STRESS AND FATIGUE IN AVIATION OPERATIONS

1. STRESS AND FATIGUE IN AVIATION OPERATIONS Every day, Army aircrew members are involved in stressful situations that are a standard part of the aviation operational environment. Long hours, noise and vibration, altitude effects on the body, and potential mechanical malfunctions are just a few examples of aviation stressors. This environment is also where multiple decisions must be made, some of which may be life-threatening. Since the research literature and common experience tell us that stress and fatigue can affect decision-making in the cockpit, it is imperative that aircrew be aware of and address this problem. Every day, Army aircrew members are involved in stressful situations that are a standard part of the aviation operational environment. Long hours, noise and vibration, altitude effects on the body, and potential mechanical malfunctions are just a few examples of aviation stressors. This environment is also where multiple decisions must be made, some of which may be life-threatening. Since the research literature and common experience tell us that stress and fatigue can affect decision-making in the cockpit, it is imperative that aircrew be aware of and address this problem.

3. TERMINAL LEARNING OBJECTIVE ACTION: Manage the effects of stress and fatigue. CONDITION: While performing as an aircrew member STANDARD: IAW FM 3-04.301, DA Pam 600-24, FM 22-51, AR 95-1, Flight Stress, Fundamentals of Aerospace Medicine, Leader’s Guide to Crew Endurance, Health Psychology This class identifies the specific effects of psychophysiological factors on aircrew and recommends countermeasures and leader actions for controlling the negative effects of stress and fatigue. During this block of instruction, it is important that you consider the information presented not only from an individual perspective, but also from the perspective of a senior aircrew member and leader. Think about how your subordinates cope (or fail to cope) with stress and fatigue, and how the information presented relates to problems in your workplace. . This class identifies the specific effects of psychophysiological factors on aircrew and recommends countermeasures and leader actions for controlling the negative effects of stress and fatigue. During this block of instruction, it is important that you consider the information presented not only from an individual perspective, but also from the perspective of a senior aircrew member and leader. Think about how your subordinates cope (or fail to cope) with stress and fatigue, and how the information presented relates to problems in your workplace. .

4. ENABLING LEARNING OBJECTIVE #1 ACTION: Select the three definitions of stress. CONDITION: Given a list. STANDARD: IAW FM 3-04.301, Flight Stress, and Health Psychology

5. History of Research about Stress Walter Cannon (1932) – “Fight-or-flight” Rapid arousal of the sympathetic nervous system and endocrine system Provides the “rush” you feel when scared or surprised Stress = the physiological rush Around 1926 an Austrian endocrinologist, Hans Selye, identified what he believed was a consistent pattern of mind-body reactions that he called “the nonspecific response of the body to any demand.” He later referred to this pattern as the “rate of wear and tear on the body.” Selye’s definition of stress is necessarily broad, as stress is a broad concept. However, it incorporates two very important points: (1) that stress is a physical or “body” phenomenon and (2) that stress involves some “demand” placed upon an individual. When the body perceives some threat or challenge, a number of immediate physiological changes occur, for example: Heart rate and blood pressureincrease. The pupils of the eyes dilate for better vision. The lungs take in more oxygen. The bloodstream brings extra oxygen and glucose into circulation for fuel. And digestion stops to allow the body to focus its energy on the muscles. This response has been called the “Fight or Flight Response.” If the stress response is activated too often, it can harm the body, causing damage to the immune system, brain, and heart. Around 1926 an Austrian endocrinologist, Hans Selye, identified what he believed was a consistent pattern of mind-body reactions that he called “the nonspecific response of the body to any demand.” He later referred to this pattern as the “rate of wear and tear on the body.” Selye’s definition of stress is necessarily broad, as stress is a broad concept. However, it incorporates two very important points: (1) that stress is a physical or “body” phenomenon and (2) that stress involves some “demand” placed upon an individual. When the body perceives some threat or challenge, a number of immediate physiological changes occur, for example: Heart rate and blood pressureincrease. The pupils of the eyes dilate for better vision. The lungs take in more oxygen. The bloodstream brings extra oxygen and glucose into circulation for fuel. And digestion stops to allow the body to focus its energy on the muscles. This response has been called the “Fight or Flight Response.” If the stress response is activated too often, it can harm the body, causing damage to the immune system, brain, and heart.

6. History of Research about Stress Hans Selye (1956) - “General Adaptation Syndrome” - “General” – nonspecific response “Adaptation” – places a demand on body to adapt “Syndrome” – no adaptation = pathology Stress = the nonspecific response of the body to any demand placed upon it. Three stages alarm, resistance, exhaustion

7. History of Research about Stress Lazarus (1968) – Psychological Appraisal: Primary appraisal determines meaning of the event (positive, negative, neutral) If negative, assesses degree of harmfulness Secondary Appraisal: assessment of available coping resources Stress = perceived threat > perceived coping

8. ENABLING LEARNING OBJECTIVE #2 ACTION: Select the signs and symptoms of stress. CONDITION: Given a list. STANDARD: IAW FM 3-04.301

9. Signs and Symptoms of Stress Physical Emotional Cognitive Behavioral In general, responses to stress overload fall into one of four categories. In general, responses to stress overload fall into one of four categories.

10. Physical Signs and Symptoms Sweaty Palms ? Heart Rate Trembling Shortness of Breath Gastrointestinal Distress Muscle Tension Sleep Problems Backaches ? Blood Pressure Immune System Suppression Fatigue Anxiety Disorders The immediate physical response to a stressful situation involves overall heightened arousal of the body: increased heart rate, increased blood pressure, more rapid breathing, tensing of the muscles, and the release of sugars and fats into circulation to provide fuel for “fight or flight.” Prolonged stress and its continuous effects on the body may produce longer-term physical symptoms such as muscle tension and pain, headaches, high blood pressure, gastrointestinal problems and decreased immunity to infectious diseases. The immediate physical response to a stressful situation involves overall heightened arousal of the body: increased heart rate, increased blood pressure, more rapid breathing, tensing of the muscles, and the release of sugars and fats into circulation to provide fuel for “fight or flight.” Prolonged stress and its continuous effects on the body may produce longer-term physical symptoms such as muscle tension and pain, headaches, high blood pressure, gastrointestinal problems and decreased immunity to infectious diseases.

11. Emotional Signs and Symptoms Irritability Hostility Anxiety Loss of Self-Esteem Feelings of Helplessness Anhedonia Emotional responses to stress overload can range from a keyed-up sense of anxiety and irritability to social withdrawl and depression. Anhedonia is a symptom of depression involving an extreme loss of pleasure in activities that were once enjoyable. Persons suffering from stress overload may lose interest in hobbies and other leisure activities and find little happiness in life.Emotional responses to stress overload can range from a keyed-up sense of anxiety and irritability to social withdrawl and depression. Anhedonia is a symptom of depression involving an extreme loss of pleasure in activities that were once enjoyable. Persons suffering from stress overload may lose interest in hobbies and other leisure activities and find little happiness in life.

12. Cognitive Signs and Symptoms Obsession or excessive worrying Decreased attention Impaired memory Poor judgment Poor psychomotor coordination Prolonged stress may affect thinking (a.k.a. cognition) as well as emotions and behavior. This is a serious issue for aircrew, as problems with judgement, attention, or concentration pose a great risk to personnel, the mission, and the aircraft. For example, under high stress conditions there is a tendency to oversimplify problem solving and ignore important relevant information, taking the “easy way out.” This is called the Simplification Heuristic. Many individuals under high stress conditions will also forget learned procedures and skills and revert to bad habits in a phenomenon called Stress-Related Regression. For example, a student aviator preparing for take-off may forget to turn on the fuel switch and then, realizing the problem and feeling stressed and embarrassed, turn the switch on and risk overheating the engine. This action is clearly contrary to his training and represents a kind of regression or failure to utilize prior learning. Yet another stress-related cognitive error is Perceptual Tunneling. It is a phenomenon in which an individual or an entire crew under high stress becomes focused on one stimulus, like a warning signal, and neglects to attend to other important tasks or information, such as flying the aircraft. A similar situation may occur when an aviator realizes during flight that he overlooked some aspect of flight, such as missing a radio communication. He may then over-attend to rectifying this problem and/or become emotionally and mentally fixated on the error and fall “behind the aircraft,” missing new information and further compromising the mission. Beyond affecting memory, judgement and attention, stress can even decrease hand-eye coordination and muscle control. Prolonged stress may affect thinking (a.k.a. cognition) as well as emotions and behavior. This is a serious issue for aircrew, as problems with judgement, attention, or concentration pose a great risk to personnel, the mission, and the aircraft. For example, under high stress conditions there is a tendency to oversimplify problem solving and ignore important relevant information, taking the “easy way out.” This is called the Simplification Heuristic. Many individuals under high stress conditions will also forget learned procedures and skills and revert to bad habits in a phenomenon called Stress-Related Regression. For example, a student aviator preparing for take-off may forget to turn on the fuel switch and then, realizing the problem and feeling stressed and embarrassed, turn the switch on and risk overheating the engine. This action is clearly contrary to his training and represents a kind of regression or failure to utilize prior learning. Yet another stress-related cognitive error is Perceptual Tunneling. It is a phenomenon in which an individual or an entire crew under high stress becomes focused on one stimulus, like a warning signal, and neglects to attend to other important tasks or information, such as flying the aircraft. A similar situation may occur when an aviator realizes during flight that he overlooked some aspect of flight, such as missing a radio communication. He may then over-attend to rectifying this problem and/or become emotionally and mentally fixated on the error and fall “behind the aircraft,” missing new information and further compromising the mission. Beyond affecting memory, judgement and attention, stress can even decrease hand-eye coordination and muscle control.

