ADAPTING TO FATIGUE Published Dec. 20, 2010 By EDWARD L. LINCH former chief of 12th Air Force Flight Safety LOS ANGELES, Calif. -- Have you ever been airborne and felt like you desperately needed a set of toothpicks to hold your eyelids open? In today's 24/7 society, it's easy to feel trapped by fatigue with no options since mission accomplishment is the priority. However, there is a solution. You can avoid the trap and adapt to fatigue while accomplishing the mission successfully. Adaptive Airmanship Adaptive airmanship starts with knowledge of yourself, the threat (fatigue, in this case), your aircraft, and the environment followed by the ability to recognize and understand how each one directly affects you, and then a proactive and disciplined plan of action to adapt and control. Reality doesn't always match the plan so anticipate changes, be flexible, and use all alternative resources to recover and survive. Knowledge of the Threat Fatigue, resulting from sleep deprivation and/or disrupted circadian rhythms, can put you in a drunken state of mind because it shortens attention spans; increases susceptibility to spatial disorientation; reduces your situational awareness; and causes apathy, task saturation, error prone performance, poor judgment/decision making, and deadly micro-sleep events. Micro-sleep is one of our body's natural defense mechanisms causing us to initiate sleep without consent, awareness or knowledge ... just a blank stare and not processing external stimuli. How It Affects You The first step in combating fatigue in the cockpit is recognizing and admitting its existence. One of the symptoms of fatigue is denial that it exists. It's an insidious threat and can creep up on you without warning. The ability to understand your body and the discipline to listen to it, will determine how you react to fatigue. Common symptoms warning us of the onset of fatigue are: You fixate, stare off into space, and can't get or stay focused. You forget to execute basic tasks. You feel behind the aircraft, and your reactions are slow. Judgment and decision-making capability are degraded. You disregard critical information. Navigation, check list, and/or fuel calculation errors occur. You miss or make improper radio calls. Loud noises are irritating and distracting. Your sense of humor changes. The Plan of Action Fatigue is the by-product of the life as an aviator, and we have to learn to adapt and mitigate the threat via countermeasures. I've learned that the only way to survive in this business is to have a proactive, focused and disciplined plan of action that applies my knowledge and my understanding of fatigue. Sleep: The first step in my plan is to get quality sleep. Use of sleep aids such as an eye mask, earplugs, white noise and/or a hot shower might be required. White noise provides a constant stimulation to the brain and keeps unwanted noises masked, such as that noisy hotel guest or the aircraft taking off just outside your window. Get the sleep and naps that you can and then continue mitigating fatigue with other countermeasures. Food and drink: The things we eat and drink can pick us up or slow us down. I try to eat nutritious meals and snacks with little or no refined sugar plus remain hydrated with water or a sugar-free electrolyte drink. I personally stay away from all carbonated beverages. Strategic consumption of caffeine restores vigilance, alertness, and can even increase your G-tolerance; however, avoid caffeine if you're already alert. You might be able to pinpoint the best nutrition plan for your type of flying by avoiding foods that make you tired and sluggish. Remember, we determine how we look, feel and perform by the way we treat our bodies. Don't let a temporary satisfaction interfere with your long-term well being. Exercise: Get the body moving even if it's a quick 20-minute stroll after dinner, a fast-paced walk to the gym or stretching while taking a break in-flight. A well-rounded workout program (a mix of cardio, strength training and stretching) increases your strength, endurance, mobility, long-term health, deep sleep and resistance to fatigue. The more oxygen that runs through your veins, brain and muscles, the more energized you'll feel and the more you'll be alert with no urge to nap in the cockpit. Lifestyle: I avoid alcohol, nicotine and self medication. Alcohol can disrupt and hinder proper sleep, nicotine is a stimulant and can inhibit sleep, and self meds have side effects such as altered sleep and decreased performance. Recover and Survive If fatigue gets the best of you before you're able to adapt, you have to pull yourself together and take action with additional countermeasures to recover and survive. The first priority is to maintain aircraft control. If you're in a cockpit with more than one pilot, pass the controls and take a nap. Other fatigue countermeasures include eating bite-size protein/fruit snacks, consuming additional caffeine, an active conversation, stretching and even cold water in the face. As a last resort if you can't land, yelling at yourself or a sip of Tabasco hot sauce can be effective short-term aids for staying alert and surviving. Despite modern science, technology and medicine, much is still unknown about fatigue, sleep and circadian rhythms. However, we do know that food is fuel, exercise energizes, and sleep restores. Food is our fuel for life and fighting fatigue. A balanced exercise program (cardio, strength and stretching) is essential to staying alert. Proper sleep at the right time will restore your body. Pilots and other aircrew members must take responsibility for managing life in balance in order not to negatively impact the flight and/or the mission. By knowing the threat and recognizing your personal symptoms, you'll be able to plan and take action before it becomes a factor as you smartly push the envelope to get the flight and mission completed safely. __________________________________________________________________________________________________________________________________________ Retired Lt. Col. "Ned" Linch served as an F-16 instructor pilot and is the former chief of 12th Air Force Flight Safety. These days he fights fatigue as a 737 airline pilot based in Los Angeles.