"My mind clicks on
and off.… I try letting one eyelid close at a time while I prop the other open
with my will. But the effort’s too much. Sleep is winning. My whole body argues
dully that nothing life can attain is quite so desirable as sleep. My mind is
losing resolution and control."
—Charles A. Lindbergh, The Spirit of St. Louis
By Larry E. Nazimek
Air Line Pilot, March 2003, p.18
Sleep—we’ve all done it at one time or another, probably within the past 24 hours, so we should all have some experience with it. If you haven’t slept for a while and still feel great, and your method will work for the rest of us mere mortals, patent your process and then sell it. You’ll be a millionaire overnight.
|Aircraft, navaids, and jet engines have improved, but the physiology of humans has not.|
So what exactly is sleep? According to Dr. William Dement of Stanford University, in his keynote address to the NTSB’s Fatigue Symposium (Nov. l, 1995), it is "a behavioral state of complete perpetual disengagement from the environment."
And what about "fatigue"? It "is the feeling that accompanies a strong physiological tendency to fall asleep."
Dr. Dement went on to say that "most people think it takes a lot of time to fall asleep, but it doesn’t. The actual transition from wake to sleep is virtually instantaneous. Drowsiness is not the first step in the process, it’s the last step. It is the last event of wakefulness just as we are actually falling asleep."
If you find this topic, or my style of writing, boring, you don’t have to read the rest of this article. If, however, you have been directed by some instructor (in case you’re in a class), or your boss, to read it, you’ll do as you’re told, but may very well fall asleep before you finish.
On the other hand, you may find all of this very interesting, and you’ll want to finish reading it, perhaps late in the evening, following a very long day. You may even get to the last page, when you begin getting very drowsy. Because you’re almost finished, you may decide to press on and finish that last page. You may look at your watch an hour from now and find that you’re still on that last page. That’s simply the way sleep is. It can really grab you and take over.
For that past hour, you were trying to do something that required that you be fully awake, but you weren’t. Fortunately, however, you weren’t doing something, like flying, in which your life, and those of others, depended on your being awake.
Sleep has been around for a long time, but just like the jet stream and microbursts, we’re just now learning a lot about it that we didn’t know earlier. What we’re learning is crucial to safety.
Aircraft, navaids, and jet engines have improved, but the physiology of humans hasn’t. The need for sleep is a basic physiological need, just like water and food. When your body is low on water, you get thirsty; when you’re low on food, you get hungry; and when you need sleep, you get tired. When you need water, you must make the effort to get a liquid and drink it. When it comes to sleep, however, you can try to fight the urge to voluntarily go to sleep. Eventually, the need for sleep becomes great enough that sleep becomes involuntary. Not that you’ll drop right off into dreamland, however; first (probably) will come brief lapses, or microsleeps, that last for only ½ to 2 seconds, and at first, you won’t even be aware of them.
This need for sleep is definitely present. No federal aviation regulation, no company directive, no military regulation can change that. If your sense of self-preservation can’t keep you awake, how can an order to stay awake keep you from nodding off?
At one time or another, you’ve yawned and said, "I need some sleep." Being able to go to a store and buy sleep by the pound or gallon would be great, but you can’t. The fine print on the box of any stimulant you find in the store says that it is not a substitute for sleep. If someone ever develops a pill that is a safe substitute that really works, it will probably outsell Viagra by a very large margin.
The issuance of a pilot certificate, regardless of the rating, does not grant the holder superhuman powers. Pilots still need sleep, as do truck drivers, locomotive engineers, brick layers, and everyone else.
On the other hand, some people still want to believe that sleep is totally voluntary, and that anyone who does not maintain perfect alertness when ordered to do so is somehow substandard. Some people like to refer to this as part of an "aviation cadet syndrome," since so many of our concepts and ways of doing things have evolved from earlier days of aviation in the military. The "old school" says to merely "stay awake," but many accidents have been caused by those who tried that very thing. Modern-day airline pilots are paid to complete their missions safely and should constantly access their level of fatigue. Fatigue is now being listed as a cause in accidents, so reality and scientific research should now overrule machismo.
Modern society is a "24-hour society." "The city never sleeps" or "available 24/7" is often heard. People have grown accustomed to overnight mail and package delivery. Flying the "redeye" to get to business meetings is common practice. The aviation community is merely a piece in that big picture.
