Sleep Deprivation was the cause of a Pilot's Meltdown

The JetBlue airline pilot who went on a frightening in-flight tirade in March, forcing the flight to be diverted, was having a "brief psychotic disorder" because of sleep deprivation, a psychologist testified at a hearing. The psychologist's testimony, given last week, was revealed in court documents released today.

According to witnesses, Clayton Osbon, 49, was flying a New York-to-Las Vegas jetliner March 27 when he went on a rampage in the cabin, ranting about Sept. 11, 2001, making allusions to terrorists and yelling, "Guys, push it to full throttle."

"Osbon also yelled jumbled comments about Jesus, September 11, Iraq, Iran, and terrorists," according to a criminal complaint. The plane was carrying 131 passengers and six crew members.

"The captain of the plane just went berserk," passenger Wayne Holmes told ABC News. "He came out of the other end of the plane -- came running back to the cockpit and he was shouting out these numbers -- 500 something. He started banging on the cockpit door."

A passenger subdued Osbon, a veteran captain, and the flight was diverted safely to Amarillo, Texas. Osbon was later suspended from his duties and charged with interfering with flight crew instructions

The U.S. Attorney's Office did not dispute the psychologist's testimony on July 3 and a federal judge in Texas found Osbon not guilty by reason of insanity.

"The defendant appeared to suffer from a severe mental disease or defect that impaired his ability to appreciate the nature, quality or wrongfulness of his behavior," U.S. District Judge Mary Lous Robinson said last week.

Osbon was sent to a mental health facility in Fort Worth for additional treatment.

Despite denials from the airline industry, ABC News has found that large numbers of pilots have reported for duty every day after getting only a few hours of what fatigue experts call "destructive sleep" in crowded crew lounges and so-called "crash pads."

Critics say that widespread pilot fatigue is putting airline passengers at risk, and may already have cost lives.

JetBlue told ABC News today, however, that Osbon had the weekend off before that Tuesday flight and that Monday he'd only flown two trips before having an additional 17 hours off.

The airline said that it continued to comply with new rules instituted by the Federal Aviation Administration in December that require a 10-hour rest period for pilots between flights and 30 consecutive hours off during the week.

Ten passengers from the flight filed the first of what is expected to be many lawsuits demanding unspecified damages from Osbon and JetBlue.

Alison Croyle, an airline spokeswoman, told The Associated Press today that Osbon was still employed by JetBlue and on "inactive status."

Osbon could be released as early as August, when he is expected to have another hearing. A judge may determine whether he can be permanently released or committed to a facility.

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Pilot Performance, Jet Lag and Sleep Deprivation

Night-time departures, early morning arrivals, and adjusting to several time zones in a matter of days can rattle circadian rhythms, compromise attention and challenge vigilance. And yet, these are the very conditions many pilots face as they contend with a technically challenging job in which potentially hundreds of lives are at stake.

In an article to be published in a forthcoming issue of Current Directions in Psychological Science, a journal of the Association for Psychological Science, John A Caldwell, a psychologist and senior scientist at Fatigue Science, a Honolulu business focusing on fatigue assessment, examines the problem of sleep deprived pilots by teasing out the complex interplay of inadequate sleep and circadian rhythms. He explains how airline industry solutions miss the point and then suggests other options.

Caldwell points out that "fatigue-related performance problems in aviation have been consistently underestimated and underappreciated, despite the fact that decades of research on pilots and other operational personnel has clearly established that fatigue from insufficient sleep significantly degrades basic cognitive performance, psychological mood, and fundamental piloting skills."

Evidence abounds. In 2004, a corporate airlines flight crashed as it approached Kirksville Regional Airport; in 2008, Honolulu based pilots of Go! Airlines overshot their destination by more than thirty miles because they fell asleep during a trip that was only fifty minutes long. A Northwest Airlines Flight overflew its destination by 150 miles because pilots had dozed off at the controls. In 2009, fifty people were killed when a Continental Connection flight en route from Newark to Buffalo crashed into a house. Pilots failed to respond properly to a stall warning and the flight went out of control.

After examining what went wrong, the NTSB concluded that, "the pilots' performance was likely impaired because of fatigue." Since 1990 the US National Transportation Safety Board has placed pilot fatigue on the Most Wanted List of safety related priorities.

