The following questions and answers provide information that is available on a number of open-source websites.

Regulatory and Fatigue Risk Questions and Answers

Fatigue Driving Questions and Answers

Sleep Questions and Answers

Sleep Aids and Other Drugs Questions and Answers

Regulatory and Fatigue Risk Questions and Answers

What does the Code of Federal Regulations say about aviation maintenance technician (AMT) duty time?

Title 14 CFR Part 121.377 states within the United States, each certificate holder [or person performing maintenance or preventive maintenance functions for it] shall relieve each person performing maintenance or preventive maintenance from duty for a period of at least 24 consecutive hours during any seven consecutive days, or the equivalent thereof within any one calendar month.

What tools do you recommend to design a program to ensure maintenance crews are not fatigued?

Why is fatigue receiving so much attention now, when it has never been an issue in the past?

Fatigue has evolved substantially in recent years. As more people engage in shift-work and other alternative working arrangements, the potential for fatigue-related accidents increases. This risk is made worse by the increasing use of high-powered machinery, where the margin for error is lower and the potential consequences of accidents are serious. It is likely that the past few decades of applied R&D and International regulations on maintenance human factors has increased the global sensitivity to the issue. People generally believe this topic is important and has a high value return on investment.

Isn't a Fatigue Risk Management System (FRMS) just dictating to employees what they should do in their time away from work?

An FRMS is not about controlling employees' lives, but it is about setting an expectation that they arrive at work fit for duty. This includes managing their time away from work to ensure they receive adequate rest and sleep. If, for whatever reason, employees aren't able to get enough rest, it is their responsibility to report it as a potential risk. It's no different from rules about the number of hours you must wait between drinking alcohol and starting work.

How do you determine whether fatigue is a factor in accidents?

In accident statistics, fatigue is generally inferred from the time of day that the incident took place (midnight to 6 a.m.). Single vehicle accidents in which suicide has been ruled out are also included. Other factors that are considered include time on task (greater than 9 hours) and the work schedule of the previous seven days. You can see that this is not very exact — the contribution of fatigue to accidents is probably under-reported.

Can performance testing be used in the workplace as a check of fitness for duty?

Some workplaces may use performance tests for exactly that. However, there are a number of limitations. First, every employee must be tested against his or her own baseline (when they are not fatigued). Second, performance testing requires a lot of data management, and supervisors and employees need feedback right away. Third, it is difficult to draw a line at which an employee is "unfit for duty" based on the test. Tests can be used as a tool to determine how often and under what conditions employee performance is worse than normal.

Having mentioned the challenges, it can be done. Other industries like trucking, railroads, and mining are using technologies to monitor fatigue. In fact, a driver fatigue alerting system is a standard feature in the new Mercedes e350 sedan. So, it can be done.

What do you say to an employee who maintains he or she only requires 2 hours of sleep per night, and feels perfectly fine?

  • Fatigue Risk Management System for the Canadian Aviation Industry Trainer's Handbook
  • National Sleep Foundation - "Let Sleep Work for You" and other Hot Topics

I would tell them they are incorrect. They need more sleep. Research has found that most adults need 7-9 hours sleep. A small percentage of people can get by on less. More often what happens is that people get used to functioning on less sleep. Their standard of feeling wide awake and alert drops, and they get used to living and performing at a lower level of alertness. It becomes normal. When these same people take a long holiday, they usually sleep a lot more than what they usually get and feel a lot more alert. If you consistently report getting less than 7-9 hours' sleep, but don't display any fatigue-related symptoms, you're not likely to be a significant risk to the organization. However, conduct an experiment and try to get 7-9 hours sleep for a couple of weeks using asleep diary .If you feel a positive difference in your level of alertness, you should aim to get this much sleep on a more regular basis. On the other hand, if you still feel you can get by on less than 7 hours of sleep, you should consider seeing a doctor to find out whether your performance is really as good as it could be, or whether you may have a sleeping disorder.

How do I know if I have a sleep deficit?

Besides feeling tired all the time, one of the major signs of sleep deficit is sleep latency — how long it takes you to fall asleep. Normal sleep latency is approximately 15 minutes. If you need a lot less to fall asleep, it may mean that you have a sleep deficit — particularly if you fall asleep within one or two minutes, or find yourself falling asleep unintentionally. If you take a lot longer to fall asleep, you may be suffering from insomnia.

Why do we need to sleep?

Scientists don't know the exact reason we need to sleep, although it is clearly necessary to allow the body to recover from the stresses of the day. Humans that have suffered prolonged sleep deprivation experienced symptoms such as hand tremors, slurred speech, increased sensitivity to pain, and reduced mental and physical performance.

Does shiftwork have any impact upon pregnancy?

