Sjwc 2011   Sleep And Motion
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Sjwc 2011 Sleep And Motion

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The effect of sleep deprivation and motion sickness in military personnel operational effectiveness . Should we care?

The effect of sleep deprivation and motion sickness in military personnel operational effectiveness . Should we care?

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Sjwc 2011   Sleep And Motion Sjwc 2011 Sleep And Motion Presentation Transcript

  • Battle Stress ManagementSupreme Joint War College, April 7, 2011 The effect of fatigue and motion sickness in personnel operational effectiveness Should we care? LCDR P. Matsangas HN
  • Stress vs arousal Yerkes & Dodson lawSelye (1975). "Confusion and controversy in the stress field". Journal of HumanStress 1: 37–44Conceptual relationship between level of arousal and expected quality of performance Yerkes, R. M., & Dodson, J. D. (1908). The relation of strength of stimulus to rapidity of habit-formation. Journal of Comparative Neurology and Psychology, 18, 459-482.
  • Sleep deprivation and fatigue Basics and operational consequences
  • Sleep deprivation and fatigueSleep basics I Sleep is an ACTIVE process Probably all animals sleep (various lengths) May be the strongest, most insistent drive Still not known exactly why we sleep  Restorative function?  Adaptive function?
  • Sleep deprivation and fatigueSleep basics II Sleep patterns over a typical lifespanSleep stages over a typical 8-hour sleep period Miller, N.L. Matsangas, P. & Shattuck, L.G. (2008) “Fatigue and its effects on performance in military environments” in Hancock, P. & Szalma, J., eds., Performance Under Stress. Ashgate Publishers. Aldershot, UK.
  • Sleep deprivation and fatigueSleep basics III (The processes underlying sleep need) Adjusted from A. http://www.acnp.org/g4/GN401000075/Default.htm B. Borbély AA, Achermann P. Concepts and models of sleep regulation, an overview. J Sleep Res 1992;1:63-79
  • Sleep deprivation and fatigueSleep Basics IV Normal amount of sleep 8 - 8 1/4 hours  “minimum 5 hours/night to maintain performance”? Genetically determined Sleep cannot be “banked,” but sleep deficits accumulate Rest does not replace sleep
  • Operational EnvironmentBasic stressors (from a sleep perspective) Occupational StressorsTravel acrosstime zones Parameters Task PerformanceShiftwork influenced attributesEnvironmental Sleep amount Duration Physicalconditions Sleep quality PacingTemperature Sleep timing Complexity MentalHumidity ProficiencyNoise FeedbackSleep conditions FatigueLightMotion Physical Mental Psychological Moderating Moderating stressors influences on influences onDanger - Fear individual performanceMotivation response Naps Sleep tendency Medication Circadian rhythms Sleep scheduling Ultradian rhythms Motivation Individual Interest differences Personality Prior experience System design Individual differences
  • Sleep deprivation and fatigueEffects Memory is impacted tremendously by sleep. (Nature, October, 2003) Creativity is impacted by sleep. (Nature, January, 2004) Memories can actually be recovered or “healed” by getting sleep. Decision-making under uncertainty may be particularly vulnerable to sleep loss and is more pronounced with increased age. (J. Sleep Research, 2006) Moral judgment is altered by sleep deprivation. (Sleep, March 2007)
  • Sleep deprivation and fatigueSymptoms • Difficulty concentrating • Decreased vigilance and reduced attention • Slowed comprehension, responses/fuzzy reasoning • Faulty memory • Increasing number of "omission" errors • Mood changes • Impaired speed and accuracy of skilled tasks • Droning/microsleep • Reduced motivation to complete the mission • Communication difficulties
  • Sleep deprivation and fatiguePVT Adaptation to Chronic Sleep Restriction Baseline 7 Day Restricted Sleep Recovery 110Mean Speed on Psychomotor Vigilance Task 95 (as a % of Baseline) 9 Hr 80 7 Hr 5 Hr 3 Hr 65 SAFTE/FAST R2 = 0.94 50 0 T1 T2 B 1 2 3 4 5 6 7 R1 R2 R3 Day WRAIR Restricted Sleep Study Dr. Nita Shattuck, Research Asst. Prof.; NPS
  • Sleep deprivation and fatigueEffects are Task-Dependent Sense of well-being Vigilance & attention More sensitive to Fatigue Judgment & decision making Well-learned More resistant to Fatigue  simple intellectual tasks  physical tasks
  • Fatigue Avoidance Scheduling ToolFAST Early AM dip in performance Afternoon dips in Drop in performance performance 24 hour period Blood Alcohol Equivalence Scale Normal sleep periods Reduced sleep period Dr. Nita Shattuck, Research Asst. Prof.; NPS
  • Example IReasonably Good Sleep (from USS STENNIS) Dr. Nita Shattuck, Research Asst. Prof.; NPS