13. Behavioral Signs and Symptoms Late to work Poor performance Explosiveness Alcohol and/or other drug abuse Social isolation Suicide Stress overload also affects how we act at work, at home, and with our friends. For example, lateness to work or a drop in work performance can be signs of stress overload. At times, stress may become so severe that alcohol is used to self-medicate anxiety or depression. Using alcohol as a coping strategy is particularly dangerous, since it impairs judgement and increases impulsivity and can result in suicide or violence in the home or workplace.Stress overload also affects how we act at work, at home, and with our friends. For example, lateness to work or a drop in work performance can be signs of stress overload. At times, stress may become so severe that alcohol is used to self-medicate anxiety or depression. Using alcohol as a coping strategy is particularly dangerous, since it impairs judgement and increases impulsivity and can result in suicide or violence in the home or workplace.

14. ENABLING LEARNING OBJECTIVE #3 ACTION: Select the correct actions to prevent suicide in a coworker who hints about suicide. CONDITION: Given a list of actions STANDARD: IAW DA PAM 600-24

15. Danger Signals For Suicide Risk Talking/Hinting About Suicide Giving Away Possessions/ Making a Will Obsession with Death Specific Plan/Access to Lethal Means Buying a Gun Prior attempts Alcohol consumption increases risk Suicidal thoughts can be a result of stress overload. You do not need to have a history of mental health problems to consider committing suicide. Extreme stress, like the loss of a loved one, may cause previously healthy people to feel hopeless and consider harming themselves. There are several danger signals that suicidal individuals may demonstrate. If you observe these signals in a family member, friend, or coworker, you should talk to them supportively and refer them to a mental health professional or to the flight surgeon.Suicidal thoughts can be a result of stress overload. You do not need to have a history of mental health problems to consider committing suicide. Extreme stress, like the loss of a loved one, may cause previously healthy people to feel hopeless and consider harming themselves. There are several danger signals that suicidal individuals may demonstrate. If you observe these signals in a family member, friend, or coworker, you should talk to them supportively and refer them to a mental health professional or to the flight surgeon.

16. Actions to Prevent Suicide Talk to the soldier supportively Don’t “beat around the bush” If you suspect suicidal ideation, ask! Talking about suicide WILL NOT provoke it. Ensure the soldier receives prompt medical attention

17. ENABLING LEARNING OBJECTIVE #4 ACTION: Identify the different classes of stressors. CONDITION: Given a list. STANDARD: IAW FM 3-04.301

18. Environmental ALTITUDE HEAT/COLD SPEED TERRAIN WEATHER ERGONOMICS There are many environmental stressors unique to aviation. Stress caused by altitude is most evident below 5,000 feet. This is where the greatest atmospheric changes occur and aircrew members are subject to problems resulting from trapped gas. Even a common cold can cause ear and sinus problems on descent. Because flights seldom exceed an altitude of 18,000 feet, hypoxia and evolved gas problems, such as the bends, are not significant sources of stress for most Army aviators. Extreme heat or cold is another cause of stress in the aviation environment. Heat problems may be due to hot, tropic like climates or to direct sunlight entering through large canopies. Cold problems, on the other hand, may be due to altitude or arctic climates. Flight is usually associated with speeds greater than those experienced in an everyday, earthbound environment. These speeds are stressful since they require increased alertness and an optimal response level for prolonged periods. Poor weather resulting in instrument flight conditions imposes significant stress and increases the fatigue of aircrew. Awareness of a greater potential for physical danger and the need for increased vigilance and accuracy in reading, following, and monitoring flight instruments are very stressful. There is a high correlation between adverse weather and accident rates. Aviator performance is significantly affected by human factors engineering (ergonomic) items such as cockpit illumination, instrument location, accessibility of switches and controls, and seat comfort. Other influential human factors are the adequacy of heating and ventilating systems, visibility, and noise level. When such items are inadequate or uncomfortable, aircrew members will experience increased stress, and their attention may be diverted from performing operational duties. There are many environmental stressors unique to aviation. Stress caused by altitude is most evident below 5,000 feet. This is where the greatest atmospheric changes occur and aircrew members are subject to problems resulting from trapped gas. Even a common cold can cause ear and sinus problems on descent. Because flights seldom exceed an altitude of 18,000 feet, hypoxia and evolved gas problems, such as the bends, are not significant sources of stress for most Army aviators. Extreme heat or cold is another cause of stress in the aviation environment. Heat problems may be due to hot, tropic like climates or to direct sunlight entering through large canopies. Cold problems, on the other hand, may be due to altitude or arctic climates. Flight is usually associated with speeds greater than those experienced in an everyday, earthbound environment. These speeds are stressful since they require increased alertness and an optimal response level for prolonged periods. Poor weather resulting in instrument flight conditions imposes significant stress and increases the fatigue of aircrew. Awareness of a greater potential for physical danger and the need for increased vigilance and accuracy in reading, following, and monitoring flight instruments are very stressful. There is a high correlation between adverse weather and accident rates. Aviator performance is significantly affected by human factors engineering (ergonomic) items such as cockpit illumination, instrument location, accessibility of switches and controls, and seat comfort. Other influential human factors are the adequacy of heating and ventilating systems, visibility, and noise level. When such items are inadequate or uncomfortable, aircrew members will experience increased stress, and their attention may be diverted from performing operational duties.

19. Psychosocial Sources of Stress Some Major Events Are: Marriage Death of a Close Relative Reassignment Illness or Injury (Self or Family) FM 1-301 Chapter 2-2 Psychosocial stressors are those that deal with your relationships, career, and finances, as well as the factors that influence these three areas, such as your physical health. As you can see, both positive and negative life events can be stressful. TO THE INSTRUCTOR: Consider administering the stressful life events scale and discusiing results as a practical exercise.FM 1-301 Chapter 2-2 Psychosocial stressors are those that deal with your relationships, career, and finances, as well as the factors that influence these three areas, such as your physical health. As you can see, both positive and negative life events can be stressful. TO THE INSTRUCTOR: Consider administering the stressful life events scale and discusiing results as a practical exercise.

20. Cognitive Stressors How you view a stressor will effect your experience of stress “All or nothing” thinking Failure to focus on the here and now Too many “Musts and shoulds” FM 1-301, 2-7 (c) Just as life events can challenge your coping, your own style of thinking and problem solving can sometimes increase your stress level, as illustrated in the examples here. FM 1-301, 2-7 (c) Just as life events can challenge your coping, your own style of thinking and problem solving can sometimes increase your stress level, as illustrated in the examples here.

21. Physiological Stressors Maladaptive behaviors over which aircrew have significant control Use acronym “DEATH” Drugs Exhaustion Alcohol Tobacco Hypoglycemia Three things that can cross the blood brain barrier Aspirin, caffeine, alcohol It is “assumed” that after 14 hours all traces of alcohol are removed from the blood. Alcohol produces significant changes in the body systems. These changes are present long after the alcohol has been metabolized. All pilots should be aware of this residual/hangover effects of alcohol, which can be detrimental to performance even though there isn’t a detectable level of blood alcohol present: - Reduces cells ability to transport oxygen...Histotoxic hypoxia - Alcohol is a sedative, and a CNS depressant anesthetic - It inhibits ADH leading to dehydration - Body takes 3 Hrs to metabolize 1.5 oz of alcohol & 12 hrs for 6 ounces. Three things that can cross the blood brain barrier Aspirin, caffeine, alcohol It is “assumed” that after 14 hours all traces of alcohol are removed from the blood. Alcohol produces significant changes in the body systems. These changes are present long after the alcohol has been metabolized. All pilots should be aware of this residual/hangover effects of alcohol, which can be detrimental to performance even though there isn’t a detectable level of blood alcohol present: - Reduces cells ability to transport oxygen...Histotoxic hypoxia - Alcohol is a sedative, and a CNS depressant anesthetic - It inhibits ADH leading to dehydration - Body takes 3 Hrs to metabolize 1.5 oz of alcohol & 12 hrs for 6 ounces.

