The Aerospace Medical Association’s Annual Scientific Meeting was recently held this past May in Chicago, Illinois. Aerospace medicine concerns the health, well-being, safety, and performance of persons involved in aviation and space travel. AsMA provides a forum for aerospace medicine specialists, flight nurses, physiologists, psychologists, human factors specialists, physician assistants, and researchers to come together and share their expertise. AsMA areas of interest range from space to atmospheric flight to undersea activities and study a wide spectrum extending from the microenvironments of space to the increased pressures of undersea activities. This kind of research helps aerospace medicine professionals ensure participants are physically prepared, physiologically safe, and perform at the highest levels.
IBR Director of Sleep Science Dr. Jaime K. Devine had the pleasure of attending this year’s AsMA conference, which included a full-day workshop on fatigue in aviation. The workshop focused on fatigue in relation to sleep deprivation and circadian misalignment. While fatigue due to workload was briefly discussed, not enough is known about the effects of workload on cognitive performance to cover the material in a concise one-day workshop. As we’ve mentioned in previous blog posts, fatigue due to sleep and circadian factors is easier to model. Night operations, transmeridian travel, and sleep data can be measured objectively, but the best way to measure workload is still through a subjective self-report survey like the NASA Task Load Index (TLX). SAFTE-FAST allows users to model workload using their best judgment or input from the NASA TLX or any other workload survey to set triggers and weights for predictable workload factors like the number of flight segments during a duty period or the difficulty of landing at a specific airport.
The workshop instead focused on the cultural, technological, and biological components of fatigue due to sleep deprivation and circadian misalignment, followed by the relationship between sleep and health, and finally, countermeasures and fatigue monitoring systems. Cultural factors that contribute to fatigue include a disregard for sleep or machismo idealism that “sleep is for the weak”. Technology plays a role by increasing the amount of available light, which allows us to work later, and increasing the number of fun things to do, which may be why we are all playing on our phones at night instead of sleeping. Technology is also key to the human ability to traverse the globe and explore the heavens. The advent of flight has been an amazing achievement for humanity, but also means that we are frequently working against our own biological programming. The circadian rhythm was not designed for jet-setting.
Objective fatigue monitoring is also a tricky issue since the most frequently used measure, the psychomotor vigilance task (PVT), needs to be compared against a well-rested baseline. There is no instantaneous breathalyzer test for fatigue. The workshop speakers suggested that the best real-time measure of fatigue may be a combination of wrist actigraphy and biomathematical modeling. IBR agrees with this idea and is developing the SleepTank mobile app as a way for individual workers to monitor their own alertness in relation to their sleep history using consumer wearables like Fitbit, Oura, Garmin, or WHOOP.
There was more to the AsMA conference than just fatigue, of course. The meeting theme was “Honoring the Past ... Preparing for the Future.” One obvious reason for this choice of theme is that NASA is planning to go back to the moon for the first time since the 1970s. The NASA Artemis missions have the goal of returning to the moon before the end of this decade: https://www.nasa.gov/feature/artemis/. Many of the sessions at AsMA 2024 focused on the science of preparing astronauts for long-term missions to the moon and, someday, Mars. One of our favorite talks from the NASA Ames Fatigue Countermeasures Laboratory discussed sleeping arrangements and predictions of alertness for astronauts on the International Space Station.
Keynote speakers included geologist, former Senator, and astronaut Dr. Harrison Schmitt, who went to the moon in 1972. Dr. Schmitt discussed logistical considerations for future off-world missions. His talk illuminated the practical knowledge of a man who has literally walked on the moon with tips like testing astronauts for moon dust allergies before clearing them for a mission and wearing gloves under your spacesuit to avoid chafing. He also showed a video clip where comedian Norm MacDonald makes fun of him. See the full clip here.
Another keynote speaker was the Director of the Carl Sagan Institute, Dr. Lisa Kaltenegger. Dr. Kaltenegger described how astrophysicists identify potentially habitable worlds (aka, “Goldilocks worlds”) using telescopes. So far, scientists have identified over 5000 planets and estimate that one out of every five planets could be a Goldilocks. Dr. Kaltnegger recently published a book on this topic called “Alien Earths: Planet Hunting in the Cosmos”.
Back on Earth, aviation medicine sessions discussed hypoxia, mental health and personality traits in pilots, incidence and treatment options for obstructive sleep apnea, fatigue due to long COVID, and the pros and cons of therapeutic use of psychedelics in aviators. A special panel honored women pioneers in aerospace medicine. The conference was fully packed with five days of sessions running from before 0800 until after 1500 every day, followed by additional meetings and events. While it was impossible to attend every session, it was a wonderful chance to learn more about aerospace medicine and connect with SAFTE-FAST users on this planet, as well as those trying to get to another planet.
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