Management of Circadian Desynchrony (Jetlag and Shiftlag) in CF Air Operations

http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA534917&Location=U2&doc=GetTRDoc.pdf


Management of Circadian Desynchrony
(Jetlag and Shiftlag) in CF Air Operations


Background: In response to operational difficulties resulting from the effects of fatigue
(secondary to jetlag and shiftlag) on performance of Air Force personnel, the Air Force funded a
4-year project to optimize Canadian Forces (CF) ability to manipulate circadian rhythms forwards or backwards to counter jetlag and shiftlag. This report presents the highlights of that work and offers recommendation for exploitation of this new capability to sustain operational readiness.
Methods: The project consisted of 7 studies. Four studies involved light treatment, 2 studies
involved efficacy comparisons of 3 melatonin formulations to produce a phase advance and a
phase delay, and the final study involved a combination of melatonin and light treatment.
Results: We identified the best 2 of 4 light treatment devices, confirmed optimal melatonin doses
and determined the correct treatment times with light and melatonin for circadian phase advance and phase delay. Discussion: We can now develop circadian treatments using light and melatonin along with shifting sleep/wake times and avoidance of light at key times across a broad range of operational scenarios. We are therefore in a position to exploit circadian phase shifting to counterjetlag and shiftlag. Recommendations: 1. That this knowledge-base be translated into an operational implementation plan through an interface with Air Force operational personnel. This should include the development of appropriate directives, and training of squadron personnel on the use of scheduling tools such as FAST™ (Fatigue Avoidance Scheduling Tool) for fatigue management. 2. That the Air Force aerospace medical community develop medical doctrine in the utilization of circadian interventions to improve and sustain operational readiness. This should include training Bioscience Officers in circadian physiology and how to generate circadian phaseshift protocols, and Flight Surgeons in the pharmaceutical management of circadian phase shifting with melatonin, light therapy, and sleep medications. 3. That the Surgeon General acquires several different melatonin dose sizes and formulations for the CF formulary, along with light treatment devices for use at squadron/wing level.


management of jetlag and shiftlag; melatonin; light treatment; circadian phase shifting;
circadian phase advance; circadian phase delayme