22. Drugs Self Medication Known side effects Overdose risk Allergic reactions Synergistic effects Three things that can cross the blood brain barrier Aspirin, caffeine, alcohol It is “assumed” that after 14 hours all traces of alcohol are removed from the blood. Alcohol produces significant changes in the body systems. These changes are present long after the alcohol has been metabolized. All pilots should be aware of this residual/hangover effects of alcohol, which can be detrimental to performance even though there isn’t a detectable level of blood alcohol present: - Reduces cells ability to transport oxygen...Histotoxic hypoxia - Alcohol is a sedative, and a CNS depressant anesthetic - It inhibits ADH leading to dehydration - Body takes 3 Hrs to metabolize 1.5 oz of alcohol & 12 hrs for 6 ounces. Three things that can cross the blood brain barrier Aspirin, caffeine, alcohol It is “assumed” that after 14 hours all traces of alcohol are removed from the blood. Alcohol produces significant changes in the body systems. These changes are present long after the alcohol has been metabolized. All pilots should be aware of this residual/hangover effects of alcohol, which can be detrimental to performance even though there isn’t a detectable level of blood alcohol present: - Reduces cells ability to transport oxygen...Histotoxic hypoxia - Alcohol is a sedative, and a CNS depressant anesthetic - It inhibits ADH leading to dehydration - Body takes 3 Hrs to metabolize 1.5 oz of alcohol & 12 hrs for 6 ounces.

23. Exhaustion Lack of adequate sleep and rest Deployments Extreme environments Circadian desynchronosis Physical conditioning Aerobic Anaerobic Three things that can cross the blood brain barrier Aspirin, caffeine, alcohol It is “assumed” that after 14 hours all traces of alcohol are removed from the blood. Alcohol produces significant changes in the body systems. These changes are present long after the alcohol has been metabolized. All pilots should be aware of this residual/hangover effects of alcohol, which can be detrimental to performance even though there isn’t a detectable level of blood alcohol present: - Reduces cells ability to transport oxygen...Histotoxic hypoxia - Alcohol is a sedative, and a CNS depressant anesthetic - It inhibits ADH leading to dehydration - Body takes 3 Hrs to metabolize 1.5 oz of alcohol & 12 hrs for 6 ounces. Three things that can cross the blood brain barrier Aspirin, caffeine, alcohol It is “assumed” that after 14 hours all traces of alcohol are removed from the blood. Alcohol produces significant changes in the body systems. These changes are present long after the alcohol has been metabolized. All pilots should be aware of this residual/hangover effects of alcohol, which can be detrimental to performance even though there isn’t a detectable level of blood alcohol present: - Reduces cells ability to transport oxygen...Histotoxic hypoxia - Alcohol is a sedative, and a CNS depressant anesthetic - It inhibits ADH leading to dehydration - Body takes 3 Hrs to metabolize 1.5 oz of alcohol & 12 hrs for 6 ounces.

24. Alcohol Affects judgment, thermal stress tolerance, visual acuity, perception, coordination & communication 12 hours “bottle to brief” and no residual effects Risk management approach to drinking Personal risk assessment Personal countermeasures Three things that can cross the blood brain barrier Aspirin, caffeine, alcohol It is “assumed” that after 14 hours all traces of alcohol are removed from the blood. Alcohol produces significant changes in the body systems. These changes are present long after the alcohol has been metabolized. All pilots should be aware of this residual/hangover effects of alcohol, which can be detrimental to performance even though there isn’t a detectable level of blood alcohol present: - Reduces cells ability to transport oxygen...Histotoxic hypoxia - Alcohol is a sedative, and a CNS depressant anesthetic - It inhibits ADH leading to dehydration - Body takes 3 Hrs to metabolize 1.5 oz of alcohol & 12 hrs for 6 ounces. Three things that can cross the blood brain barrier Aspirin, caffeine, alcohol It is “assumed” that after 14 hours all traces of alcohol are removed from the blood. Alcohol produces significant changes in the body systems. These changes are present long after the alcohol has been metabolized. All pilots should be aware of this residual/hangover effects of alcohol, which can be detrimental to performance even though there isn’t a detectable level of blood alcohol present: - Reduces cells ability to transport oxygen...Histotoxic hypoxia - Alcohol is a sedative, and a CNS depressant anesthetic - It inhibits ADH leading to dehydration - Body takes 3 Hrs to metabolize 1.5 oz of alcohol & 12 hrs for 6 ounces.

25. Tobacco Long-term: Lung cancer Coronary heart disease Sinus infections Acute: Carbon monoxide adds 5,000 feet to your physiological altitude Affects night vision Three things that can cross the blood brain barrier Aspirin, caffeine, alcohol It is “assumed” that after 14 hours all traces of alcohol are removed from the blood. Alcohol produces significant changes in the body systems. These changes are present long after the alcohol has been metabolized. All pilots should be aware of this residual/hangover effects of alcohol, which can be detrimental to performance even though there isn’t a detectable level of blood alcohol present: - Reduces cells ability to transport oxygen...Histotoxic hypoxia - Alcohol is a sedative, and a CNS depressant anesthetic - It inhibits ADH leading to dehydration - Body takes 3 Hrs to metabolize 1.5 oz of alcohol & 12 hrs for 6 ounces. Three things that can cross the blood brain barrier Aspirin, caffeine, alcohol It is “assumed” that after 14 hours all traces of alcohol are removed from the blood. Alcohol produces significant changes in the body systems. These changes are present long after the alcohol has been metabolized. All pilots should be aware of this residual/hangover effects of alcohol, which can be detrimental to performance even though there isn’t a detectable level of blood alcohol present: - Reduces cells ability to transport oxygen...Histotoxic hypoxia - Alcohol is a sedative, and a CNS depressant anesthetic - It inhibits ADH leading to dehydration - Body takes 3 Hrs to metabolize 1.5 oz of alcohol & 12 hrs for 6 ounces.

26. Hypoglycemia Caused by lack of well-balanced meals Can lead to weakness, fainting, and decreased efficiency Overeating may also impact general health and flight performance Three things that can cross the blood brain barrier Aspirin, caffeine, alcohol It is “assumed” that after 14 hours all traces of alcohol are removed from the blood. Alcohol produces significant changes in the body systems. These changes are present long after the alcohol has been metabolized. All pilots should be aware of this residual/hangover effects of alcohol, which can be detrimental to performance even though there isn’t a detectable level of blood alcohol present: - Reduces cells ability to transport oxygen...Histotoxic hypoxia - Alcohol is a sedative, and a CNS depressant anesthetic - It inhibits ADH leading to dehydration - Body takes 3 Hrs to metabolize 1.5 oz of alcohol & 12 hrs for 6 ounces. Three things that can cross the blood brain barrier Aspirin, caffeine, alcohol It is “assumed” that after 14 hours all traces of alcohol are removed from the blood. Alcohol produces significant changes in the body systems. These changes are present long after the alcohol has been metabolized. All pilots should be aware of this residual/hangover effects of alcohol, which can be detrimental to performance even though there isn’t a detectable level of blood alcohol present: - Reduces cells ability to transport oxygen...Histotoxic hypoxia - Alcohol is a sedative, and a CNS depressant anesthetic - It inhibits ADH leading to dehydration - Body takes 3 Hrs to metabolize 1.5 oz of alcohol & 12 hrs for 6 ounces.

27. ENABLING LEARNING OBJECTIVE #5 ACTION: Select the factors that determine the impact of stress on performance. CONDITION: Given a list. STANDARD: IAW FM 3-04.301 and Flight Stress

28. Stress and PerformanceFactors Mental skills required by task/situation Stress characteristics of the situation Biological make-up of the individual Psychological make-up of the individual How one performs under stress will vary according to four major factors. The first factor is the degree of mental effort required by the task to be performed. In general, stress effects performance much less if an individual is engaged in a relatively simple task that is either overlearned (like driving a car) or does not involve complex mental skills (like filling sand bags or some other form of manual labor). The characteristics of the situation in which a task is performed make up the second factor that affects the stress-performance relationship. For example, a student will do much better on a written acheivement test if he is working in a quiet, comfortable room as opposed to working in a hot, noisy room. The biological make-up of the individual also influences the stress/performance relationship. For example, an individual prone to fatiguing easily will not make a good Army Aviator, where long hours and night flights are common. The fourth and final factor affecting the stress/performance relationship is one’s personality and mental health. For example, individuals prone to obsession, perfectionism, and rigid thinking are less likely to perform well under stress than those persons with more flexible, realistic problem solving and decision making. How one performs under stress will vary according to four major factors. The first factor is the degree of mental effort required by the task to be performed. In general, stress effects performance much less if an individual is engaged in a relatively simple task that is either overlearned (like driving a car) or does not involve complex mental skills (like filling sand bags or some other form of manual labor). The characteristics of the situation in which a task is performed make up the second factor that affects the stress-performance relationship. For example, a student will do much better on a written acheivement test if he is working in a quiet, comfortable room as opposed to working in a hot, noisy room. The biological make-up of the individual also influences the stress/performance relationship. For example, an individual prone to fatiguing easily will not make a good Army Aviator, where long hours and night flights are common. The fourth and final factor affecting the stress/performance relationship is one’s personality and mental health. For example, individuals prone to obsession, perfectionism, and rigid thinking are less likely to perform well under stress than those persons with more flexible, realistic problem solving and decision making.