Although the effects of shiftwork on pregnancy are slight (only marginally higher than for day workers), there are some effects that are worth being aware of. Some types of shiftwork have been linked to increased time to conception, increased risk of premature birth, lower rates of fetal growth, and increased risk of miscarriage. Although these risks are slight, you may wish to discuss them with your doctor.

How prevalent is fatigue among AMTs?

In 2002, a study sponsored by the FAA concluded: The assessment of sleep duration showed that aviation maintenance technicians are receiving an average of 5 hours and 7 minutes of sleep per tonight. This finding indicates that many aviation maintenance technicians are working fatigued and represent a possible safety risk.

Johnson, W. B., Hall, S., & Watson, J.. (April, 2002) The current picture of rest among aviation maintenance technicians in airline environments. [Oral presentation] 16th Human Factors in Aviation Maintenance Symposium, San Francisco, CA.

When do maintenance fatigue related errors tend to occur?

A recent NASA study, "Maintenance Personnel Fatigue Related Incidents," suggests that maintenance errors tend to be more common in the wee hours. The study, which looked at more than 100 ASRS reports filed from 1990 to the present, indicated that 30.5 percent of the incidents occurred from 1 to 6 a.m. in the morning, 20 percent from 6 p.m. to midnight, and only 14.3 percent between 6 a.m. and noon local time. About one-fifth of the reports (21 percent) did not state a time.

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Fatigue Driving Questions and Answers

Where can I get information on how to implement a drowsy driver prevention program for shift workers?

The National Highway Traffic Safety Administration (NHTSA) in cooperation with the National Center on Sleep Disorders Research (NCSDR) at the National Institutes of Health (NIH) developed an education program to address the problem of drowsy driving among persons who work beyond the typical "9 to 5" workday (shift workers). Specifically, the objective of this program is to reduce the risk of fatigue-related motor vehicle crashes by improving the quality of sleep among shift workers. This guide provides a step by step program implementation.

I find that rolling down the window or listening to the radio or chewing gum helps me to stay awake when driving home. How effective are these strategies for reducing the risk of a fatigue-related accident?

Contrary to popular opinion, these techniques for staying alert while driving are not enough to safeguard you against falling asleep at the wheel or causing an accident.

These won't keep you awake while driving:

  • Turning up the volume of your radio.
  • Singing loudly.
  • Chewing gum or eating food.
  • Getting out of the car and running around.
  • Slapping yourself.
  • Sticking your head out the window.

What are some of the warning signs of drowsy driving?

  • You can't stop yawning.
  • You have trouble keeping your eyes open and focused, especially at stop lights.
  • Your mind wanders or you have disconnected thoughts.
  • You can't remember driving the last few miles.
  • Your driving becomes sloppy — you weave between lanes, tailgate or miss traffic signals.
  • You find yourself hitting the grooves or rumble strips on the side of the road.

Driving fatigued impairs your performance in a way that is similar to driving drunk. Even if you think you're okay, keep in mind that sleep can come when you're not expecting it. You are not always able to accurately judge just how sleepy you really are.

What groups are at the highest risk for drowsy driving?

  • - "Who's at Risk?"
  • NCSDR/NHTSA Expert Panel On Driver Fatigue and Sleepiness - "Drowsy Driving and Automobile Crashes"

The drivers at highest risk are:

  • Young people — especially males under age 26
  • Commercial drivers-especially long-haul drivers — at least 15% of all heavy truck crashes involve fatigue
  • People with undiagnosed or untreated disorders-people with untreated obstructive sleep apnea have been shown to have up to a seven times increased risk of falling asleep at the wheel
  • People with untreated sleep apnea syndrome and narcolepsy
  • Business travelers-who spend many hours driving or may be jet lagged

What are some good driver safety tips for AMTs with a long commute to work?

  • Maintain a regular sleep schedule.
  • When the signs of fatigue begin to show, get off the road. Take a short nap for 15-45 minutes in a well-lit area. Do not simply stop on the side of the road.
  • Avoid driving between midnight and 6am.
  • Get plenty of sleep.
  • Share driving responsibilities (car pool) with a companion.
  • Keep the temperature cool in the car.
  • Drive with correct posture — keep your head up, shoulders back and legs flexed at about a 45 degree angle.

How does sleepiness affect driving reaction time?

Just like drugs or alcohol, sleepiness slows reaction time, decreases awareness, and impairs judgment. Just like drugs or alcohol, it can be fatal when driving.

  • Death rates based on mileage were 2.3 times higher at night than during the day in 2003.
  • For many, shift work results in sleep deprivation, which can be risky when employees are behind the wheel.
  • According to the AAA Foundation, people at work who sleep only six hours and work more than 60 hours per week have 4 times increased risk for drowsy driving.
  • The specific at-risk group for drowsy-driving-related crashes comprises people who drive after having not slept enough, qualitatively or quantitatively.
  • 37% of drivers surveyed by the National Highway Traffic Safety Administration admitted to falling asleep at the wheel at some point in their driving career.
    • 8% admitted doing so in the past six months
    • 60% admitted falling asleep while driving on an interstate- type of highway with posted speeds of 55 MPH or higher.

