaceflight make it difficult to evaluate the magnitude of performance impairment during spaceflight. Work is underway to standardize measures of performance evaluation during spaceflight. Once established, such performance indicators need to be correlated with operational performance. Individual differences in sleep need and circadian preference, phase shifting ability and period have been documented in ground-based studies. Individual differences in response to sleep loss and circadian misalignment have also been documented and are presumed to be associated with genetic polymorphisms. No studies have systematically reported individual differences in sleep or circadian-related outcomes during spaceflight. More work is needed in this area in order to identify genetic or phenotypic biomarkers that predict resilience or vulnerability to sleep loss in order to personalize countermeasure strategies and mitigate performance impairment during spaceflight. Two laboratory and field investigations specific to this topic are currently ongoing; additional efforts, including an effort to mine existing biological data from spaceflight relative to sleep and circadian outcomes, are planned. Sex differences in sleep need and circadian period and phase have been reported in ground-based studies. The impact of these sex differences on performance is unclear. Sex differences in sleep need and circadian rhythms have not been systematically studied during spaceflight, presumably due to the small number of women that have flown in space. More research is needed in this area to evaluate whether any of the observed sex differences in physiology lead to altered performance in spaceflight and on the ground