29. Stress and Performance Factors Yerkes-Dodson “Law”: How one performs under stress will vary according to four major factors. The first factor is the degree of mental effort required by the task to be performed. In general, stress effects performance much less if an individual is engaged in a relatively simple task that is either overlearned (like driving a car) or does not involve complex mental skills (like filling sand bags or some other form of manual labor). The characteristics of the situation in which a task is performed make up the second factor that affects the stress-performance relationship. For example, a student will do much better on a written acheivement test if he is working in a quiet, comfortable room as opposed to working in a hot, noisy room. The biological make-up of the individual also influences the stress/performance relationship. For example, an individual prone to fatiguing easily will not make a good Army Aviator, where long hours and night flights are common. The fourth and final factor affecting the stress/performance relationship is one’s personality and mental health. For example, individuals prone to obsession, perfectionism, and rigid thinking are less likely to perform well under stress than those persons with more flexible, realistic problem solving and decision making. How one performs under stress will vary according to four major factors. The first factor is the degree of mental effort required by the task to be performed. In general, stress effects performance much less if an individual is engaged in a relatively simple task that is either overlearned (like driving a car) or does not involve complex mental skills (like filling sand bags or some other form of manual labor). The characteristics of the situation in which a task is performed make up the second factor that affects the stress-performance relationship. For example, a student will do much better on a written acheivement test if he is working in a quiet, comfortable room as opposed to working in a hot, noisy room. The biological make-up of the individual also influences the stress/performance relationship. For example, an individual prone to fatiguing easily will not make a good Army Aviator, where long hours and night flights are common. The fourth and final factor affecting the stress/performance relationship is one’s personality and mental health. For example, individuals prone to obsession, perfectionism, and rigid thinking are less likely to perform well under stress than those persons with more flexible, realistic problem solving and decision making.

30. Stress and Performance Factors This relationship is not scientifically supported Has to do with “arousal” Coma Hyperactivity There is no link between increased levels of stress and better performance – it always declines!! How one performs under stress will vary according to four major factors. The first factor is the degree of mental effort required by the task to be performed. In general, stress effects performance much less if an individual is engaged in a relatively simple task that is either overlearned (like driving a car) or does not involve complex mental skills (like filling sand bags or some other form of manual labor). The characteristics of the situation in which a task is performed make up the second factor that affects the stress-performance relationship. For example, a student will do much better on a written acheivement test if he is working in a quiet, comfortable room as opposed to working in a hot, noisy room. The biological make-up of the individual also influences the stress/performance relationship. For example, an individual prone to fatiguing easily will not make a good Army Aviator, where long hours and night flights are common. The fourth and final factor affecting the stress/performance relationship is one’s personality and mental health. For example, individuals prone to obsession, perfectionism, and rigid thinking are less likely to perform well under stress than those persons with more flexible, realistic problem solving and decision making. How one performs under stress will vary according to four major factors. The first factor is the degree of mental effort required by the task to be performed. In general, stress effects performance much less if an individual is engaged in a relatively simple task that is either overlearned (like driving a car) or does not involve complex mental skills (like filling sand bags or some other form of manual labor). The characteristics of the situation in which a task is performed make up the second factor that affects the stress-performance relationship. For example, a student will do much better on a written acheivement test if he is working in a quiet, comfortable room as opposed to working in a hot, noisy room. The biological make-up of the individual also influences the stress/performance relationship. For example, an individual prone to fatiguing easily will not make a good Army Aviator, where long hours and night flights are common. The fourth and final factor affecting the stress/performance relationship is one’s personality and mental health. For example, individuals prone to obsession, perfectionism, and rigid thinking are less likely to perform well under stress than those persons with more flexible, realistic problem solving and decision making.

31. ENABLING LEARNING OBJECTIVE #6 ACTION: Select the impact of stress on pilot performance. CONDITION: Given a list. STANDARD: IAW FM 3-04.301 and Flight Stress

32. Necessary Pilot Abilities Psychomotor (stick & rudder) Attention Memory Judgment and decision making Prioritization of tasks Cockpit communication

33. Performance Under “Stress” Psychomotor Decreased tracking abilities Attention Perceptual tunneling Cognitive tunneling – narrowing salience (missed radio call) Task shedding – entire tasks abandoned

34. Performance Under “Stress” Memory Memory Capacity Declines (Short-term memory) Memory Strategies Compromised Simplification Heuristic Speed/Accuracy Tradeoff New Learning Declines – Stress Related Regression

35. Performance Under “Stress” Judgment/Decision Making Communication Speech production (articulation, pitch, syntax) Comprehension Group Think

36. Performance Under “Stress” Boredom Increased risk-taking behaviors Vigilance declines (aspect of attention)

37. ENABLING LEARNING OBJECTIVE #7 ACTION: Match individual stress coping mechanisms with the four classes of stress coping mechanisms. CONDITION: Given a list. STANDARD: IAW FM 3-04.301

38. Stress Coping Mechanisms AVOIDING STRESSORS CHANGE YOUR THINKING LEARN TO RELAX VENTILATE Now that we’ve reviewed the definition of stress and you are familiar with the various responses to stress overload, it is important to discuss coping techniques to prevent stress overload. Coping techniques can be thought of as falling into one of four categories: Avoiding stressors, changing your thinking, learning to relax, and ventilating.Now that we’ve reviewed the definition of stress and you are familiar with the various responses to stress overload, it is important to discuss coping techniques to prevent stress overload. Coping techniques can be thought of as falling into one of four categories: Avoiding stressors, changing your thinking, learning to relax, and ventilating.

39. AVOIDING STRESSORS Most powerful technique. Involves avoiding the stress or reducing exposure. Examples: Leaders model good time management Implement tough, realistic training Maintain an effective PT program Exercise sound judgement and decision-making Good cockpit communication Avoiding stressors is the most powerful technique for managing stress, since it actually prevents one from ever experiencing the full effect of a stressor. Avoiding does not mean running away from stress, however. Foresight and good planning go a long way in helping to avoid unnecessary stress. Prioritizing one’s work load effectively will also help to avoid last minute crises. Planning and time management are especially important tasks for leaders, as subordinates will often model their work behavior after the examples set by their chain of command. Realistic, mission-focused training and an effective PT program also help prevent stress overload by providing aircrew with the knowledge, skills, and physical endurance to perform under stressful conditions such as Chemical MOPP and NVG flight, continuous operations and combat. If an aviator’s comfort in performing mission essential tasks derives solely from garrison flight time with little realistic combat training, combat conditions and stressors will be new and unanticipated when encountered, and potentially fatal. Finally, paying close attention to communication and coordination in the cockpit will also help avoid unnecessary stress and prevent mishaps. The stress of military operations can degrade communication, affecting the sound, rate, and content of speech, as well as the pilot’s ability to comprehend communications. Pilots under high stress may be less precise in their messages, talk faster, and misinterpret messages more easily. The ability of the crew to work together as a cohesive team is also essential, as a number of accidents have resulted from crew members’ feeling that they could not talk openly or disagree with an excessively authoritative PC. Avoiding stressors is the most powerful technique for managing stress, since it actually prevents one from ever experiencing the full effect of a stressor. Avoiding does not mean running away from stress, however. Foresight and good planning go a long way in helping to avoid unnecessary stress. Prioritizing one’s work load effectively will also help to avoid last minute crises. Planning and time management are especially important tasks for leaders, as subordinates will often model their work behavior after the examples set by their chain of command. Realistic, mission-focused training and an effective PT program also help prevent stress overload by providing aircrew with the knowledge, skills, and physical endurance to perform under stressful conditions such as Chemical MOPP and NVG flight, continuous operations and combat. If an aviator’s comfort in performing mission essential tasks derives solely from garrison flight time with little realistic combat training, combat conditions and stressors will be new and unanticipated when encountered, and potentially fatal. Finally, paying close attention to communication and coordination in the cockpit will also help avoid unnecessary stress and prevent mishaps. The stress of military operations can degrade communication, affecting the sound, rate, and content of speech, as well as the pilot’s ability to comprehend communications. Pilots under high stress may be less precise in their messages, talk faster, and misinterpret messages more easily. The ability of the crew to work together as a cohesive team is also essential, as a number of accidents have resulted from crew members’ feeling that they could not talk openly or disagree with an excessively authoritative PC.

