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NEWS | Oct. 14, 2010

Fatigue countermeasures, staying awake and sharp

By Brian McGloin 502nd Air Base Wing OL-B public affairs

To help Randolph personnel stay sharp and safe, the 359th Aerospace Medicine Squadron is offering classes to illustrate fatigue countermeasures, which are especially helpful to shift and overnight workers.

"The class is where we talk to base personnel about different issues with their sleep, said 1st Lieutenant Amanda Burnette, 359th AMDS, Logistics Element Chief, Aerospace and Operational Physiology. "Fatigue continues to be a huge issue with many occupations, including our flyers."

The classes are held once a month in building 747 on the second Thursday of every month at 1 p.m.

"As of right now, people can just show up," Lieutenant Burnette said about class enrollment. "They don't need anything, other than their bright, shining faces."

"The class will teach about sleep and fatigue in general, specific sleep disorders that people may or may not have and techniques the average person can employ to aid in sleep," she said.

"Humans are meant to be asleep when it's dark and awake when it's light. When something changes that natural schedule, problems can arise." Lieutenant Burnette said. "With this class, hope to offer methods that people can use to sleep better."

The Centers for Disease Control and Prevention said shift and night workers often are tired and sleepy because of how their work schedules force them to deviate from natural biological rhythms, also known as circadian rhythm. Being unnecessarily tired makes it difficult to concentrate, which increase the possibility of mistakes. The stress of shift work also can exasperate health conditions, such as heart disease or digestive disorders.

"Mental and physical fatigue are different things," she said. "They can add up."
Fatigue affects more than just night maintenance workers; it can hinder the performance of anyone deprived of sleep.

"The effects of fatigue, night shift assignments and sleep deprivation on human performance and the quality and safety of medical care are subjects of enormous interest within and beyond the medical community," said Dr. Steven H. Rose, MD, Mayo Clinic Department of Anesthesiology, in a Nov. 2009, article in the Mayo Clinic Proceedings journal.

"Duty hour restrictions for resident physicians in training programs accredited by the Accreditation Council for Graduate Medical Education were implemented on July 1, 2003, in response to concerns that fatigue contributes to medical errors," said Dr. Rose in the article. "Since then, a number of studies have suggested that reducing resident work hours and modifying their duty shifts may lead to fewer attention failures, fewer medical errors and greater resident well-being."

To help Randolph Airmen -- active duty and civilians -- the class teaches simple techniques they can use to prevent fatigue, such as having a routine before going to bed and a proper sleep environment.

In addition to getting proper rest, the classes examine things like exercise, which is a good way to help keep the mind and body in balance.

"People don't always realize how important exercise is for sleep," she said. "There are simple things you can do to sleep better and fall asleep faster."
She said humans are bad at judging levels of fatigue, partially because higher level reasoning is affected first when one is fatigued.

It's not likely someone who works a shift that goes against their circadian rhythm can simply make a schedule change.

"Cognitive ability is the first thing to suffer," she said. "Shift work at night may set you up for problems, but even a hectic home life could cause you to lose out on sleep."
According to the CDC, sleep loss can accumulate over time and may reach dangerous levels.

"Sleep can't be banked," she said. "Sleep loss is additive."

All hope isn't lost for those in less than ideal work schedules. The CDC suggests a nap during the day can help with fatigue and sleepiness, but too little sleep -- 15 minutes or less -- can be counterproductive and make a worker sleepier. A nap of 30 minutes or more can help a worker remain focused for the rest of his or her shift.

"A short nap can do a world of good, but it's not a replacement a good night's sleep," Lieutenant Burnette said.

She said the amount and quality of sleep is more important than the time one is asleep.

Information on the CDC's Web site suggests night workers may break their sleep cycles into two shorter periods totaling in the recommended eight hour period. It also says everyone is different, and what may be ideal for one worker may be detrimental to another.

"Clearly, fatigue is not a one-dimensional phenomenon, but rather the product of several factors related to physiological sleep needs and internal biological rhythms," according to the Jan. 2009 issue journal Aviation, Space and Environmental Medicine.

According to 2004 data from the Bureau of Labor Statistics, almost 15 million Americans work full time on evening shift, night shift, rotating shifts or other employer arranged irregular schedules.

"Determining individual sleep requirements is not easy since there is wide variability in sleep needs. Individual requirements range from about four to 10 hours." say the authors John A. Caldwell, J. Lynn Caldwell in their book, "A guide to staying awake at the stick," about fatigue prevention in military and civilian aviation. "Unless you know for a fact that eight hours is more than you need, the safe approach is to make sure you get a minimum of eight full hours each day, even if work demands mean you have to split this requirement into more than one consolidated period."