A great deal of attention has been given to the effects of alcohol on driving (and, of course, flying), but depending on one’s degree of fatigue, a person’s performance may be degraded more by fatigue than if that person was well-rested but drank two beers with dinner. Pilots sometimes fly at times when they wouldn’t even think of driving their cars. Fatigue can’t be measured in the blood or breath, and nobody is being cited for driving or flying while fatigued.
Maximum duty/minimum rest
For FAR Part 121/135 flying, the regs mandate maximum duty and minimum rest periods. Dr. Mark R. Rosekind, president and chief scientist of Alertness Solutions and former leader of the NASA Ames Research Center’s Fatigue Countermeasures Program, has pointed out that "these regulations were drawn up in 1937, before anyone could have conceived of jet travel and the types of operations we have now, but they really haven’t changed much since they were originally drawn up."
|All too often, scheduling gives no weight to sensibility and fatigue considerations.|
Whatever the regulations spell out, some people will try to skirt the spirit of the law while staying within the letter of it. Some employers will try to say that a rest period begins when the wheels touch the runway, and the period ends upon takeoff. Some will allow for pre- and post-flight duties, but they act as though rest takes place from the moment the flight crew leaves the terminal to the time they return, neglecting the time needed for transportation to/from the hotel, check in/out, meals, and personal hygiene.
When the current domestic duty/rest regulations were revised in 1985, the drafters realized that weather and maintenance would sometimes cause delays that would necessitate keeping pilots on duty longer than originally planned, so they made provisions for "reduced rest" periods that would necessitate later extended rest periods. Some carriers then decided to schedule flight crews under the provisions of these reduced-rest periods. Many carriers treat limitations as the norms to which they schedule flight crews—"If the limitations weren’t good enough, they wouldn’t be the limitations." In other words, these carriers are not scheduling for safety, but rather, scheduling to meet regulatory requirements. These regulations do not guarantee (none can, but these do not even try) that the flight crews will be well-rested when they report for their next flight.
Some reserve pilots may not know when their next flight will take place. They may not fly for several days, only to get a call at midnight to report for duty immediately. As long as they had their minimum time off work, the carrier’s management assumes that the pilots are, by the regs, "well rested." A fairly large operator may schedule crews to be on standby for day flights and others for night duty. Many operators, particularly the smaller ones, will find such an arrangement unworkable. It would require them to hire more pilots with a subsequent decrease in the amount of flying hours per pilot.
Some carriers will, on a pilot’s last day of a trip, schedule that pilot for the maximum they can under FAR Part 121/135, but will then have the same pilot fly for ferry, training, or checkride purposes, because such flying will be under FAR Part 91, where maximums are not spelled out.
Although no duty/rest requirements are spelled out in Part 91, the Flight Safety Foundation’s Fatigue Countermeasures Task Force has issued a list of guidelines, suggesting minimum time off, maximum duty periods, and maximum flight times within those duty periods. It provides separate guidance for situations in which the flight crew will be augmented with a third pilot. Like the FAR requirements under Part 121/135, the guidelines also make provisions for times when the recommendations for maximum flight/duty times must be extended, so that additional rest is provided.
Unlike the FARs, the FSF Task Force guidelines also provide a second table of guidelines/recommendations for flights that involve the "window of circadian low," which it defines as 0200–0600 pilot local time.
In a giant leap forward (and it’s unfortunate that anyone should consider this a "giant leap"), the FSF provides guidance for pilots in a standby status: such pilots should have provisions for an 8-hour sleep opportunity that is "predictable" (in that they should have prior notice, hopefully, at least 24 hours, as to when this 8-hour period will be) and "protected" (in that it should not be interrupted by assignment to a duty period). Of course, some operators will shrug this off as "unworkable," although the solution to their problem is often as simple as hiring more pilots.
Of course, all flying is governed by the underlying prohibition against flying in a careless and reckless manner. A pilot who is too tired to fly, in theory, is required to inform the employer that he or she cannot accept the flight. With the ratio of highly qualified pilots to available jobs as high as it is, however, one need not be a genius to figure out what would happen to such a pilot. He or she might score an "A" for safety, but an "F" for judgment.
