Stress and Fatigue Flashcards
Stress
Nonspecific Response of the body to any demand on it
Yerkes-Dodson Curve
On Curve(s)
(EUSTRESS -> DISTRESS)
(Boredom -> Moderate arousal -> Overwhelmed)
(sleep - boredom - mild alert - optimal - stress - anxiety - panic)
(seeing improvement - optimal performance - fatigue - exhaustion - health - breakdown)
Cognitive/psychological appraisal
Thoughts about a situation impact how you experience it
- Primary Appraisal - what meaning placed on event (positive, neutral, negative)
- Secondary Appraisal - how we view our ability to cope with the event
What are the 4 categories for Symptoms of Stress
Physical
Cognitive
Emotional
Behavioral
What are the 4 Types of stressors
Psychosocial - Things in your social world that impact you emotionally, cognitively (divorce, death in family)
Cognitive - Ways you think about, process, and interpret information (not thinking “here and now”)
Physiological - Physical health/state - DEATH
Drugs
Exhaustion
Alcohol
Tobacco
Hypoglycemic (diet)
Environmental - You have little control of - temperature, aircraft design, speed, etc.
Physical signs of stress
Sweaty Palms
Increased HR
Trembling
Shortness of Breath
Muscle Tension
Behavioral signs of stress
Late to work
Poor performance
Explosiveness
Alcohol/drug abuse
Social isolation
Suicide/suicidal thoughts
Emotional signs of stress
Irritability
Hostility
Anger
Anxiety
Sadness
Loss of self-esteem
Feeling helpless
Feeling numb
Cognitive signs of stress
Decreased attention
Impaired memory
Poor judgement
Necessary Pilot abilities
Psychomotor (stress causes decreased tracking ability)
Attention (perceptual/cognitive tunneling; task shred)
Memory (short-term memory loss; over-simplifying)
Judgement
Decision making
Prioritization of tasks
Emotion regulation
Cockpit communication (speech production worsens, group think can set in)
What are the 4 ways of Stress Coping
Minimize/avoid stressors - most powerful technique
Change thinking - positive self talk
Relaxation - can’t be stressed and relaxed
Ventilate - exercise, talk it out
Combat Stress
Every stress encountered as a result of an operational environment
Long-term stress
*Stress reaction may arise/persist long after event
Flashbacks
Isolation
Sleep problems
Hyper-alert
Problem trusting others
Alcohol/drug abuse
**Pilots and aircrew CAN get treatment and fly
Fatigue
The state of feeling tired, weary or sleepy resulting from periods of anxiety, activity, hash environments or lack of sleep
Acute fatigue symptoms
*Between two regular sleeps
Inattention Distractability Errors in timing Neglect of secondary tasks Loss of accuracy/control Lack of awareness of error accumulation Irritability
Chronic fatigue
*Occurs over longer periods, often inadequate recovery from acute fatigue
Insomnia Depressed mood Irritability Weight loss Poor judgement Loss of appetite Slowed reaction time Poor motivation and performance on job
Motivational exhaustion
*If chronic fatigue goes untreated for long periods, individual will “shut down” occupationally and socially
Results of Fatigue/impairment in the cockpit
- Reaction time increases - not as smooth, slow/irregular inputs
- Attention reduction - lapse/”microsleeps,” tunneling, reduced scanning
- Diminished memory - recall declines, learning declines
- Greater tolerance for error - poor/careless performance
- Impaired communication/cooperation - repetitive/fragmented conversations, misinterpretations
What is Sleep and what is its function?
Biological process that involves physical/mental changes that result in recuperation.
-Regulation of core temp, digestion, heart rate, hormone levels and tissue repair
- adequate sleep is not an option
- average person needs 7-9 hours of sleep per night
What are the 4 Sleep Stages?
N1 (drowsiness) - transition from awake to sleep
N2 - light sleep; eye movement stops, HR slows, body temp decreases
N3 (slow wave) - slowed brain waves, most important state for recovery, hard to wake (deepest sleep)
N4 (REM) - dreaming, occurs on 70-90min cycles (3-5 REMs per night)
What is Sleep Inertia?
Short - term grogginess after waking
Can be problematic after napping or poorly timed wake-up (waking in N3 is 30min grogginess)
What is the Circadian cycle(rhythm), and what does it do?
Internal “clock” regulating biological function on a cycle of approx. 24 hours.
- Regulates: Core temp; Hormones; Alertness
- Cycle set by: Sunrise/set; ambient temp; meals; social
*24 hour cycle: 0800-1200 peak
1200-1500 decrease
1500-2100 increase
2100 + decrease to sleep
What is Circadian disruption (desynchronosis) and what does it cause?
Disconnect between environmental cues and what the body is programmed to do (travel, shift work)
fatigue depressed mood lack of motivation confusion digestive disorders
Sleep disruptions
Circadian disruption - adjusting to non-24hr schedule
Intentional sleep restriction - decrease sleep hours, long hours and family demands, activity - sometimes avoidable
Personal Habits - create behavior habits through chaining - behaviors linked to other behaviors… can cause unconscious secondary action by habit
*See FS if >2 weeks of sleep issues
What are the Risk indicators for fatigue?
Often fly during “sleepy” times
Work 12-14 hour days
Have 9 our less hours off per day
Fly on <7 hours of sleep
Rely on caffeine
Little time off previous work week
Inflexible work schedule (no nap breaks)
What are some Fatigue Countermeasures?
Prevention - maintain optimal circadian adaptation
Stick to constant bedtime/wake-up
Bedroom for sleep and sex only
Resolve stressors outside bedroom
Establish bedtime routine
Comfortable sleep area
Aerobic exercise (not 3-4 hours before sleep)
Dont consume caffeine 4 hours before bed
Dont use alcohol as sleep aid
Dont smoke one hour before bed
Dont nap if you have sleep issues
Dont watch the clock
Get out of bed after 30min of no sleep
What are some Strategies for shift and jet lag?
Reduce mental demands on night flights
Have crew double check everything
Shorter periods at controls
Minimize admin duties on ground
After shift, go to bed!
Maximize sleep opportunities
Readjust circadian if needed
What are some Strategies for sleep restriction?
*Strategic napping - (best) 20-30 minutes is good, 2-4 hours is best; 0100-0600 and 1400-1600 are best times, but remember sleep inertia!
Rest breaks - reduce boredom, add recovery
Exercise - can increase arousal
Postural changes - sit up, stand
Sleep aids/aeromed policy
*All hypnotics/sleep aids are class 4 meds - cannot be used without FS approval, grounded while using, need a waiver for underlying condition
FS can give meds for short-term use in-theater, no waiver needed (fight or die circumstance for stimulant use)
Caffeine Advantages
Advantages - can create temporary energy boost, easy to get
Caffeine Disadvantages
Disadvantages - adaptation means lost effect, wears off quickly, can worsen sleep issues, not a sleep substitute
What are the four ways to decrease vulnerability to Combat Stress?
4 C’s
Competence in work
Confidence in abilities
Cohesion of group, high morale
Control, or perceived control