Why? Because as fatigue increases, "accuracy and timing degrade, lower standards of performance are accepted, the ability to integrate information from individual flight instruments into a meaningful and overall pattern declines, and attention narrows. "

In one study, F-117 pilots were deprived of one night of sleep and then were tested on precision instruments. Not only did pilot errors on those instruments double after one night of sleep loss, pilots reported feeling depressed and confused.

Clearly fatigue is fundamentally the result of insufficient sleep, but for pilots the important issue is the consequences of that sleep loss when they are sitting at the control panel. The author suggests that "fatigue related risks increase substantially when (a) the waking period is longer than 16 hours, (b) the preduty sleep period is shorter than 6 hours, or (c) the work period occurs during the pilot's usual sleep hours."

"Regulators, and often the pilots themselves, have tried to address the fatigue problem by focusing on duty hours rather than focusing on the physiological factors that are truly responsible," Caldwell says. "The combination of insufficient sleep and circadian factors is at the heart of the fatigue problem in any operational context."

The two most important variables for alertness are recent sleep and the body's natural circadian rhythm, or "body clock." What that means is that when a pilot reports for duty, he or she should have had from seven to nine hours of good sleep within a reasonable period of time before work and that as often as possible, the work schedule is in some harmony with the pilot's natural daily rhythm.

The amount of time that a pilot is actually working is much less important. But that is the area airlines and regulators have focused on to address the problem. "Hours-of- service" regulations have been instituted to mitigate fatigue, but "that seems to be a function of convenience rather than science." Caldwell writes that in traditional regulatory approaches "one hour of daytime flight in one's home time zone after plenty of sleep is considered to generate the same amount of fatigue as an hour of nighttime flight" that was preceded by a transcontinental transition and sleep outside of a normal sleep cycle. Fortunately, new Federal Aviation Administration regulations better account for the true physiological nature of fatigue, but additional fatigue-management strategies are needed.

Caldwell acknowledges that the very nature of airline travel predisposes pilots to disrupted sleep schedules, but he points out several approaches that can both predict a truly impaired pilot and mitigate the consequences of a lack of sleep. There are some fatigue prediction models that can help determine the impact of work/rest schedules on aviator performance. Crew members should be educated on sleep hygiene so they can snag some restorative rest before duty or during layovers. Onboard cockpit napping should be authorized so that pilots will be able to compensate for a lack of sleep. And new wearable sleep-tracking technologies should be utilized to actually measure the pre-duty and layover sleep of flight crews so that they can better manage and optimize their own sleep.

"As a society, we must come to grips with the fact that the average adult needs 7-9 hours of sleep every single day," he says. "And there is no amount of willpower, professionalism, training, or money that will prevent the performance losses associated with the failure to routinely acquire sufficient sleep."

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Tips for a Better Night's Sleep if You're Sleepy on the Job

There's no denying that sleep deprivation, and the health issues that result, are becoming more prevalent in our go-go, techno society. But a recent sleep study by the National Sleep Foundation (NSF) grabbed my attention as particular cause for concern.

Every year, the NSF releases a Sleep in America® poll. For its 2012 survey, the NSF examined the specific sleep habits and work performances of transportation workers -- pilots, train operators, and truck, bus, taxi and limousine drivers. The transportation workers were asked about the duration and quality of their sleep, specifically on work nights, and how it affects their work performance.

Some of the results of the survey were:

• About one-fourth of the train operators and pilots polled said that sleepiness has affected their job performance at least once a week.

• One in five pilots polled -- about 20 percent -- said they have made a "serious error" as a result of on-the-job sleepiness.

• One in five pilots and one in six train operators admit to a "near miss" due to on-the-job sleepiness.

• Pilots and train operators are more likely than non-transportation workers to have been involved in a sleep-related car accident while commuting.

• Among all workers surveyed, train operators and pilots report the most work day sleep dissatisfaction.

• Almost two-thirds of train operators and one-half of pilots say they rarely or never get a good night's sleep on work nights.

• About one-third of bus, taxi, and limo drivers said they rarely or never get a good night's sleep on work nights.

The results of the poll are some cause for alarm and reinforce the growing problem of sleep disorders and the potential risks they pose, such as commuter car accidents and errors by public transportation drivers responsible for many people.

Persistent sleep problems left untreated can also lead to myriad health problems, including memory and concentration problems, increased risk of high blood pressure, hypertension, stroke and heart attacks, depression, diabetes and sexual dysfunction. Severe cases of sleep apnea can even be fatal.

