"Oh Man, Am I Beat!" Published Aug. 7, 2008 By Lt Col Joe Hayslett, Jr 36th Wing Andersen AFB, Guam -- While attending a Flight Safety Officer class, I looked around at all the "young guns" attending with me, and my first thought was, "These folks aren't old enough to be fighting wars." Then it hit me: I was the oldest guy in the room. After that initial shock, and then being made class leader, I was immediately heartened to know these young men and women were willing to work hard, maintain the highest level of technical and professional skills, and perform all tasks requested by our nation. I quickly replayed my career through my ever-slowing brain cells. I remembered the excitement of going to new places, long days performing missions under less than-glamorous circumstances, eating at whatever fast food joints we could find on base, and how my crew members would forever be family. During the first day of training, some class members felt jet lag from traveling halfway around the world to attend this course. We performed our obligatory head nods into sleep-wake cycles and drank enough coffee to maintain a world-class aerobic heartbeat, giving us a decent workout without leaving our seats. We also skipped lunch, so we didn't have to stand in back of the classroom all afternoon. The phrase for the day is, "Oh man, am I beat!" This spawned the idea for my article and some interesting research on sleep-deprivation effects. Everyone has experienced sleep deprivation either from travel, sickness, a lost night's sleep, shift change at work, or a late night out on the town. Many studies have been performed to test these effects on the human body, and the conclusions are not earthshattering. They support what you already suspect, but how much they affect your performance could surprise you and help you perform your mission in a safer manner. To make this hit even closer to home, I'll compare sleep deprivation in relation to the effects of alcohol consumption. These tests are very close to the time frames and day lengths that many have encountered on missions all around the world. In 2000, 39 subjects were tested -- 30 from the transport industry and nine from the U.S. Army. They were tested on sleep deprivation (up to 28 hours), and then again tested using varying levels of alcohol ingestion instead of sleep deprivation to compare results of the same individual against the different test results (Williamson, Feyer, 2000). After 17-19 hours awake (equating to between 10:30 p.m. and 1 a.m. when many of us go to bed), the participant's performance corresponded to 0.05 percent blood alcohol content; half the legal limit. This is a fairly normal day for most military members, especially those flying large aircraft on long cargo-carrying or air-bridge missions. Their response speeds during the tests were 50 percent slower overall, and accuracy measures were significantly poorer than at the 0.05 percent BAC level of alcohol. At longer levels without sleep, their performance reached levels equivalent to the maximum alcohol dose given to subjects of 0.10 percent (Williamson, Feyer, 2000). Alcohol testing on athletes (18-24 years old) in 2000 revealed that alcohol has a causative effect in sports-related injuries, with an injury incidence of 54.8 percent in drinkers, compared with 23.5 percent (less than half) of non-drinkers. Researchers believe that this is due to the hangover effect of alcohol consumption, which has been shown to reduce athletic performance by 11.4 percent (O'Brien, Lyons, 2000). Additionally, an alcohol study done on military pilots yielded some interesting results. Ten pilots were tasked to fly simulators before and after consuming alcohol. They drank no alcohol 48 hours before the test, and then were asked to drink alcohol mixed with diet soft drinks until 0.10 percent BAC was reached. When retesting in the simulator 14 hours after consuming the alcohol, pilot performance was worse in the hangover condition on virtually all measures (Yesavage, Leirer, 1986). Interesting results when you compare that to our current standard of "12 hours, bottle-to-throttle." Combine those results with a poor night's sleep in some far-away land, and you have a set-up for extremely poor crew performance. Will crew members in this condition be able to meet their requirements during a critical phase of flight or perform the needed tasks during an emergency situation? Reduced opportunity for sleep and reduced sleep quality are frequently related to accidents. Poor quality sleep and inappropriate recovery leads to increased fatigue, decreased alertness and impaired performance in a variety of psychomotor skills. Add in the formula that each 0.01 percent of alcohol ingested equates to 1.16 percent of performance reduction, which associates to 11.6 percent performance reduction at .10 percent BAC. That, and the reduction of performance during the hangover phase, and you soon realize the combined effects of sleep deprivation and alcohol consumption drastically reduce your ability to perform any task (Dawson, Reid, 1997). How can this help you? Easy. If you lead a crew, watch for signs of excessive fatigue, ensure your crew members are receiving adequate rest before a mission, and pay attention when crew members tell you they're having trouble sleeping or having problems at home. In all testing reviewed, only the 10 percent alcohol rule was used as a standard, but what about the drinkers who bust that standard when out for a night? Accidents can happen in the blink of an eye, and without adequate rest, your recognition and reaction to an incident could make the difference between life or death for you or your crew. If you're not leading a crew, you're not off the hook, either. An aircrew by its name ensures continuity and teamwork. Watch your crew mates both in the plane and on the ground. Ask questions, and if you lead students, ensure they understand the ramifications of their actions relative to their crew responsibilities. We depend on everyone to do their job effectively and safely. I'm not saying, "Don't drink," but when drinking, ensure you don't overindulge. Remember, our 18- to 24-year-olds, "the invincibles," need your guidance. Explain what you expect in relation to proper rest and nutrition, and then explain to them what could happen to their performance after binge drinking or not receiving the needed rest before strapping on their jet. Lastly, after 24 hours of sustained wakefulness, cognitive psychomotor performance decreases to levels equivalent to the performance deficit observed with alcohol concentration of 0.10 percent. Effects of sleep loss are equivalent to moderate alcohol intoxication. By relating sleep deprivation to alcohol intoxication, we give our leaders an index of relative impairment associated with fatigue (Dawson, Reid, 1997). This could lead to decreased risk-taking on noncritical missions, ways to judge crew performance over long TDYs, and allow for assessment of crew needs, where mission accomplishment requires continually leapfrogging of time zones, while providing a safer operating environment. Take care of each other and fly safe! References Williamson, AM, and Feyer, Anne-Marie (2000). "Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication," Occupational Environmental Medicine Online, retrieved from: http://oem.bmj.com/cgi/content/ O'Brien, Conor P., and Lyons, Frank (2000). "Alcohol and the Athlete," Sports Medicine, retrieved from: http://sportsmedicine.adisonline.com/pt/re/spo Dawson, Drew and Reid, Kathryn (1997). "Fatigue, alcohol, and performance impairment," Nature, Vol 388, July 1997 Yesavage JA and Leirer VO (1986). "Hangover effects on aircraft pilots 14 hours after alcohol ingestion: a preliminary report," The American Journal of Psychiatry, retrieved from: http://ajp.psychiatryonline.org/cgi/content/