The people who do the scheduling are usually not the ones who must fly those schedules. All too often, scheduling gives no weight to sensibility and fatigue considerations. In some cases, this is a matter of ignorance or a lack of appreciation for the problem, but in other cases, simply a lack of concern for the pilots (as well as safety). "If they can’t cut the mustard, we’ll replace them." After all, accidents seldom occur, and when they do, employers can try to pin the blame on pilot error, maintenance, or anything other than themselves.
|You can change the position of Mickey’s small hand in a few seconds, but your biological clock can take a few days to make the adjustment to your new time zone.|
Fortunately, with NASA’s research and the publicity given to some aviation disasters in which fatigue was listed as a cause, some carriers are realizing that pilots are humans and not machines. A great deal of credit must go to the Air Line Pilots Association, whose motto is "Schedule with Safety."
The case for sleep
We humans need roughly 8 hours of sleep per day (the amount varies from person to person), but each day has only 24 hours, so the 8 hours of sleep leaves us with only 16 hours for everything else. For many Americans and Canadians, 16 hours simply isn’t enough, so that’s why we are, for the most part, sleep-deprived. For many of us, if we wanted to devote an extra hour to our physical well-being, we might get a better return for our investment by sleeping an extra hour instead of working out.
The different stages of sleep come in cycles. The "REM" (rapid eye movement) sleep is the time spent dreaming. "Non-REM" sleep is when we are not dreaming, and it comes in four different "stages." In the lower two depths of non-REM sleep, you are "sound asleep."
Dr. Rosekind says that most people think that sleep is like putting a car into the garage for the night. He can agree with that analogy as far as the non-REM sleep is concerned, when the body and brain slow down. REM sleep, however, is like "taking that car into the garage and throwing your foot on the accelerator and the brake at the same time." When you are dreaming, your brain is active.
Some people complain that when they wake up after a long night’s sleep, they’re still tired. Dr. Rosekind attributes this to those who "take their work to bed." Some people need help in learning to relax.
When you don’t get the sleep you need, you accumulate a "sleep debt," which generally takes two nights to "catch up." Making up a sleep debt, fortunately, is not a question of paying the debt, hour for hour. Sleep is not only a question of quantity but also one of quality. Hour for hour, deeper sleep is more efficient sleep.
Sleepiness can affect your performance without your falling asleep. It has degrees of degradation, with the ultimate being nodding off. It can affect one’s mood; decision-making; ability to learn, concentrate, and remember; and it can cause one to accept lower standards of precision. In general, it degrades your ability to think and act efficiently.
Normally, you can succeed in staying awake, but depending on what you are doing, as well as how great your sleep debt, you may be so drowsy that you can’t stay awake, even if you were to crush No Doz® in water and shoot it into a vein or chew on jalapeños.
The sleepier you are, the more rapid and frequent are the intrusions of sleep into wakefulness. Spontaneous sleep episodes can be very short in duration (i.e., "microsleeps" or "lapses" that last only ½ to a few seconds) or extended (i.e., that last several minutes).
Our sleep mechanisms, as well as some of our other bodily functions, follow a type of "biological clock." Generally, it means a schedule of sleeping at night and being awake during the day. Some people are "night people" and some "day people"—these people go to sleep much later (or much earlier) than the population’s average, but as long as they are consistent, their biological clock does the same thing for them as it does for the majority.
Our biological clocks are far more complex than could possibly be described in a few paragraphs. These clocks do not merely determine that we’ll feel tired at certain times; they include such things as a variable bodily temperature. In addition to the body’s wanting to go to sleep (usually at night), during a "circadian low" (approximately 0300–0500, although some researchers prefer to use 0200–0600), your biological clock’s "go to sleep" mode will be particularly strong.
A daytime circadian low occurs at about 1500–1700, sometimes leading to yawning spells late in the afternoon.
If we try to drastically alter our circadian rhythm, by trying to sleep when we would normally be awake, and vice versa, we can have difficulty falling asleep when we do try to sleep, as well as difficulty staying awake when our body tells us we should be asleep.
One of the most common ways of disrupting our circadian rhythm is to traverse several time zones. Because our biological clocks were designed with a cycle closer to 25 hours than 24, prolonging our day is easier than shortening it. In other words, if you travel to the west, you’ll be extending your day, so making that adjustment is easier than making one when traveling eastbound, when one’s day is shortened.
Crossing multiple time zones may not have been much of a concern for our grandparents, but we live in a world in which crossing several zones is commonplace. It’s one of the "benefits" of jet travel.
