Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Sep 6:12:712628.
doi: 10.3389/fphys.2021.712628. eCollection 2021.

Fatigue in Aviation: Safety Risks, Preventive Strategies and Pharmacological Interventions

Yara Q Wingelaar-Jagt  1   2 , Thijs T Wingelaar  3 , Wim J Riedel  2 , Johannes G Ramaekers  2
Affiliations
Review

Fatigue in Aviation: Safety Risks, Preventive Strategies and Pharmacological Interventions

Yara Q Wingelaar-Jagt et al. Front Physiol. .

Abstract

Fatigue poses an important safety risk to civil and military aviation. In addition to decreasing performance in-flight (chronic) fatigue has negative long-term health effects. Possible causes of fatigue include sleep loss, extended time awake, circadian phase irregularities and work load. Despite regulations limiting flight time and enabling optimal rostering, fatigue cannot be prevented completely. Especially in military operations, where limits may be extended due to operational necessities, it is impossible to rely solely on regulations to prevent fatigue. Fatigue management, consisting of preventive strategies and operational countermeasures, such as pre-flight naps and pharmaceuticals that either promote adequate sleep (hypnotics or chronobiotics) or enhance performance (stimulants), may be required to mitigate fatigue in challenging (military) aviation operations. This review describes the pathophysiology, epidemiology and effects of fatigue and its impact on aviation, as well as several aspects of fatigue management and recommendations for future research in this field.

Keywords: aerospace medicine; caffeine; hypnotics and sedatives; modafinil; pilots; sleep; temazepam; wakefulness-promoting agents.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Root cause analysis of fatigue and areas of influence of fatigue management in aviation.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Aljurf T. M., Olaish A. H., BaHammam A. S. (2018). Assessment of sleepiness, fatigue, and depression among gulf cooperation council commercial airline pilots. Sleep Breath. 22, 411–419. 10.1007/s11325-017-1565-7, PMID: - DOI - PubMed
    1. MOEBUS Aviation (2008). “Scientific and Medical Evaluation of Flight Time Limitations”. (Zurich, Switzerland: MOEBUS Aviation; ).
    1. Bafna T., Hansen J. P. (2021). Mental fatigue measurement using eye metrics: A systematic literature review. Psychophysiology 58:e13828. 10.1111/psyp.13828, PMID: - DOI - PubMed
    1. Balkin T. J., Wesensten N. J. (2011). “Differentiation of sleepiness and mental fatigue effects,” in Cognitive Fatigue: Multidisciplinary Perspectives on Current Research and Future Applications. ed. Ackerman P. L. (Washington, DC., U.S.A.: American Psychological Association; ), 47–66.
    1. Batejat D., Coste O., Van Beers P., Lagarde D., Pierard C., Beaumont M. (2006). Prior sleep with zolpidem enhances the effect of caffeine or modafinil during 18 hours continuous work. Aviat. Space Environ. Med. 77, 515–525. PMID: - PubMed

LinkOut - more resources