Besides these sobering health risks, an untreated sleep disorder can also be the root cause of poor performance at work or school, car accidents and other activities that require focus and concentration.

Common Symptoms of Sleep Disorders

Many people experience some occasional difficulty sleeping and/or daytime fatigue. But how does a person know if he or she has a temporary sleep problem that can be remedied with some simple behavioral changes or if it is a legitimate disorder, such as snoring, sleep apnea, sinusitis or nasal obstruction that should be diagnosed and treated properly?

The first step is to be aware of some common symptoms of sleep disorders. Keep in mind that symptoms vary between disorders, such as snoring, sleep apnea, insomnia, restless leg syndrome, nasal obstruction, and narcolepsy, so it pays to do some research based on what you are personally experiencing.

Some common symptoms of sleep disorders include:

• Trouble falling asleep at night

• Waking throughout the night

• Chronic snoring

• Morning headaches

• Poor memory

• Daytime sleepiness/falling asleep during the day/low energy

• Bad moods/ irritability

• Increased depression

• Trouble concentrating/driving/making decisions

The Link Between Lifestyle and Sleep Problems

If you or someone you know is experiencing some of the above common symptoms of sleep disorders, the next step is to examine if lifestyle habits are contributing to the difficulty sleeping, fatigue and irritability during the day and other symptoms.

Some behavioral and lifestyle questions to ask include:

• Am I watching TV or using the computer late at night and too close to bedtime?

• Am I consuming too much caffeine during the day?

• Am I taking a medication that may be affecting my sleep quality and duration?

• Is there something particularly stressful going on in my life that is causing me worry and anxiety?

• Am I exercising enough to help alleviate some of that stress and tension?

See a Specialist -- And Be Specific

Many sleep problems can be remedied by making some common-sense behavioral changes. However, if you or someone you know is experiencing one or more of the above symptoms on a regular basis, see a qualified ear, nose and throat doctor or otolaryngologist to get diagnosed and treated properly. There are multiple options and minimally-invasive techniques available today to treat your sleep disorder.

When you see a specialist, be specific about the symptoms you are experiencing. Many times, sleep apnea and other sleep disorders can be misdiagnosed as chronic fatigue, insomnia, depression, or some other non-specific condition. Some doctors, for example, still associate sleep apnea more with men than women, and are too quick to prescribe a medication, rather than do a full sleep disorder work up.

It may help to keep a sleep log (or, more accurately, lack-of-sleep log) next to your bed to write down what you are experiencing, when you wake and some symptoms you experience. Again, to try and avoid misdiagnosis, go to a qualified sleep specialist and be specific about your symptoms. Don't wait -- it could save your life.

To read the full report, see "Sleepy Pilots, Train Operators and Drivers" on the National Sleep Foundation website.

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25% of Pilots are Sleepy on the Job

The people we trust to take us or our loved ones from place to place struggle with sleep, according to the National Sleep Foundation's (NSF) 2012 Sleep in America^® poll. It is the first poll to ask transportation professionals, including pilots, train operators,* truck, bus, taxi and limo drivers about their sleep habits and work performance.

Pilots and train operators are most likely to report sleep-related job performance and safety problems

The results of the poll are striking. About one-fourth of train operators (26%) and pilots (23%) admit that sleepiness has affected their job performance at least once a week, compared to about one in six non-transportation workers (17%).

Perhaps more disturbingly, a significant number say that sleepiness has caused safety problems on the job. One in five pilots (20%) admit that they have made a serious error and one in six train operators (18%) and truck drivers (14%) say that they have had a "near miss" due to sleepiness.

Sleepiness has also played a role in car accidents commuting to and from work. Pilots and train operators are significantly more likely than non-transportation workers (6% each, compared to 1%) to say that they have been involved in a car accident due to sleepiness while commuting.

"Driving home from work after a long shift is associated with crashes due to sleepiness," says Dr. Sanjay Patel, a sleep researcher at Brigham and Women's Hospital and Harvard Medical School. "We should all be concerned that pilots and train operators report car crashes due to sleepiness at a rate that is six times greater than that of other workers."

