Fatigue in military aviation: an overview of US military-approved pharmacological countermeasures.
Uncomfortable working and sleeping environments, high operational tempos, sustained operations, and insufficient staffing make fatigue a growing concern. In aviation, where a single mistake can cost millions of dollars, it is essential to optimize operator alertness. Although behavioral and administrative fatigue countermeasures should comprise the "first line" approach for sustaining aircrew performance, pharmacological fatigue countermeasures are often required. Various components of the U.S. military have authorized the use of specific compounds for this purpose. Hypnotics such as temazepam, zolpidem, or zaleplon can mitigate the fatigue associated with insufficient or disturbed sleep. Alertness-enhancing compounds such as caffeine, modafinil, or dextroamphetamine can temporarily bridge the gap between widely spaced sleep periods. Each of these medications has a role in sustaining the safety and effectiveness of military aircrews. The present paper provides a short overview of these compounds as well as factors to be considered before choosing one or more to help manage fatigue.
Caldwell
John A
JA
Biosciences and Protection Division, United States Air Force Research Laboratory, Brooks City-Base, TX 78235, USA.
Caldwell
J Lynn
JL
D000081:Acetamides / Q000494:pharmacology / Q000627:therapeutic use; D000337:Aerospace Medicine; D014151:Anti-Anxiety Agents / Q000494:pharmacology / Q000627:therapeutic use; D001559:Benzhydryl Compounds / Q000494:pharmacology / Q000627:therapeutic use; D002940:Circadian Rhythm / Q000187:drug effects; D005221:Fatigue / Q000517:prevention & control*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology / Q000627:therapeutic use; D008887:Military Medicine; D000077408:Modafinil; D011725:Pyridines / Q000494:pharmacology / Q000627:therapeutic use; D011743:Pyrimidines / Q000494:pharmacology / Q000627:therapeutic use; D012890:Sleep / Q000187:drug effects; D013693:Temazepam / Q000494:pharmacology / Q000627:therapeutic use; D014481:United States; D000077334:Zolpidem
D000081:Acetamides; D014151:Anti-Anxiety Agents; D001559:Benzhydryl Compounds; D006993:Hypnotics and Sedatives; D011725:Pyridines; D011743:Pyrimidines; D000077334:Zolpidem; D013693:Temazepam; D000077408:Modafinil; C085665:zaleplon