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5 Sleep Disruption and Fatigue
Pages 122-138

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From page 122...
... The third is sleep inertia, which results in impaired performance immediately on awakening from sleep. These three factors combine to make it exceedingly difficult to work effectively or safely for prolonged periods of time without a carefully planned strategy of countermeasures designed to address each factor.
From page 123...
... Ablation studies performed independently in two different laboratories indicated that bilateral destruction of a pair of hypothalamic neuronal clusters located on either side of the anterior tip of the third ventricle resulted in a loss of both endocrine and behavioral circadian rhythms (Moore and Eichler, 1972; Stephan and Zucker, 1972~. It was further demonstrated that these central nervous system structures, the suprachiasmatic nuclei (SCN)
From page 124...
... Whenever human subjects have been studied in environments free of environmental time cues for more than two months, the timing of the self-selected rest-activity cycle loses synchrony with the stable, near24-hour oscillations that can be detected in physiological variables such as the body temperature cycle (Czeisler, 1978; Czeisler and Jewett, 19901. Yet even under such conditions of internal desynchrony, prominent circadian variations in alertness, cognitive performance, short-term memory, sleep tendency, spontaneous sleep duration, awakening and rapid eye movement (REM)
From page 125...
... It is thus not surprising that field studies of human performance among shift workers demonstrate strikingly similar results. During the latter half of the night, responses to calls for service take the longest; performance on an F-104 flight simulator is worst; shooting range performance among military personnel is least efficient; mental arithmetic is slowest; alertness is lowest; short-term memory is markedly impaired; and the rate of singlevehicle truck accidents due to sleepiness is by far the greatest (Czeisler et al., 1986; Folkard et al., 1978; Froberg et al., 1975; Harris, 1977; Klein et al., 1977~.
From page 126...
... Although additional incentives (e.g., monetary rewards) can raise signal detection to normal baseline levels for one night and the following day of sleep deprivation, by the second night detection rate falls regardless of the incentive offered (Home, 1988~.
From page 127...
... Finally, sleep deprivation impairs information processing, resulting in increased time requirements for making decisions (Asken and Raham, 19831. Several studies have employed protocols of extended wakefulness to investigate the interaction of the effects of sleep deprivation and circadian rhythmicity on reaction time, cognitive function, and shooting range performance (Babkoff et al., 1988; Carskadon and Dement, 1979; Dinges et al., 1987; Froberg et al., 1975~.
From page 128...
... found that specific tank crew duties (e.g., those that required consistent, sustained alertness or perceptual-motor activities) were most sensitive to sleep loss in a 48-hour field test.
From page 129...
... Since physiologic sleep tendency is low during the evening, crew members may not attempt to sleep until they have already suffered from considerable sleep loss. The imposition of strict work-rest schedules by the military will ensure that crew members' circadian pacemakers are mutually synchronized, resulting in all of them reaching their performance nadir simultaneously.
From page 130...
... If such extended-duty performance is demanded, there will inevitably be a critical zone of vulnerability each day during which microsleep episodes involuntarily intrude on the waking brain, leading to dangerous lapses of attention (Torsvall and Akerstedt, 1987~. In addition, if performance is abruptly required after a period of low workload, during which crew members are likely to have fallen asleep, then, because of sleep inertia, they may subsequently be disoriented, confused, and unable to consolidate memories or perform efficiently for at least 30 minutes after awakening.
From page 131...
... Nonetheless, the use of properly timed exposure to bright light (both natural and artificial) and strict scheduling of exposure to darkness could enable commanders to disperse periods of vulnerability either within individual tank crews or across tank divisions.
From page 132...
... Certainly, cumulative sleep deprivation should be avoided at all costs during such periods, since many studies have documented the impairments of performance associated with the habitual restriction of nocturnal sleep (Hamilton et al., 1972~. While none of these countermeasures can eliminate the effects of this powerful homeostatic regulatory mechanism on human performance, they can dissipate the impact of sleep loss and misalignment of circadian phase and minimize their deleterious consequences during the critical transition period from inactivity to combat.
From page 133...
... Allan 1986 Circadian rhythms and performance decrements in the transportation industry.
From page 134...
... Monk, and M.C. Lobban 1978 Short and long-term adjustment of circadian rhythms in "permanent" night nurses.
From page 135...
... Levi, and L Lidberg 1975 Circadian rhythms of catecholamine excretion, shooting range performance and self-ratings of fatigue during sleep deprivation.
From page 136...
... Mills, J.N. 1974 Phase relations between components of human circadian rhythms.
From page 137...
... Zucker 1972 Circadian rhythms in drinking behavior and locomotor activity of rats are eliminated by hypothalmic legions. Proceedings of the National Academy of Sciences 69:1583-1586.
From page 138...
... Goodnow 1959 Impaired performance with acute sleep loss. Psychology Monogram 73:1-26.


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