Our bodies take a while to adjust to time zone changes. You can change the position of Mickey’s small hand in a few seconds, but your biological clock can take a few days to make the adjustment to your new time zone. That may not be too bad for a military squadron going on a deployment when they will be operating out of the new time zone for a few weeks, but airline pilots will probably be off to a different zone before their bodies can adjust to the first change.
Another way to disrupt your biological clock is to fly a night flight when you’ve been flying days. Your body’s response to a disruption of its circadian rhythm will be the same, whether the disruption is due to time zone changes or a change in your schedule.
Scientists have learned that light plays a role in setting our biological clocks. Therefore, one way to get your body onto the schedule of your upcoming time zone is to put yourself in a room with very bright lights for the time when your new time zone will be in daylight, and to put yourself in darkness when the new zone experiences night.
The Fatigue Countermeasures Program (aka "Z-Team") at NASA’s Ames Research Center has been studying sleep and what we can do about it since 1980.
The Z-Team has conducted studies to learn about the effects of flying schedules on pilots’ sleep patterns. The Team has monitored pilots on trips of several days for short-haul, long-haul, and overnight cargo operations, and they have even studied pilots of helicopter operations in the North Sea’s Shetland Basin. The layovers of the trips studied were long enough to permit plenty of time for sleep. The Team learned that pilots tend to get less sleep on the road than at home. As the trips progressed from day to day, the pilots would get less sleep, which meant a mounting "sleep debt." Our biological mechanisms were designed for normal people—not pilots.
One of the Team’s more interesting projects, conducted in collaboration with the FAA, was to determine the effects of planned napping periods on the flight decks of long-range flights. The Team, which already knew that naps are beneficial for most people, wanted to see what naps would do for pilots.
|Real physiological mechanisms underlie fatigue—we need our sleep, but that need, and the best way to satisfy that need, varies from person to person.|
The Team chose three-member flight crews so that two crew members would be awake while the third napped. The crews studied were divided into the "Rest Group," whose members were permitted to nap under certain conditions, and the "No-Rest Group," whose members were not allowed to nap. All three crew members of a given flight were of the same group.
Transpacific flights were chosen so that napping would take place during times of relatively low work loads.
The rest periods lasted 40 minutes. Longer rest periods would not have been beneficial because the subjects would then go into deeper dream sleep stages, which could cause "sleep inertia," a type of grogginess and confusion experienced when suddenly waking from such sleep.
After waking up, the crew member would spend 20 minutes taking a Psychomotor Vigilance Task (PVT) test before resuming duty. The PVT test was administered at several points in the flight as well as on the ground. Members of both groups took this test at the same points in the flight so that comparisons in their performance could be made. This test measures one’s reactions time as a button is pressed in response to a light coming on.
The crew members wore sensors to determine when they were sleeping and the stages of their sleep.
The first question is whether the test subjects would be able to sleep in their seats during the scheduled rest periods. In 93 percent of the test cases, they were. None of this was REM sleep.
Members of the No-Rest Group also slept—involuntarily. Most of this was in the form of brief lapses, but some of these episodes of nodding off extended for as long as 10 minutes. Some lapses occurred during the descent and approach phases of the flight.
The Rest Group subjects had far fewer episodes of microsleeps than did their No-Rest counterparts. In addition, the Rest Group did much better on the PVT tests.
With such overwhelming results supporting the concept of controlled napping, the FAA should logically permit such inflight rest. That, however, is not what has happened. A draft advisory circular dated Jan. 4, 1993, would have permitted the napping, but it was never blessed and finalized. A spokesperson for the FAA stated that its legal department decided that an advisory circular was not the proper place to make the change to allow the napping. It had to go through the notice of proposed rulemaking process. At this time, therefore, 10 years later, controlled napping is not permitted on U.S. carriers, although some foreign carriers do permit it.
Even if the napping had been permitted, it would have included only three-member crews. Cmdr. David F. Neri (USN), former director of the Fatigue Countermeasures Program, explains that the concern for many people is that with a two-member crew, with one pilot intentionally napping, the other one might nod off. With the three-member crew, however, the two non-napping flightcrew members can act to ensure each other’s alertness. He said that one option could be for a flight attendant to come into the cockpit to be the third person who would ensure that the pilot who was supposed to be awake would not fall asleep. Other promising approaches might incorporate technology that continuously monitors the awake pilot’s vigilance level and produces an alert or other feedback when needed.