40. CHANGE YOUR THINKING Practice positive self-talk Focus on the here and now Recognize the choices you make Avoid absolutes and perfectionism As discussed earlier, how one thinks about stress partly defines one’s reaction to it, often creating a self-fulfilling prophecy. Pessimism and negativity will produce self-defeating behavior and negative results. Practicing positive self-talk is an important step toward accomplishing one’s goals. Keeping a focus on what’s going on RIGHT NOW, TODAY also helps prevent stress overload. You can’t change the past, and you can only PLAN for the future. You cannot control the future. Spending time obsessing about past mistakes or worrying about future potential problems is distracting and creates a potential for failing at the task at hand. This is a serious danger for aviators. While in the aircraft, the pilot’s mind must be on flying and not on family, career concerns, or other issues past or future. Recognizing the choices one makes in life is also an important strategy for avoiding stress overload. Blaming failures and disappointments on others actually surrenders personal control and makes one’s experience of life akin to being strapped down, blind folded in the back seat of a aircraft flown by someone else. It is important to make decisions, take appropriate risks, and accept responsibility for those decisions and risks. It is also important to recognize that sometimes one’s decisions and actions will not be successful. When this happens, it is necessary to have the flexibility to accept setbacks and drive on, as opposed to engaging in self-pity or obsessing about repercussions. As discussed earlier, how one thinks about stress partly defines one’s reaction to it, often creating a self-fulfilling prophecy. Pessimism and negativity will produce self-defeating behavior and negative results. Practicing positive self-talk is an important step toward accomplishing one’s goals. Keeping a focus on what’s going on RIGHT NOW, TODAY also helps prevent stress overload. You can’t change the past, and you can only PLAN for the future. You cannot control the future. Spending time obsessing about past mistakes or worrying about future potential problems is distracting and creates a potential for failing at the task at hand. This is a serious danger for aviators. While in the aircraft, the pilot’s mind must be on flying and not on family, career concerns, or other issues past or future. Recognizing the choices one makes in life is also an important strategy for avoiding stress overload. Blaming failures and disappointments on others actually surrenders personal control and makes one’s experience of life akin to being strapped down, blind folded in the back seat of a aircraft flown by someone else. It is important to make decisions, take appropriate risks, and accept responsibility for those decisions and risks. It is also important to recognize that sometimes one’s decisions and actions will not be successful. When this happens, it is necessary to have the flexibility to accept setbacks and drive on, as opposed to engaging in self-pity or obsessing about repercussions.

41. RELAXATION The opposite of stress is relaxation. You can’t be stressed and relaxed simultaneously. Learn how to relax: breathing relaxation exercises pleasurable hobbies Relaxation is an essential, albeit widely underutilized, coping technique. It is impossible to be relaxed and stressed at the same time. Find a relaxation technique that works and use it regularly. Some examples are: meditiation, yoga, self-hypnosis, reading, or pleasurable hobbies (like assembling models or listening to relaxing music).Relaxation is an essential, albeit widely underutilized, coping technique. It is impossible to be relaxed and stressed at the same time. Find a relaxation technique that works and use it regularly. Some examples are: meditiation, yoga, self-hypnosis, reading, or pleasurable hobbies (like assembling models or listening to relaxing music).

42. VENTILATING STRESS Exercise Talk it out with a friend your spouse chaplain mental health Ventilation is the fourth and final category of coping techniques. It involves “letting off steam” either interpersonally by talking to someone or physically through exercise. Verbally expressing emotions helps resolve traumas and reduce stress and can be accomplished with a friend, family member, chaplain, or mental health professional. Exercise has long been recognized as a valuable way to “let off steam.” Be careful not to overdo it, however, as this may result in injuries and thus more stress.Ventilation is the fourth and final category of coping techniques. It involves “letting off steam” either interpersonally by talking to someone or physically through exercise. Verbally expressing emotions helps resolve traumas and reduce stress and can be accomplished with a friend, family member, chaplain, or mental health professional. Exercise has long been recognized as a valuable way to “let off steam.” Be careful not to overdo it, however, as this may result in injuries and thus more stress.

43. ENABLING LEARNING OBJECTIVE #8 ACTION: Select the factors that will decrease one’s vulnerability to combat stress. CONDITION: Given a list of categories. STANDARD: IAW FM 22-51, Flight Stress

44. Combat Stress Signs and Symptoms Hyperalertness Fear, anxiety Loss of confidence ? Impaired senses Weakness/paralysis Hallucinations or delusions Combat Stress can produce a wide range of behaviors, some of which are positive, such as heightened alertness, strength, and endurance, acts of courage and self-sacrifice, and strong personal bonding between soldiers. Misconduct behaviors such as fratricide, killing of prisoners, and desertion may also result from the stress of the battlefield. Some soldiers may manifest the effects of combat stress as battle fatigue, which ranges from normal, common signs experienced by many soldiers such as hyperalertness, irritability, and loss of confidence to less frequently observed warning signs that require immediate attention such as impaired speech or muteness, impaired vision, touch, or hearing, paralysis, or hallucinations. Combat Stress can produce a wide range of behaviors, some of which are positive, such as heightened alertness, strength, and endurance, acts of courage and self-sacrifice, and strong personal bonding between soldiers. Misconduct behaviors such as fratricide, killing of prisoners, and desertion may also result from the stress of the battlefield. Some soldiers may manifest the effects of combat stress as battle fatigue, which ranges from normal, common signs experienced by many soldiers such as hyperalertness, irritability, and loss of confidence to less frequently observed warning signs that require immediate attention such as impaired speech or muteness, impaired vision, touch, or hearing, paralysis, or hallucinations.

45. Combat Stress Buddy Aid Reassurance If no response, seek medical treatment Decreasing Your Vulnerability Competence in your work Confidence in your abilities High morale, group cohesion, and esprit de corps Control, or even perceived control Combat Stress can produce a wide range of behaviors, some of which are positive, such as heightened alertness, strength, and endurance, acts of courage and self-sacrifice, and strong personal bonding between soldiers. Misconduct behaviors such as fratricide, killing of prisoners, and desertion may also result from the stress of the battlefield. Some soldiers may manifest the effects of combat stress as battle fatigue, which ranges from normal, common signs experienced by many soldiers such as hyperalertness, irritability, and loss of confidence to less frequently observed warning signs that require immediate attention such as impaired speech or muteness, impaired vision, touch, or hearing, paralysis, or hallucinations. Combat Stress can produce a wide range of behaviors, some of which are positive, such as heightened alertness, strength, and endurance, acts of courage and self-sacrifice, and strong personal bonding between soldiers. Misconduct behaviors such as fratricide, killing of prisoners, and desertion may also result from the stress of the battlefield. Some soldiers may manifest the effects of combat stress as battle fatigue, which ranges from normal, common signs experienced by many soldiers such as hyperalertness, irritability, and loss of confidence to less frequently observed warning signs that require immediate attention such as impaired speech or muteness, impaired vision, touch, or hearing, paralysis, or hallucinations.

46. ENABLING LEARNING OBJECTIVE #9 ACTION: Select the definition of fatigue. CONDITION: Given a list of definitions. STANDARD: IAW FM 3-04.301, and Leader’s guide to Crew Endurance.

47. Fatigue is the state of feeling tired, weary, or sleepy that results from prolonged mental or physical work, extended periods of anxiety, exposure to harsh environments, or loss of sleep. Boring or monotonous tasks may increase fatigue. As with many other physiological problems, crew members may not be aware of fatigue until they make serious errors. Sleep deprivation, disrupted diurnal cycles, or life event stress may all play a role in producing fatigue and concurrent performance decrements. Fatigue is the state of feeling tired, weary, or sleepy that results from prolonged mental or physical work, extended periods of anxiety, exposure to harsh environments, or loss of sleep. Boring or monotonous tasks may increase fatigue. As with many other physiological problems, crew members may not be aware of fatigue until they make serious errors. Sleep deprivation, disrupted diurnal cycles, or life event stress may all play a role in producing fatigue and concurrent performance decrements.

48. ENABLING LEARNING OBJECTIVE #10 ACTION: Select the three types of fatigue. CONDITION: Given a list. STANDARD: IAW FM 3-04.301, and Leader’s guide to Crew Endurance.

49. Types of Fatigue Acute Chronic Gradually builds over time Motivational Exhaustion - “Burnout” Results from excessive unmanaged stress Restorative measures are only temporary if stress continues FM 1-30-1 chapter 2-8 Acute Chronic MotivationalFM 1-30-1 chapter 2-8 Acute Chronic Motivational

50. ENABLING LEARNING OBJECTIVE #11 ACTION: Select the signs and symptoms of fatigue. CONDITION: Given a list. STANDARD: IAW FM 3-04.301, and Leader’s guide to Crew Endurance.