  • Example IReasonably Good Sleep (from USS STENNIS) Dr. Nita Shattuck, Research Asst. Prof.; NPS
  • Example IIPoor Sleep (from USS STENNIS) Dr. Nita Shattuck, Research Asst. Prof.; NPS
  • Example IIPoor Sleep (from USS STENNIS) Dr. Nita Shattuck, Research Asst. Prof.; NPS
  • FatigueEffects on operational performance No-sleep platoons militarily ineffective after 48 hours without sleep (Haslam, 1982) Decreased vigilance, mood changes, perceptual and cognitive decrements (Krueger, 1990) Deteriorating marksmanship (McLellan et al., 2005; Tharion, Shukitt-Hale, & Lieberman, 2003, Miller et al, 2010) In SUSOPS of an artillery fire direction center, planning and maintaining situational awareness most affected; evident decrements in the first 24-48 hours (Banderet et al, 1981) Decreased pilot performance, less accurate flight maneuvers, increased error rates, significant judgment lapses (Billings, Eggspuehler, Gerke, & Chase, 1968; Krueger, Armstrong, & Cisco, 1985; Pereli, 1980, J. A. Caldwell, 2005, Brictson, 1990; Brictson, McHugh, & Naitoh, 1980; Brictson & Young, 1980) Micro-sleeps
  • FatigueSleep studies at NPS Operational Sleep Predeployment training (USS RENTZ - FFG) Predeployment training (USS CHUNG HOON - DDG) Sea trials (HSV-2 SWIFT) Sea trials (USS HENRY M. JACKSON - SSN) RIMPAC 2008 (USS LAKE ERIE/ PORT ROYAL - CG) GOMEX 05-1 (HSV-2 SWIFT) Various operations (SSN/SSBN) Infantry officers from Iraq/Afghanistan (Fort Benning Survey) Mine hunting operations (Naval Aviation MH-53 squadron) Flight operations in Iraq (USMC AH-64 Helicopter Battalion) Operation Enduring Freedom (USS STENIS - CVN) 0.00 2.00 4.00 6.00 8.00 10.00 Daily Sleep [hrs] Sleep during Training FLW Basic combat training Marine Aviation, Weapons and Tactics School (MAWTS WTI 1-06) Marine Aviation, Weapons and Tactics School (MAWTS WTI 2-05) USMA study (West Point) USN enlisted training at RTC Great Lakes 0.00 2.00 4.00 6.00 8.00 10.00 Daily Sleep [hrs]
  • Motion sicknessBasis and operational consequences
  • The effect of motion on the humanA proposed model Human Element Working efficiency (or performance) Motion Sickness Incidence Motion Sickness (MSI) Sopite Syndrome Sleep amount and quality Motion Induced Interruptions (MII) Manual Material Handling Effects on human activity (MMH) Other effects Motion-induced fatigue (MIF) Induced Human Motion Performance Comfort or amenities Comfort Occupational health and safety Long-term exposure health effects Health and safety effects Short-term exposure safety effects (injury)
  • Motion Sickness  General term that describes the discomfort and associated emesis (vomiting) induced by many kinds of motions  Airsickness, space sickness (SAS), cybersickness, simulator sickness, etcVestibular system Current Vision sensory input Proprioception Error signal Neural store
  • Motion Sickness Symptoms and Effects on Performance Symptoms II Symptoms III Symptoms I (Effects on (Life threatening) performance)• Pallor • Nausea • Dehydration• Cold sweating • Drowsiness (through (significant in life rafts)• Yawning sopite syndrome) • Shock (during• Burping • Retching sustaining symptoms)• Increased salivation • Vomiting• Mood changes • Carelessness• Headache • Incoordination • Significant reduction in motivation to work
  • Motion SicknessHFR model (1974, 1976) Model Characteristics Vertical Acceleration Only true motion MSI: % of people who vomit Two-hour nauseogenic period Nauseogenic frequency range 0.05 – 0.7 [Hz] Central nauseogenic frequency 0.167 [Hz] Used Metric A historically common index of motion sickness severity is the Motion Sickness Incidence (MSI), which is the percentage of people who vomit when exposed to a nauseogenic environment. OHanlon, J. F., & McCauley, M. E. (1974). Motion sickness incidence as a function of the frequency and acceleration of vertical sinusoidal motion. Aerosp Med, 45(4), 366-369. McCauley, M. E., Royal, J. W., Wylie, D. C., OHanlon, J. F., & Mackie, R. R. (1976). Motion Sickness Incidence: Exploratory Studies of Habituation, Pitch and Roll, and the Refinement of a Mathematical Model (Technical Report No. HFR 1733-2). Santa Barbara, CA: Human Factors Research, Inc.
  • Motion SicknessAdaptation Space: 2 – 3 d 100 Proposed model HFR data MSI [%] ARMS=0.333 [Hz] Sea: 1-2 d 50 0 1 2 10 10 Motion specific 100 Proposed model HFR data MSI [%] ARMS=0.222 [Hz] 50 Adaptation transfer? 0 1 2 10 10 40 Proposed model HFR data MSI [%] ARMS=0.111 [Hz] 20 0 10 20 30 40 50 60 70 80 100120 Time in [min]Colwell, J. L. (1994). Motion sickness habituation in the naval environment(No. DREA Technical Memorandum 94/211). Dartmouth, N.S.: DefenceResearch Establishment Atlantic.