Could controlled napping ever have a place in short-haul operations? Cmdr. Neri thinks it might, particularly on overnight flights, but that would need to be studied, so don’t expect to see it soon. [ALPA’s position is that controlled napping is a Band-Aid solution and that a better solution is better regulations regarding flight and duty time limits and required rest.]
Some pilots with military experience may recall a system for fighting circadian rhythm problem that involves taking relaxants to induce sleep and stimulants to suppress it in flight. Cmdr. Neri says that this practice is not among the things NASA is looking at. Dr. Rosekind says that such practices should take place only under the supervision of flight surgeons, as is the case in the military, and only after the aircrews have first been administered such drugs on the ground to ensure that their bodies can tolerate them. He advises that over-the-counter sleep aids not be taken because they may not wear off in time for the flight. He is aware that British Harrier pilots were administered sleep-inducing medications on their way to the Falklands, and this proved beneficial in altering their circadian clocks. [Editor’s note: "Go pills" and "no-go pills," often amphetamines and tranquilizers, which are authorized for military pilots, are not allowed for airline pilots. Military pilots have used such drugs to improve performance since World War II; such use has recently been spotlighted in military hearings investigating "friendly fire" deaths in Afghanistan.]
So, here you are, in the cockpit, and you can’t stop yawning. You just know it’s going to be a long day/night. What can you do now? Now is definitely time for operational countermeasures, rather than preventive strategies.
Consideration should be given to physical activity, if practical. That doesn’t mean doing jumping jacks inside the cockpit, but it does mean that doing something is better than doing nothing. For example, more physical activity occurs in writing than in reading. Rewriting your will or filling out an ASRS report is better than staring into infinity.
|Fatigue can have severe consequences. We must take it seriously.|
Another consideration is that of "social interaction." In other words, conversation tends to keep people awake. Tell a funny story or get into a heated political argument if you have to (but don’t talk about the grandkids, as that deviates toward monotony), but keep talking.
Be vigilant for radio calls, but any you miss while conversing will be fewer than what you’d be missing if you were asleep. Unfortunately, the purists of the old school will argue that nothing should be discussed in the cockpit outside of the mission.
If you have time for a nap during a layover, by all means take advantage of the opportunity. This is particularly true for pilots hauling freight who must wait while packages are being sorted and the airplanes loaded.
A nap of 2 hours or any other duration is fine. After 2 hours, you’ve probably gone through a sleep cycle, and sleep inertia shouldn’t be a problem.
Some experts also recommend a "strategic" or "judicious" use of caffeine. "Strategic" does not mean downing caffeine pills by the handful.
Some modern airplanes have a system for alerting pilots if it detects no activity (e.g., moving a throttle, keying a microphone) for 5 minutes. While this would prevent both pilots from lapsing into a prolonged involuntary sleep, it won’t do much to prevent microsleep episodes.
Caffeine comes in many forms, including industrial-strength coffee, white pills, "Jolt" cola ("All the sugar and twice the caffeine"), chocolate, and tea, just to name a few. Not all drinks containing caffeine contain the same amount. Generally, brewed coffee has more caffeine than the instant type, which has more than a glass of iced tea.
You can build up a tolerance to caffeine. In other words, the person who seldom touches caffeine may be "wired" after a single cup of coffee, while a person who habitually ingests caffeine may hardly be phased by chugging several cups of a caffeinated drink.
Caffeine is a diuretic. In other words, it will cause more frequent trips to the lavatory. If your flight situation is such that frequent trips are impractical, then you ought to "think before you drink" that coffee. Caffeine is a stimulant, but it does take time (about 15-45 minutes after ingestion) to work. In other words, if you wait for your eyelids to be down and locked before you get your caffeine "hit," you’re definitely too late.
If you’re a real trooper, you might try chewing your caffeine pills rather that swallowing them, with the hope that the shock to your taste buds will give you a temporary lift; but if you do this often enough, even your taste buds will become accustomed to, and tolerant of, this taste.
Unless you have a sleep disorder like narcolepsy, your eyelids don’t simply close and your head drop without warning. Do your eyeballs tend to cross or their muscles pull in that direction? Do you tend to squint, even in the absence of bright lights? Do certain muscles in your face tighten or do some other muscles lose their effectiveness? Do you stare forward with your eyeballs caged?