51. Signs and Symptomsof Fatigue Attention/Concentration difficult Feel or appear dull and sluggish General attempt to conserve energy Feel or appear careless, uncoordinated, confused, or irritable Cognitive deficits are seen before the physical effects are felt

52. ENABLING LEARNING OBJECTIVE #12 ACTION: Select the effects of fatigue on performance. CONDITION: Given a list. STANDARD: IAW FM 3-04.301, Flight Stress, and Leader’s guide to Crew Endurance.

53. Impairment in the Cockpit Reaction time increases Errors in timing and accuracy Not as smooth Slow and irregular motor inputs Attention is reduced Lapse or “microsleeps” Tunneling Need enhanced stimuli Reduced audio-visual scan Fatigue has a number of negative effects in the cockpit. One result can be a change in reaction time. Increases in reaction time occur because of the general decrease in motivation and sluggishness that often accompany fatigue. Decreases may also occur, however, when individuals become impulsive and react too quickly and poorly. Fatigue also reduces attention. Fatigued crew members may exhibit a tendency to overlook or misplace sequential task elements, like leaving out items on a pre-flight checklist. Aviators may also become preoccupied with single tasks or elements, like paying too much attention to objects outside the aircraft while in NVG flight, to the exclusion of checking instruments and flying the aircraft. In general, fatigued crew members have little awareness of their impaired performance and may feel physically OK. It is therefore important that crew members monitor each other closely in operations where fatigue is likely. Fatigue also impairs memory. Although long-term memory is reasonably well preserved during fatigue, short-term memory and processing capacity are greatly affected. Aviators may have difficulty recalling operational events, like the location of the Objective Rally Point, and may neglect peripheral tasks, like forgetting to check if the landing gear is down. Communication is also impaired by fatigue, as crew members may become more withdrawn or irritable, less clear in their speech, and more prone to misunderstanding messages. Extreme fatigue can actually lead to hallucinations and problems thinking, causing the individual to appear as if they have a thought disorder or psychosis. Fatigue has a number of negative effects in the cockpit. One result can be a change in reaction time. Increases in reaction time occur because of the general decrease in motivation and sluggishness that often accompany fatigue. Decreases may also occur, however, when individuals become impulsive and react too quickly and poorly. Fatigue also reduces attention. Fatigued crew members may exhibit a tendency to overlook or misplace sequential task elements, like leaving out items on a pre-flight checklist. Aviators may also become preoccupied with single tasks or elements, like paying too much attention to objects outside the aircraft while in NVG flight, to the exclusion of checking instruments and flying the aircraft. In general, fatigued crew members have little awareness of their impaired performance and may feel physically OK. It is therefore important that crew members monitor each other closely in operations where fatigue is likely. Fatigue also impairs memory. Although long-term memory is reasonably well preserved during fatigue, short-term memory and processing capacity are greatly affected. Aviators may have difficulty recalling operational events, like the location of the Objective Rally Point, and may neglect peripheral tasks, like forgetting to check if the landing gear is down. Communication is also impaired by fatigue, as crew members may become more withdrawn or irritable, less clear in their speech, and more prone to misunderstanding messages. Extreme fatigue can actually lead to hallucinations and problems thinking, causing the individual to appear as if they have a thought disorder or psychosis.

54. Impairment in the Cockpit Diminished memory Recall declines Learning declines Overall poor and careless performance Greater tolerance for error Impaired communication, cooperation, and crew coordination More fragmented conversations Misinterpretations Fatigue has a number of negative effects in the cockpit. One result can be a change in reaction time. Increases in reaction time occur because of the general decrease in motivation and sluggishness that often accompany fatigue. Decreases may also occur, however, when individuals become impulsive and react too quickly and poorly. Fatigue also reduces attention. Fatigued crew members may exhibit a tendency to overlook or misplace sequential task elements, like leaving out items on a pre-flight checklist. Aviators may also become preoccupied with single tasks or elements, like paying too much attention to objects outside the aircraft while in NVG flight, to the exclusion of checking instruments and flying the aircraft. In general, fatigued crew members have little awareness of their impaired performance and may feel physically OK. It is therefore important that crew members monitor each other closely in operations where fatigue is likely. Fatigue also impairs memory. Although long-term memory is reasonably well preserved during fatigue, short-term memory and processing capacity are greatly affected. Aviators may have difficulty recalling operational events, like the location of the Objective Rally Point, and may neglect peripheral tasks, like forgetting to check if the landing gear is down. Communication is also impaired by fatigue, as crew members may become more withdrawn or irritable, less clear in their speech, and more prone to misunderstanding messages. Extreme fatigue can actually lead to hallucinations and problems thinking, causing the individual to appear as if they have a thought disorder or psychosis. Fatigue has a number of negative effects in the cockpit. One result can be a change in reaction time. Increases in reaction time occur because of the general decrease in motivation and sluggishness that often accompany fatigue. Decreases may also occur, however, when individuals become impulsive and react too quickly and poorly. Fatigue also reduces attention. Fatigued crew members may exhibit a tendency to overlook or misplace sequential task elements, like leaving out items on a pre-flight checklist. Aviators may also become preoccupied with single tasks or elements, like paying too much attention to objects outside the aircraft while in NVG flight, to the exclusion of checking instruments and flying the aircraft. In general, fatigued crew members have little awareness of their impaired performance and may feel physically OK. It is therefore important that crew members monitor each other closely in operations where fatigue is likely. Fatigue also impairs memory. Although long-term memory is reasonably well preserved during fatigue, short-term memory and processing capacity are greatly affected. Aviators may have difficulty recalling operational events, like the location of the Objective Rally Point, and may neglect peripheral tasks, like forgetting to check if the landing gear is down. Communication is also impaired by fatigue, as crew members may become more withdrawn or irritable, less clear in their speech, and more prone to misunderstanding messages. Extreme fatigue can actually lead to hallucinations and problems thinking, causing the individual to appear as if they have a thought disorder or psychosis.

55. ENABLING LEARNING OBJECTIVE #13 ACTION: Select the characteristics of the body’s diurnal (or circadian) rhythms. CONDITION: Given a list of effects of diurnal (or circadian) rhythms. STANDARD: IAW Leader’s guide to Crew Endurance.

56. Diurnal (Circadian) Rhythms Regulate bodily functions Core Body Temperature Alertness Heart rate Hormonal secretions 24 Hour Cycle 0800 - 1200 hrs. Peak 1300 - 1500 hrs. Decrease 1500 - 2100 hrs. Increase 2100 + Decrease to sleep “Zeitgeber” Sunrise/sunset Ambient temperature Meals Social cues One of the factors that influences fatigue is the body’s diurnal rhythm. All human beings have an intrinsic biological clock, or diurnal rhythm, with a cycle of roughly 24-25 hours. Many important bodily functions such as core body temperature, alertness, heart rate and sleep cycle along this rhythm. Given the typical dirunal cycle, performance, alertness, and body temperature peak between 0800 and 1200 hours, drop off slightly between 1300 and 1500, then begin to increase again from 1500 to 2100, and then drop off again and fall to a minimum trough between 0300 and 0600 hours. While the body clock is inherently capable of monitoring the passage of time, it differs from most clocks in that it is flexible and must be set, or synchronized, before it can accurately predict the timing of events. External synchronizers or “Zeitgebers” (a German word that literally means “time givers”) are sunlight, meals, one’s work schedule, and ambient temperature. Of these cues, sunlight is the most influential in setting the biological clock. One of the factors that influences fatigue is the body’s diurnal rhythm. All human beings have an intrinsic biological clock, or diurnal rhythm, with a cycle of roughly 24-25 hours. Many important bodily functions such as core body temperature, alertness, heart rate and sleep cycle along this rhythm. Given the typical dirunal cycle, performance, alertness, and body temperature peak between 0800 and 1200 hours, drop off slightly between 1300 and 1500, then begin to increase again from 1500 to 2100, and then drop off again and fall to a minimum trough between 0300 and 0600 hours. While the body clock is inherently capable of monitoring the passage of time, it differs from most clocks in that it is flexible and must be set, or synchronized, before it can accurately predict the timing of events. External synchronizers or “Zeitgebers” (a German word that literally means “time givers”) are sunlight, meals, one’s work schedule, and ambient temperature. Of these cues, sunlight is the most influential in setting the biological clock.

57. ENABLING LEARNING OBJECTIVE #14 ACTION: Select when an individual may be subject to circadian desynchronization. CONDITION: Given a list. STANDARD: IAW Leader’s guide to Crew Endurance.