Train operators and pilots report most sleep dissatisfaction

Among all workers surveyed, train operators and pilots report the most work day sleep dissatisfaction. Almost two-thirds of train operators (57%) and one-half of pilots (50%) say they rarely or never get a good night's sleep on work nights, compared to 44% of truck drivers and 42% of non-transportation workers. Bus, taxi, and limo drivers report the best work day sleep satisfaction, with about one-third (29%) saying they rarely or never get a good night's sleep on work nights.

"The margin of error in these professions is extremely small. Transportation professionals need to manage sleep to perform at their best," says David Cloud, CEO of the National Sleep Foundation. "As individuals and employers, we need to know more about how sleep improves performance."

Sleepiness is common for all workers

Roughly one in ten Americans say they are likely to fall asleep at an inappropriate time and place, such as during a meeting or while driving. The poll included a validated assessment tool used by doctors to determine whether a person is "sleepy." Anyone who suffers from excessive sleepiness should seek professional help to identify underlying conditions. This study finds that 11% of pilots, train operators, bus, taxi, and limo drivers and 8% of truck drivers as well as 7% of non-transportation workers are "sleepy."

"We found that although pilots are especially focused on obtaining adequate sleep, one in ten can still be classified as 'sleepy.' This is not acceptable. Who among us wants to take a one in ten chance of flying on a plane with a sleepy pilot?" says CPT Edward Edens, PhD of the Walter Reed Army Institute of Research.

A sleepy transportation worker is far more prone to mistakes: sleepy transportation workers report job performance problems about three times more often and report averaging about 45 minutes less sleep per night than their non-sleepy peers.

Significant number of transportation workers say their schedules do not allow enough time for sleep

Many transportation workers cite their schedule as a major contributor to sleep problems. Almost one-half of train operators (44%) and more than one-third of pilots (37%) report that their current work schedule does not allow adequate time for sleep, compared to about one-fourth of non-transportation workers and truck drivers (27% each) and one-fifth of bus, taxi and limo drivers (20%).

In general, transportation professionals work more varied shifts than other workers, which may play a role in their sleep problems. Only 6% of pilots and 47% of train operators say they work the same work schedule each day, compared to 76% of non-transportation workers.

Time off between shifts may play a role in transportation workers' sleepiness. Non-transportation workers report having an average of 14.2 hours off between shifts, compared to 12.9 hours for pilots; 12.5 for train operators; 12.1 for truck drivers; and 11.2 hours for bus, taxi, and limo drivers. If given one more hour off between work shifts, over one-half of pilots (56%) and train operators (54%) report that they would use that hour for sleep.

Long commutes cut into transportation workers' already shortened time between shifts. Pilots report the longest commutes with 37% saying it takes more than an hour to get to work from home. Pilots and train operators have the highest average commute time of 45.5 minutes and 31 minutes, respectively, compared to a 23.8 minute average for non-transportation workers. Other research has consistently found that longer commute times have been associated with shorter individual sleep times.

"Transportation workers experience considerable variability in the days they work, the times they work, and the amount of time off between shifts. This makes it difficult for such workers to maintain regular sleep/wake schedules, which can, in turn, make it difficult for these workers to maintain alertness on the job. Employers should put more effort into designing work/rest schedules that facilitate sleep and minimize workers exposure to irregular, variable schedule changes," says Patrick Sherry, PhD, a sleep researcher and professor from theUniversity of Denver Intermodal Transportation Institute.

Pilots and train operators nap twice as frequently

The poll shows that transportation professionals are taking more naps than other workers. More than one-half of pilots (58%) and train operators (56%) take at least one nap on work days, compared to about one-fourth of non-transportation workers (27%). About one in five pilots (20%), bus, taxi and limo drivers (20%), truck drivers (16%) and train operators (16%) say they take 3-5 naps during the work week. Among those who report napping on work days, one-half of pilots (50%), almost one-half of truck drivers (42%), one-third of train operators (33%) and nearly one-fourth of bus, taxi and limo drivers (24%) say they actually napped during work hours in the past two weeks, compared to about one in five non-transportation workers (19%).

"Transportation workers have challenging schedules that compete with the natural need for sleep. While I'm impressed that transportation professionals nap when they are off duty, we need to better understand how to use naps to reduce sleep deprivation and overcome scheduling issues," says Thomas Balkin, PhD, a sleep researcher from the Walter Reed Army Institute of Research.

Read more: http://www.sciencedaily.com/releases/2012/03/120304141858