Adam Fletcher

The impact of a week of simulated night work on sleep, circadian phase, and performance

Aims: To investigate factors that may contribute to performance adaptation during permanent night work. Methods: Fifteen healthy subjects participated in an adaptation and baseline night sleep, directly followed by seven simulated eight-hour night shifts (2300 to 0700 hours). At the end of each shift they were taken outside and exposed to natural light for 20 minutes. They then slept from approximately 0800 hours until they naturally awoke. Results: There was a significant increase in mean performance on a visual psychomotor vigilance task across the week. Daytime sleep quality and quantity were not negatively affected. Total sleep time (TST) for each of the daytime sleeps was reduced, resulting in an average cumulative sleep debt of 3.53 hours prior to the final night shift. TST for each of the daytime sleep periods did not significantly differ from the baseline night, nor did TST significantly vary across the week. There was a significant decrease in wake time after sleep onset and sleep onset latency across the week; sleep efficiency showed a trend towards greater efficiency across the consecutive daytime sleeps. Hours of wakefulness prior to each simulated night shift significantly varied across the week. The melatonin profile significantly shifted across the week. Conclusions: Results suggest that under optimal conditions, the sleep debt that accumulates during consecutive night shifts is relatively small and does not exacerbate decrements in night-time performance resulting from other factors. When sleep loss is minimised, adaptation of performance during consecutive night shifts can occur in conjunction with circadian adaptation.

A quantitative model of work-related fatigue: background and definition.

Fatigue has been identified as a major risk factor for shiftworkers. However, few organizations or governments currently manage work-related fatigue in any systematic or quantitative manner. This paper outlines an approach to managing fatigue that could improve shiftwork management. Using shift start and finish times as an input, the outlined model quantifies work-related fatigue on the basis of its known determinants; that is shift timing and duration, work history and the biological limits on sleep length at specific times of day. Evaluations suggest that work-related fatigue scores correlate very highly with sleep-onset latency, neurobehavioural impairment and subjective sleepiness. The model is useful in that it allows comparisons to be made between rosters independent of shift length and timing or the total number of work hours. Furthermore, unlike many models of sleepiness and fatigue, individuals sleep times are not required as hours of work are used as the input. It is believed the model provides the potential quantitatively to link the effects of shiftwork to specific organizational health and safety outcomes. This simple approach may be especially critical at a time when many organizations view longer and more flexible hours from their employees as an immediate productivity gain.

Countermeasures to driver fatigue: a review of public awareness campaigns and legal approaches

Objective: Driver fatigue accounts for 10–40% of road crashes and is a critical area for public health. As other major road safety issues are more successfully managed, driver fatigue becomes proportionately more important. Both public awareness and legal developments have been slow to reach the same levels as for other road safety risks. The aim of this article is to review countermeasures for non‐commercial drivers that are designed to reduce the likelihood of fatigue‐related crashes through education and legislation.

A quantitative model of work-related fatigue: empirical evaluations

Systematic and quantitative management of work-related fatigue within workplaces has been a challenging task due to a lack of useful tools. A previous paper provided background and development of a work-related fatigue modelling approach. The current paper outlines model evaluations using sleep deprivation experiments and recommendations of work scheduling. Previous studies have reported cumulative effects of sleep restriction (4–5 h per night) on a number of measures. Model predictions were correlated against psychomotor vigilance task lapses (r= 0.92) and reaction time responses (slowest 10%,r= 0.91) as well as sleep latency (r=-0.97). Further correlations were performed on four measures from a 64 h continuous sleep deprivation study; that is objective vigilance (r=-0.75) as well as subjective performance (r=-0.75), sleepiness (r= 0.82) and tiredness (r= 0.79). Evaluation against current scheduling recommendations illustrated consistency with the literature with the exception that forward rotation did not provide benefits over backward rotation. The results indicate that model predictions correlate well across a range of objective and subjective measures. This relationship also appears to hold for cumulative and continuous sleep deprivation protocols. Future studies will also focus on field-based evaluation.