58. Circadian Desynchronization Disrupted circadian rhythms due to rapid travel across time zones (“Jet Lag”). Eastward travel shortens the day Westward travel lengthens the day Resynchronization is faster when traveling west Shift work can have similar effects Rapid travel from one time zone to another causes the body to resynchronize its diurnal rhythms to the local geophysical and social time cues. Until intrinsic rhythms are reset, sleep disorders and fatigue will prevail. This condition is known as “jet lag.” Traveling eastward shortens the day, whereas westward travel lengthens the day. Consequently, resynchronization occurs much more rapidly when traveling west. Importantly, it is the timing of sleep, not necessarily the amount of sleep, that is most significant in determining whether one will be rested or fatigued. A sleep schedule that is inconsistent with one’s diurnal rhythm and the light and social cues of the environment will ultimately result in fatigue. Frequent changes in one’s sleep schedule may also cause fatigue. Consequently, shift work can have effects similar to crossing time zones due to the changes in light exposure and activity times. Rapid travel from one time zone to another causes the body to resynchronize its diurnal rhythms to the local geophysical and social time cues. Until intrinsic rhythms are reset, sleep disorders and fatigue will prevail. This condition is known as “jet lag.” Traveling eastward shortens the day, whereas westward travel lengthens the day. Consequently, resynchronization occurs much more rapidly when traveling west. Importantly, it is the timing of sleep, not necessarily the amount of sleep, that is most significant in determining whether one will be rested or fatigued. A sleep schedule that is inconsistent with one’s diurnal rhythm and the light and social cues of the environment will ultimately result in fatigue. Frequent changes in one’s sleep schedule may also cause fatigue. Consequently, shift work can have effects similar to crossing time zones due to the changes in light exposure and activity times.

59. ENABLING LEARNING OBJECTIVE #15 ACTION: Select the characteristics of the sleep cycle. CONDITION: Given a list. STANDARD: IAW Leader’s guide to Crew Endurance.

60. Sleep Cycle Sleep is an essential, active process. Sleeping brain cycles between 5 stages One complete cycle takes about 90 minutes Usual 8 hour sleep period involves 5-6 cycles of REM and non-REM sleep Body temperature affects the duration and quality of sleep. Leaders Guide to Crew Endurance Appendix B Page 27-28Leaders Guide to Crew Endurance Appendix B Page 27-28

61. Human Sleep Cycle

62. Sleep Cycle It is the timing of sleep, not necessarily the amount that is important. Sleep efficiency deteriorates with age Older individuals spend less time in deep non-REM sleep. Night-time awakenings and daytime sleepiness result. Leaders Guide to Crew Endurance Appendix B Page 27-28Leaders Guide to Crew Endurance Appendix B Page 27-28

63. ENABLING LEARNING OBJECTIVE #16 ACTION: Select the factors that determine the sleep required by the average aircrew member. CONDITION: Given a list of factors. STANDARD: IAW Leader’s guide to Crew Endurance.

64. Sleep RequirementsDetermining Factors We cannot determine our own impairment from sleep loss Average human sleep length is 7-9 hours/day Sleep length can be reduced 1-2 hrs without performance decrement over extended period 5 hours/night is absolute minimum for CONOPS Some individuals may tolerate as little as 4 hours/ night Sleep is not simply being unconscious. It is a life-essential active process. The sleeping brain cycles between rapid eye movement (REM) and Non-REM sleep through 5 stages. The cycling occurs every 90 minutes. In 8 hours of sleep one normally attains five to six REM stages. The duration and “quality” of sleep are also partly dependent upon body temperature. Consequently, a cool sleep environment is essential for adequate rest and preventing fatigue. The average person sleeps 7 to 9 hours per day. However, sleep length can be reduced 1 to 2 hours without any serious performance decrement over an extended period. Once the period ends, the individual must return to their normal sleep length to prevent negative effects on mental and physical functioning. As a rule, 5 hours of sleep per night is the absolute minimum for continuous operations (in other words, operations lasting 14 days or more). However, some individuals may tolerate as little as 4 hours per night for short periods (up to 1 week), but there is no way to determine which soldiers require the least amount of sleep other than through actual experience. Sleep is not simply being unconscious. It is a life-essential active process. The sleeping brain cycles between rapid eye movement (REM) and Non-REM sleep through 5 stages. The cycling occurs every 90 minutes. In 8 hours of sleep one normally attains five to six REM stages. The duration and “quality” of sleep are also partly dependent upon body temperature. Consequently, a cool sleep environment is essential for adequate rest and preventing fatigue. The average person sleeps 7 to 9 hours per day. However, sleep length can be reduced 1 to 2 hours without any serious performance decrement over an extended period. Once the period ends, the individual must return to their normal sleep length to prevent negative effects on mental and physical functioning. As a rule, 5 hours of sleep per night is the absolute minimum for continuous operations (in other words, operations lasting 14 days or more). However, some individuals may tolerate as little as 4 hours per night for short periods (up to 1 week), but there is no way to determine which soldiers require the least amount of sleep other than through actual experience.

65. Sleep RequirementsContinued Sleep restriction decisions should consider: Complexity of the job Potential for loss from errors Individual’s tolerance to sleep loss When determining sleep requirements for an individual or crew endurance plan, three main factors should be considered. One factor is the complexity of the job to be performed. The more complex the task to be performed, the more sleep required for the individual to execute the task. For example, flying duties involve a great deal of attention, concentration, and rapid decision-making and therefore require much more rest to perform than manual labor tasks, like digging fighting positions, that are not challenging intellectually. A second factor to be considered is the potential for loss from errors due to fatigue. Aviators require strict crew rest plans since flying is a dangerous endeavor with high potential for loss of life and high-tech equipment. The individual’s ability to function with little sleep must also be taken into account, since this ability varies from person to person. When determining sleep requirements for an individual or crew endurance plan, three main factors should be considered. One factor is the complexity of the job to be performed. The more complex the task to be performed, the more sleep required for the individual to execute the task. For example, flying duties involve a great deal of attention, concentration, and rapid decision-making and therefore require much more rest to perform than manual labor tasks, like digging fighting positions, that are not challenging intellectually. A second factor to be considered is the potential for loss from errors due to fatigue. Aviators require strict crew rest plans since flying is a dangerous endeavor with high potential for loss of life and high-tech equipment. The individual’s ability to function with little sleep must also be taken into account, since this ability varies from person to person.

66. ENABLING LEARNING OBJECTIVE #17 ACTION: Select the strategies for preventing fatigue. CONDITION: Given a list of strategies. STANDARD: IAW FM 3-04.301, FM 26-2, Fundamentals of Aerospace Medicine, and Leader’s guide to Crew Endurance.

67. Prevention of Fatigue Get adequate sleep Prevent/control desynchronosis Maintain consistent schedules of sleep, daylight exposure, and naps. Control sleeping environment Sleep in darkness. Control noise. Control room temperature. Total prevention of fatigue is impossible, but its effects can be significantly moderated. The following recommendations should be considered in any individual or crew endurance plan. First, to ensure restful, quality sleep, the sleep environment should be cool, dark, and quiet. It is also best to avoid working or reading in bed, as this may actually contribute to problems in falling asleep. The bed should be associated only with sleeping and sexual activity. If you desire to read before going to bed, do this in a chair outside the bedroom and then go to bed. It is also important to take actions to adjust to shift work and prevent circadian desynchronization. This can be accomplished by maintaining a consistent sleep/wake schedule even on days off. It is also important, when on the night shift, to avoid exposure to daylight from dawn to 1000. Wear sunglasses if you cannot go to sleep before the sun rises (as long as this does not pose a safety hazard), and while asleep consider wearing a sleep mask to avoid any exposure to light. Exposure to light before you go to sleep will interfere with the quality of your sleep. You may eat a light snack before going to sleep, but do not go to sleep too full or too hungry. Also avoid caffeine consumption for about 6 hours prior to going to sleep. Maintaining good physical fitness with regular, strenuous exercise will also help resist the effects of fatigue. Total prevention of fatigue is impossible, but its effects can be significantly moderated. The following recommendations should be considered in any individual or crew endurance plan. First, to ensure restful, quality sleep, the sleep environment should be cool, dark, and quiet. It is also best to avoid working or reading in bed, as this may actually contribute to problems in falling asleep. The bed should be associated only with sleeping and sexual activity. If you desire to read before going to bed, do this in a chair outside the bedroom and then go to bed. It is also important to take actions to adjust to shift work and prevent circadian desynchronization. This can be accomplished by maintaining a consistent sleep/wake schedule even on days off. It is also important, when on the night shift, to avoid exposure to daylight from dawn to 1000. Wear sunglasses if you cannot go to sleep before the sun rises (as long as this does not pose a safety hazard), and while asleep consider wearing a sleep mask to avoid any exposure to light. Exposure to light before you go to sleep will interfere with the quality of your sleep. You may eat a light snack before going to sleep, but do not go to sleep too full or too hungry. Also avoid caffeine consumption for about 6 hours prior to going to sleep. Maintaining good physical fitness with regular, strenuous exercise will also help resist the effects of fatigue.