Many of us have gone through training in the hyperbaric (altitude) chamber to determine our initial symptoms of hypoxia. If you know your initial symptoms, which can vary from person to person, you can take the proper action when you encounter them.
Few of us, however, notice initial symptoms for falling asleep. Sleep, like hypoxia, has its "insidious onset" and, depending on the situation, can be just as fatal. Taking caffeine upon encountering your first symptoms that sleep is on its way will put you ahead of the one who waits.
Some pilots may decide to slowly take caffeine ahead of their need for it, but who can determine ahead of time that it will be needed? If caffeine is a part of your pretakeoff checklist, you’re probably overdoing it.
Caffeine, like any other stimulant, eventually wears off, and the drop-off can be rather sudden. The sooner you take it, the sooner it wears off, so taking it very early in a flight, when you do not feel the least bit tired, may not be in your best interests.
Dr. Rosekind feels that fatigue has a lot in common with hypoxia and the effects of alcohol in that a person is generally not aware of its onset. People commonly underestimate the effect that alcohol is having on them when they’ve had a few drinks. Similarly, in NASA’s tests, in which pilots rated the effect of fatigue on their performance, they consistently underrated it.
While caffeine in any form is still caffeine, some persons of the old school feel that pills equal dope, so they condemn those who take caffeine pills. This is merely another example of the need for education, but old beliefs, like old habits, are hard to change.
Those who tell the caffeine pill users to simply "fight it and stay awake on your own!" are frequently among those who nod off, then lunge for the controls, trying to make a recovery from a perceived dive. (When the head drops forward, the semicircular canals notify the brain of the change in the head’s pitch. The half-awake brain, realizing that it is flying, assumes that this angle is caused by a sudden pitch down of the aircraft instead of a pitch down merely of the head.)
Will caffeine ultimately ruin a user’s bodily systems? That all depends on which report most recently hit the airwaves. You don’t have to watch many health segments on the evening news to hear about the latest report, refuting the previous report, on long-term effects of caffeine. Newscasts will tell you if caffeine will lead to good or bad health, while the newsmagazine shows will tell you if its use will lead to death or immortality. Cram enough of anything into a laboratory rat and you will kill it!
The one caution about caffeine that just about all doctors can agree with is that it should not be ingested shortly before bedtime. If the stimulant effects do not interfere with sleep, the diuretic effects certainly will.
As for the future, Cmdr. Neri says that NASA’s research will continue, examining various aspects of the fatigue problem, including a more in-depth analysis of the causes of fatigue. They’re looking at utilizing "video-based technology" to show the degradation of human performance caused by fatigue.
The Z-Team has developed an Education and Training Module, "Alertness Management in Flight Operations," in which people can attend a 2-day workshop at Ames concerning fatigue countermeasures. It is designed to "train the trainer," so that those who attend the workshop will provide training to others in their company.
Airlines, military, and corporate flight departments have been among those who have participated in this training. Then NTSB Chairman Jim Hall attended the training, and this led to a "Fatigue Symposium" on Nov. l-2, 1995, hosted by the NTSB and NASA and attended by some 600 participants from 16 countries.
The Module comes with the highest recommendation from those who have participated. Anyone interested in this program should call Z-Team Fatigue Lab coordinator Sandy Bowman at 650-604-6435.
Real physiological mechanisms underlie fatigue—we need our sleep, but that need, and the best way to satisfy that need, varies from person to person. No single "magic bullet"—no one countermeasure—will work for everyone in every situation, nor will a solution work for the same person in every situation.
Fatigue can have severe consequences. We must take it seriously.
Larry E. Nazimek, a freelance writer, wrote "It’s Official Now: No Pilot Shortage," May 1994. He points out that "the author is not a doctor, so nothing in this article should be taken as medical advice." He has read many articles and reports of sleep studies for this article and has interviewed experts. He has experienced sleep since birth, like everyone else, and has ingested enough caffeine to kill a laboratory rat. He would like to thank everyone who provided him with information for this article, particularly Sandy Bowman (Fatigue Lab coordinator, NASA Ames Research Center), Jay Evans (NBAA senior manager for Airmen and Operations), Bob Vandal (Flight Safety Foundation), Cmdr. David F. Neri, Ph.D., (former director of the Fatigue Countermeasures Program, NASA Ames Research Center), and Dr. Mark R. Rosekind (president and chief scientist, Alertness Solutions)."