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Fatigue is an expected and ubiquitous aspect of life. For the average
individual, fatigue presents a minor inconvenience, resolved
with a nap or by stopping whatever activity that brought it on.
Typically, there are no significant consequences. However, if that person
is involved in safety-related activities such as operating a motor vehicle,
piloting an aircraft, performing surgery, or running a nuclear reactor, the
consequences of fatigue can be disastrous.
Definition. Defining fatigue in humans is extremely difficult due
to the large variability of causes. Causes of fatigue can range from
boredom to circadian rhythm disruption to heavy physical exertion. In
lay terms, fatigue can simply be defined as weariness. However, from
an operational standpoint a more accurate definition might be: "Fatigue
is a condition characterized by increased discomfort with lessened
capacity for work, reduced efficiency of accomplishment, loss of power
or capacity to respond to stimulation, and is usually accompanied by a
feeling of weariness and tiredness."
Two key concepts can be derived from this second
1 . Fatigue can develop from a variety of sources. The important factor
is not what causes the fatigue but rather the negative impact fatigue
has on a person's ability to perform tasks. A long day of mental
stimulation such as studying for an examination or processing data
for a report can be as fatiguing as manual labor. They may feel
different— a sore body instead of a headache and bleary eyes— but
the end effect is the same, an inability to function normally.
2. Fatigue leads to a decrease in your ability to carry out tasks. Several
studies have demonstrated significant impairment in a person's
ability to carry out tasks that require manual dexterity, concentration,
and higher-order intellectual processing. Fatigue may happen
acutely, which is to say in a relatively short time (hours) after some
significant physical or mental activity. Or, it may occur gradually
over several days or weeks. Typically, this situation occurs with
someone who does not get sufficient sleep over a prolonged period of
time (as with sleep apnea, jet lag, or shift work) or someone who is
involved in ongoing physical or mental activity with insufficient rest.
Stressors. General aviation pilots are typically not exposed to the
same occupational stresses as commercial pilots (i.e., long duty
days, circadian disruptions from night flying or time zone changes,
or scheduling changes). Nevertheless, they will still develop fatigue
from a variety of other causes. Given the single-pilot operation
and relatively higher workload, they would be just as much at risk
(possibly even more) to be involved in an accident than a commercial
crew. Any fatigued person will exhibit the same problems: sleepiness,
difficulty concentrating, apathy, feeling of isolation, annoyance,
increased reaction time to stimulus, slowing of higher-level mental
functioning, decreased vigilance, memory problems, task fixation, and
increased errors while performing tasks.
None of these are good things to have happen to a pilot, much less if
there is no one else in the aircraft to help out.
In a variety of studies, fatigued individuals consistently underreported
how tired they really were, as measured by physiologic parameters. A
tired individual truly does not realize the extent of actual impairment.
No degree of experience, motivation, medication, coffee, or will
power can overcome fatigue.
Antidote to Fatigue. Obtaining adequate sleep is the best way
to prevent or resolve fatigue. Sleep provides the body with a period
of rest and recuperation. Insufficient sleep will result in significant
physical and psychological problems. On average, a healthy adult
does best with eight hours of uninterrupted sleep, but significant
personal variations occur. For example, increasing sleep difficulties
occur as we age, with significant shortening of nighttime sleep. A
variety of medical conditions can influence the quality and duration
of sleep. To name a few: sleep apnea, restless leg syndrome, certain
medications, depression, stress, insomnia, and chronic pain. Some of
the more common social or behavioral issues are: late-night activities,
excessive alcohol or caffeine use, travel, interpersonal strife,
uncomfortable or unfamiliar surroundings, and shift work.
Prevention. No one is immune from fatigue. Yet, in our society,
establishing widespread preventive measures to combat fatigue
is often a very difficult goal to achieve. Individuals, as well as
organizations, often ignore the problem until an accident occurs.
Even then, implementing lasting change is not guaranteed. Lifestyle
changes are not easy for individuals, particularly if that person isn't
in complete control of the condition. For example, commercial pilots
must contend with shift work and circadian rhythm disruption. Often,
they also choose to commute long distances to work, so that by the
time a work cycle starts they have already traveled for several hours.
While a general aviation pilot may not have to deal with this, a
busy lifestyle or other issues may lead to fatigue. Therefore, general
aviation pilots must make every effort to modify personal lifestyle
factors that cause fatigue.
• Consume alcohol or caffeine 3-4 hours before going to bed.
• Eat a heavy meal just before bedtime.
• Take work to bed.
• Exercise 2-3 hours before bedtime. While working out promotes a
healthy lifestyle, it shouldn't be done too close to bedtime.
• Use sleeping pills (prescription or otherwise).
• Be mindful of the side effects of certain medications, even over-
the-counter medications - drowsiness or impaired alertness is a
• Consult a physician to diagnose and treat any medical conditions
causing sleep problems.
• Create a comfortable sleep environment at home. Adjust heating
and cooling as needed. Get a comfortable mattress.
• When traveling, select hotels that provide a comfortable
• Get into the habit of sleeping eight hours per night. When needed,
and if possible, nap during the day, but limit the nap to less
than 30 minutes. Longer naps produce sleep inertia, which is
• Try to turn in at the same time each day. This establishes a routine
and helps you fall asleep quicker.
• If you can't fall asleep within 30 minutes of going to bed, get up
and try an activity that helps induce sleep (watch non-violent TV,
read, listen to relaxing music, etc).
• Get plenty of rest and minimize stress before a flight. If problems
preclude a good night's sleep, rethink the flight and postpone it
MEDICAL FACTS FOR PILOTS
Publication #OK-07- 193
GJ. Salazar, MD
FAA Civil Aerospace Medical Institute
AAM-400, P.O. Box 25082
Oklahoma City, OK 73125
To request copies of this brochure, write to the above address
or call (405) 954-4831.
For more pilot and traveler safety information, visit the FAA
www. f aa. gov/pilots/amelocator
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