Adaptation of performance during a week of simulated night work

This study aimed to provide a comparative index of the performance impairment associated with the fatigue levels frequently experienced in workplaces that require night work. To do this, we equated fatigue-related impairment with the impairment resulting from varying levels of alcohol intoxication. Fifteen young individuals participated in two counterbalanced conditions which required them to (1) ‘work’ seven consecutive 8-h night shifts, and (2) consume an alcoholic beverage at hourly intervals until their blood alcohol concentration (BAC) reached 0.10%. In each condition, performance was measured at hourly intervals using a 10-min psychomotor vigilance task (PVT). Analysis indicated that as BAC increased, performance impairment significantly increased. Similarly, response times significantly increased during the first six simulated night-shifts, and lapse frequency significantly increased during the first two shifts. Equating the two conditions indicated that the first simulated night shift was associated with the greatest degree of performance impairment. In general, the impairment at the end of this shift was greater than that observed at a BAC of 0.10%. During the second and third simulated night shifts, the performance impairment was less than on the first night, but greater than that observed at a BAC of 0.05%. For the final four nights, the performance decrements generally did not exceed those observed at a BAC of 0.05%. This suggests that during a week of consecutive night shifts, adaptation of performance occurs.

Predicting the timing and duration of sleep in an operational setting using social factors

In recent years, there has been increasing interest in the use of bio‐mathematical models to predict alertness, performance, and/or fatigue in operational settings. Current models use only biological factors to make their estimations, which can be limited in operational settings where social and geo‐physical factors also dictate when sleep occurs. The interaction between social and biological factors that help determine the timing and duration of sleep during layover periods have been investigated in order to create and initially validate a mathematical model that may better predict sleep in the field. Participants were 32 male transmeridian airline pilots (17 captains, 10 first officers, and 5 second officers) flying the Sydney‐Bangkok‐London‐Singapore‐Sydney (SYD‐LHR) pattern. Participants continued their regular schedule while wearing activity monitors and completing sleep and work diaries. The theoretical sleep timing model underpinning this analysis consists of separate formulations for short (<32 h) and long (>32 h) break periods. Longer break periods are split into three distinct phases—recovery (break start until first local night), personal (first local night until last local night), and preparation phases (last local night until break end)—in order to exploit potential differences specific to each. Furthermore, an iterative procedure combining prediction and retrodiction (i.e., using future duty timing information to predict current sleep timing) was developed to optimize predictive ability. Analysis found an interaction between the social and circadian sleep pressures that changed over the break period. Correlation analysis indicated a strong relationship between the actual sleep and new models predictions (r=0.7–0.9), a significant improvement when compared to existing models (r=0.1–0.4). Social and circadian pressures play important roles in regulating sleep for international flight crews. An initial model has been developed in order to regulate sleep in these crews. The initial results have shown promise when applied to small sets of data; however, more rigorous validation must be carried out.

FIELD-BASED VALIDATIONS OF A WORK-RELATED FATIGUE MODEL BASED ON HOURS OF WORK

This paper attempts to develop the framework of a work-related fatigue modelling approach. While no model can ever predict work-relatd fatigue entirely, current scientific knowledge should be sufficient to initiate systematic quantitative modelling. The paper argues that the most appropriate method is to use determinants of fatigue observed from experimental research and to develop a generalized model suitable for any workplace, rather than the popular method of extrapolating from laboratory assessments pf specific rosters to an operational workplace.

Using task analysis to improve usability of fatigue modelling software

The design of any interactive computer system requires consideration of both humans and machines. Software usability is one aspect of human-computer interaction that can benefit from knowledge of the user and their tasks. One set of methods for determining whether an application enables users to achieve their predetermined goals effectively and efficiently is task analysis. In the present study, a task analysis was applied to the graphical user interface of fatigue modelling software used in industry. The task analysis procedure allowed areas of usability improvement to be identified and then addressed with alternate interface prototypes. The present method of task analysis illustrates a practical and efficient way for software designers to improve software usability, user effectiveness and satisfaction, by involving users in the design process.