68. Prevention of Fatigue Build endurance through physical conditioning and stress coping Practice good nutrition Practice good sleep hygiene Use the bed for sleep and sex only Establish a bedtime routine Avoid checking the clock Total prevention of fatigue is impossible, but its effects can be significantly moderated. The following recommendations should be considered in any individual or crew endurance plan. First, to ensure restful, quality sleep, the sleep environment should be cool, dark, and quiet. It is also best to avoid working or reading in bed, as this may actually contribute to problems in falling asleep. The bed should be associated only with sleeping and sexual activity. If you desire to read before going to bed, do this in a chair outside the bedroom and then go to bed. It is also important to take actions to adjust to shift work and prevent circadian desynchronization. This can be accomplished by maintaining a consistent sleep/wake schedule even on days off. It is also important, when on the night shift, to avoid exposure to daylight from dawn to 1000. Wear sunglasses if you cannot go to sleep before the sun rises (as long as this does not pose a safety hazard), and while asleep consider wearing a sleep mask to avoid any exposure to light. Exposure to light before you go to sleep will interfere with the quality of your sleep. You may eat a light snack before going to sleep, but do not go to sleep too full or too hungry. Also avoid caffeine consumption for about 6 hours prior to going to sleep. Maintaining good physical fitness with regular, strenuous exercise will also help resist the effects of fatigue. Total prevention of fatigue is impossible, but its effects can be significantly moderated. The following recommendations should be considered in any individual or crew endurance plan. First, to ensure restful, quality sleep, the sleep environment should be cool, dark, and quiet. It is also best to avoid working or reading in bed, as this may actually contribute to problems in falling asleep. The bed should be associated only with sleeping and sexual activity. If you desire to read before going to bed, do this in a chair outside the bedroom and then go to bed. It is also important to take actions to adjust to shift work and prevent circadian desynchronization. This can be accomplished by maintaining a consistent sleep/wake schedule even on days off. It is also important, when on the night shift, to avoid exposure to daylight from dawn to 1000. Wear sunglasses if you cannot go to sleep before the sun rises (as long as this does not pose a safety hazard), and while asleep consider wearing a sleep mask to avoid any exposure to light. Exposure to light before you go to sleep will interfere with the quality of your sleep. You may eat a light snack before going to sleep, but do not go to sleep too full or too hungry. Also avoid caffeine consumption for about 6 hours prior to going to sleep. Maintaining good physical fitness with regular, strenuous exercise will also help resist the effects of fatigue.

69. Napping Even 10 minute naps are restorative. Longer naps are better but may leave you feeling more tired (“Sleep Inertia”) for 20-30 minutes after awakening. Best to nap when body temp is low (around 0300 and 1300). Practice napping as prevention. Napping is a good strategy for coping with sleep deprivation during continuous operations or other times when it is difficult to get a good night’s sleep. In general, longer naps are more effective than short ones, but even 10 minute naps can be beneficial. It is important to note, however, that if you chose to nap longer than about 20 minutes, you will feel the effects of “sleep inertia,” a feeling of sluggishness and difficulty in waking up. Consequently, if you know you will have to perform a complex task such as flying shortly after awaking from a nap, do not nap for longer than 20 minutes. It is better to nap when your body temperature is low, early in the morning, or in the afternoon around 1300, as this will facilitate falling asleep and the general quality of sleep. One note of caution: A person with difficulty sleeping during their normal sleeping period should NOT nap at other times of the day, as this will perpetuate the insomnia. Napping is a good strategy for coping with sleep deprivation during continuous operations or other times when it is difficult to get a good night’s sleep. In general, longer naps are more effective than short ones, but even 10 minute naps can be beneficial. It is important to note, however, that if you chose to nap longer than about 20 minutes, you will feel the effects of “sleep inertia,” a feeling of sluggishness and difficulty in waking up. Consequently, if you know you will have to perform a complex task such as flying shortly after awaking from a nap, do not nap for longer than 20 minutes. It is better to nap when your body temperature is low, early in the morning, or in the afternoon around 1300, as this will facilitate falling asleep and the general quality of sleep. One note of caution: A person with difficulty sleeping during their normal sleeping period should NOT nap at other times of the day, as this will perpetuate the insomnia.

70. ENABLING LEARNING OBJECTIVE #18 ACTION: Select the appropriate treatments for sleep deprivation and fatigue. CONDITION: Given a list of treatments. STANDARD: IAW FM 3-04.301, and Leader’s guide to Crew Endurance.

71. Delegate responsibility Use physical exercise Nutrition Remove from flying duties Treatment Rest and Natural Sleep Alcohol is the most widely used sleep aid in the US It suppresses REM sleep Keep sleep area quiet, dark, and cool Change or rotate duties Pace yourself Avoid complex tasks The most essential action to take for treating fatigue once it’s occurred is to get plenty of natural sleep. Although alcohol is the most widely used sleep aid in the U.S., it’s use as such is not appropriate, since it is disruptive to the quality of sleep. Specifically, alcohol will put you to sleep quickly, but later in the night you will not sleep as soundly and will spend less time in REM sleep, which will cause you to feel fatigued during the waking hours. After 24 - 48 hours of sleep deprivation DO NOT sleep overly long during the recovery period. This could interfere with your normal sleep/wake cycle and cause sleeping problems the next night. When trying to sleep outside your normal bedtime, prepare for sleep as you normally would have - wear the clothes to bed that you would normally wear, darken the room, and keep noise to a minimum. If you can’t fall asleep within 30 minutes of going to bed, get up, read a boring book, like your “dash 10,” in a room other than your bedroom, preferably with soft lights, and then try again to go to bed again when you begin to feel drowsy. You may need to repeat this strategy a couples of times in a night until you are fatigued enough to fall soundly asleep. It is also important when treating fatigue to maintain a reasonable work schedule during waking hours. It makes no sense to try to catch up on sleep and then exhaust yourself during the day. Also ensure that you eat properly to give your body the fuel it needs to recuperate. If you find that you are having consistent sleep problems for more than two weeks, consult your flight surgeon. Also, if fatigue threatens to impair your flying, ground yourself until you are rested enough to fly again. This is certainly a more reasonable course of action than crashing an aircraft due to fatigue! The most essential action to take for treating fatigue once it’s occurred is to get plenty of natural sleep. Although alcohol is the most widely used sleep aid in the U.S., it’s use as such is not appropriate, since it is disruptive to the quality of sleep. Specifically, alcohol will put you to sleep quickly, but later in the night you will not sleep as soundly and will spend less time in REM sleep, which will cause you to feel fatigued during the waking hours. After 24 - 48 hours of sleep deprivation DO NOT sleep overly long during the recovery period. This could interfere with your normal sleep/wake cycle and cause sleeping problems the next night. When trying to sleep outside your normal bedtime, prepare for sleep as you normally would have - wear the clothes to bed that you would normally wear, darken the room, and keep noise to a minimum. If you can’t fall asleep within 30 minutes of going to bed, get up, read a boring book, like your “dash 10,” in a room other than your bedroom, preferably with soft lights, and then try again to go to bed again when you begin to feel drowsy. You may need to repeat this strategy a couples of times in a night until you are fatigued enough to fall soundly asleep. It is also important when treating fatigue to maintain a reasonable work schedule during waking hours. It makes no sense to try to catch up on sleep and then exhaust yourself during the day. Also ensure that you eat properly to give your body the fuel it needs to recuperate. If you find that you are having consistent sleep problems for more than two weeks, consult your flight surgeon. Also, if fatigue threatens to impair your flying, ground yourself until you are rested enough to fly again. This is certainly a more reasonable course of action than crashing an aircraft due to fatigue!

72. In this block of instruction we reviewed the definition of stress, identified stressors in the aviation environment, and discussed strategies for coping with the effects of stress. Part of this discussion involved a review of the concepts of combat stress and battle fatigue, and how to address their effects on individual behavior and the unit mission. Finally, we reviewed the definition of fatigue, the effects of fatigue on performance in the cockpit, and countermeasures for dealing with the effects of fatigue. The information you learned in this block of instruction should be incorporated into the planning and execution of all aviation operations, both in garrison and on deployment. Although we are taught as soldiers to push ourselves to the limits of our abilities, to be tough and effective, it is wrong to think that denial of the effects of stress and fatigue will help accomplish these goals. Failing to identify and control for the effects of stress and fatigue will weaken individual soldiers, units, and threaten aviation safety and mission completion.In this block of instruction we reviewed the definition of stress, identified stressors in the aviation environment, and discussed strategies for coping with the effects of stress. Part of this discussion involved a review of the concepts of combat stress and battle fatigue, and how to address their effects on individual behavior and the unit mission. Finally, we reviewed the definition of fatigue, the effects of fatigue on performance in the cockpit, and countermeasures for dealing with the effects of fatigue. The information you learned in this block of instruction should be incorporated into the planning and execution of all aviation operations, both in garrison and on deployment. Although we are taught as soldiers to push ourselves to the limits of our abilities, to be tough and effective, it is wrong to think that denial of the effects of stress and fatigue will help accomplish these goals. Failing to identify and control for the effects of stress and fatigue will weaken individual soldiers, units, and threaten aviation safety and mission completion.