Sleep Expert Stresses Need for Fatigue Management

Organizations can implement targeted fatigue-risk-management programs and still achieve their economic goals, says a leading fatigue expert. But if they don’t pay attention to fatigue risks, the results could have safety consequences, added Daniel Mollicone, CEO of sleep research specialist Pulsar Informatics, during Bombardier’s annual Safety Standdown.

Pulsar analyzes helicopter accidents and reports to the FAA on the potential of fatigue involvement, and found that as many as one in five has a fatigue factor, Mollicone said. He also pointed to an accident involving a fatigued American Airlines pilot who failed to deploy spoilers and lost directional control on the runway. “These are mistakes that don’t need to happen.”

A company can provide adequate rest time, but then it is up to pilots to ensure they get that rest. This is part of their professionalism, Mollicone said.

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Most people are not aware of how much sleep they need. Nearly 30 percent believe that they require only six to seven hours, but only 5 percent of the population is actually in that category. That means 25 percent of people are "deluding themselves,” Mollicone said.

Sleep deprivation adds up and can result in serious degradation of performance. Tests have shown that the number of lapses—times when a brain stops processing and a person is unaware that it is happening—increases as the sleep “debt” grows. Studies revealed that a person who remains in the six-hour-a-night group for a week has reached the cognitive level of someone who has lost an entire night’s sleep. But the “six-hour group systematically underestimates how badly they are doing,” Mollicone said.

Time of day matters since sleeping and waking at the wrong time can upset the natural function of a body, he added. “When we fly at night, there are risks there, because we are actually working against what our body is trying to do at that moment,” he said. This doesn’t mean that pilots can’t fly at night, but they need to ensure that they use technology and follow procedures carefully.

Further, managers must be aware of long days. Cognitive impairment starts to set in after 17 hours. At 22 hours of wakefulness, the brain reacts like that of someone with a blood alcohol content of .08. “It is startling to me how quickly we can get to incapacitation,” Mollicone said. “Things get precipitously bad when we push ourselves past our limits.” Studies on the trucking industry showed that drivers are 500 percent more likely to text when they are fatigued.

Studies also have shown that despite the belief that people get used to lack of sleep, they don’t. A number of other factors can exacerbate fatigue, including the use of medications and alcohol, as well as medical issues. A review Pulsar made in one company revealed 3 percent of workers with significant fatigue issues. Some of those workers discovered that they had undiagnosed serious medical conditions that needed to be treated.

The goal is to identify those scenarios in flight operations where the risk of incapacitation becomes real and to mitigate that, he said. That doesn’t mean pilots won’t ever be fatigued. But what they don’t want is for pilots to be pushed to the point of incapacitation.

By carefully monitoring risk areas, an organization can manage fatigue, Mollicone said, adding that organizations do not have to choose between being successful and managing fatigue risk.

This includes understanding biology and correlating it to risk. Studies show that a relatively small number of missions actually involve risks of incapacitation. But knowing the ones that do, an organization can focus time and resources on mitigation factors and planning of missions, Mollicone said.