  • Motion SicknessEffects are Task-Dependent Complex tasks Vigilance tasks More sensitive to Sustained performance (long) Motion Sickness Self-paced Viewed as non-essential Well-learned/simple tasks More resistant to Short Motion Sickness Externally paced
  • Countermeasures and what should be done
  • Countermeasures I Fatigue Dark Dexedrine (dextro- amphetamine) Prescription Quiet Sleep Modafinil conditions Stimulants or Temperate alerting drugs Caffeine Non- Safe prescription Nicotine Pharmacol. Work/rest Interventions schedules Ambien Daily activity (zolpidem) Non- optimization Prescriptionpharmacological Naps, rest breaks Restoril Interventions (temazepam) Exercise Sedatives or sleep aids Melatonin Physical fitness Non- Benedryl Environmental prescription stimulation Trytophan Task attributes Miller, N.L. Matsangas, P. & Shattuck, L.G. (2008) “Fatigue and its effects on performance in military environments” in Hancock, P. & Szalma, J., eds., Performance Under Stress. Ashgate Publishers. Aldershot, UK.
  • Countermeasures IIFatigue and motion sickness Fatigue/Sleep deprivation  Operational  Observe your personnel  Napping  Duty cycle optimization  Morningness-eveningness preference  Organizational  Regulations’ development and implementation  NSWW Motion sickness  Observe you personnel  Assigned duties optimization  Screening  Better system designs
  • Warfare is a ‘24-7’ activityWhat should we do? Operational sleep hygiene Regulatory policies Optimize sleep/wake cycles/duty time Use appropriate Human Performance models Observe your personnel (for fatigue and soporific symptoms) Better system design Education and training on human performance Kill the “myth of the warrior” (Shay, 1998) “[Fatigue is] … the big gray elephant we muscle out of the cockpit when we fly, step around when we enter the bridge, and push aside when we peer into the periscope” (CAPT Davenport, 2006). Shay, J. (1998). Ethical Standing for Commander Self-Care: The Need for Sleep. Parameters, 28(2), 93-105.
  • Bibliography for further reading Matsangas, P. and Miller, N.L. (2006). The Effects of Ship Motion on the Sleeping Patterns of Crewmembers aboard a High Speed Naval Vessel. Sleep, 29(Suppl.S), A126-A126. McCauley, M.E., Pierce, E., and Matsangas, P. (2007). The High Speed Navy: Vessel Motion Influences on Human Performance. Naval Engineers Journal, 119(1), 35-44. Miller, N.L., Shattuck, L.G., Matsangas, P., and Dyche, J. (2008). Sleep Patterns and Academic Performance in U.S. Military Training and Education Programs. Mind, Brain, and Education, 2(1),29-33. Matsangas, P., McCauley, M.E., Miller, N.L. (2008). [The effect of fatigue and motion sickness in ship operational effectiveness: review and preliminary results from non-conventional naval designs] [in greek]. Nafsivios chora, 2, 113-132. Miller, N.L., Shattuck, L.G., Matsangas, P. (2009). Sleep and Fatigue Issues in Continuous Operations: A Survey of U.S. Army Officers. Behavioral Sleep Medicine. Accepted for publication. McCauley, M.E., Matsangas, P., and Lewis-Miller, N. (2005). Motion and Fatigue Study in High Speed Vessel Operation: Phase 1 Report. Technical Report. Prepared for Naval Surface Warfare Center, Coastal Systems Station, Panama City, Florida. McCauley, M.E., Matsangas, P., Pierce, E., Price, B., LaBreque, J., and Blankeship, J. (2007). Vessel Motion Effects on Human Performance aboard the FSF-1 Sea Fighter. Technical Report. Prepared from PMS-501, NSWC Panama City, Florida, and Naval Postgraduate School, Monterey, California, October 2007. Miller, N.L., Shattuck, L.G., Tvaryanas, A. Matsangas, P. (2010). Effects of Sleep on Training Effectiveness in Soldiers at Fort Leonard Wood (Phase 1). Technical Report NPS-OR-10-003, February 2010, Monterey, California, USA. Miller, N.L. Matsangas, P. & Shattuck, L.G. (2008) “Fatigue and its effects on performance in military environments” in Hancock, P. & Szalma, J., eds., Performance Under Stress. Ashgate Publishers. Aldershot, UK. McCauley, M.E. & Matsangas, P. (2005). Ship’s Motion Effects on Crew Performance: A Preliminary Analysis of Motion Induced Effects on High Speed Vessel (HSV). Presented in Network Centric Warfare Conference 2005, 09-10 November, Athens, McCauley, M.E., Pierce, E., and Matsangas, P. (2007). The High Speed Navy: Vessel Motion Influences on Human Performance. Presented in Human Systems Integration Symposium 2007, 16-19 March, Annapolis, USA Pierce, Ε., McCauley, M.E., Price, B., Matsangas, P. (2008). Vessel motion influences on human performance and manual materials handling. Presented in Pacific 2008 International Maritime Conference (IMC), 29-31 January, Sydney, Australia.