Where can I find information about driving fatigued?

What should I do if I feel tired or drowsy while driving?


What should I do when I feel drowsy after my shift is over and it's time to drive home?

Avoid driving home from work if you're drowsy. Some experts recommend drinking two cups of coffee, then taking a short 15-20 minute nap. You'll get some sleep before the caffeine takes effect, and when it does, you'll wake up and be alert for your drive home.

  • Avoid alcohol or any medications that could make you drowsy.
  • Carpool if possible, so that you're driving with someone else awake in the car or get a ride from a family member.
  • Take a taxi or public transportation.
  • If you hit a rumble strip, it's a sure sign that you need to pull off to a safe place, take a nap, or get some coffee.

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Sleep Questions and Answers

What are circadian rhythms?

Our internal circadian biological clock regulates the timing of periods of sleepiness and wakefulness throughout the day. The circadian rhythm dips and rises at different times of the day, so adults' strongest sleep drive generally occurs between 2:00-6:00 am and in the afternoon between 1:00-3:00 p.m., although there is some variation depending on whether you are a "morning person" or "evening person." The sleepiness we experience during these circadian dips will be less intense if we have had sufficient sleep, and more intense when we are sleep deprived.

When is the human body most susceptible to the effects of fatigue?

  • National Sleep Foundation - "Sleep Drive and Your Body Clock"

The lowest point in the circadian rhythms that affect the body's alertness is between 2 a.m. and 6 a.m. and in the afternoon between 1:00-3:00 p.m., If you wake from a nap in this period, remember that you're likely to experience sluggishness (sleep inertia). Sleep inertia refers to the feeling of grogginess most people experience after awakening. Sleep inertia can last from 1 minute to 4 hours, but typically lasts 15-30 minutes. During this period, you are at a reduced level of capacity and may have trouble doing even simple everyday actions.

Is there an ideal length for a nap?

If you are really fighting sleep, and are trying to perform a job that involves any level of risk (e.g., driving, engine overhaul, refueling), any nap is better than no nap. Research has found that naps as short as 10 minutes can be effective in increasing alertness. The longer the nap, the longer the benefits will last. However, longer naps are also associated with longer periods of sleep inertia (that groggy feeling when you wake up). When napping is permitted in the workplace, it should be limited to about 40 minutes. Read more information on naps from the Boston Globe.

I have difficulty falling asleep, could I have Insomnia?

Difficulty falling asleep is but one of four symptoms generally associated with insomnia. The others include waking up too early and not being able to fall back asleep, frequent awakenings, and waking up feeling unrefreshed. Insomnia can be a symptom of a sleep disorder or other medical or psychological/psychiatric problem, and can often be treated. According to the National Sleep Foundation's 2002 Sleep in America poll, 58 percent of adults in this country reported at least one symptom of insomnia in the past year. When insomnia symptoms occur more than a few times a week and affect a person's daytime functioning, the symptoms should be discussed with a doctor or other health care provider.

Does daytime sleepiness always means a person isn't getting enough sleep?


What can I do to protect myself against fatigue during the night shift?

  • Avoid long commutes and extended hours.
  • Take short nap breaks throughout the shift.
  • Work with others to help keep you alert.
  • Try to be active during breaks (e.g., take a walk, shoot hoops in the parking lot, or even exercise).
  • Drink a caffeinated beverage (coffee, tea, colas) to help maintain alertness during the shift.
  • Don't leave the most tedious or boring tasks to the end of your shift when you are apt to feel the drowsiest. Night shift workers are most sleepy around 4-5 a.m.
  • Exchange ideas with your colleagues on ways to cope with the problems of shift work. Set up a support group at work so that you can discuss these issues and learn from each other.

What are the physical, mental, and emotional symptoms associated with fatigue?

  • Difficulty concentrating
  • Trouble focusing with eyes
  • Poor hand eye coordination
  • Feeling sluggish or tired
  • Excessive blinking
  • Constant yawning
  • Headache
  • Reduced immune system function
  • Appetite loss
  • Short term memory problems
  • Dizziness
  • Sore or aching muscles
  • Muscle weakness
  • Slowed reflexes and responses
  • Irritability
  • Low motivation

How much sleep do I really need?

Newborns (1-2 months): 10.5-18 hours

Infants (3-11 months): 9-12 hours during night and 30-minute to two-hour naps, one to four times a day

Toddlers (1-3 years): 12-14 hours

Preschoolers (3-5 years): 11-13 hours

School-aged Children (5-12 years): 10-11 hours

Teens (11-17): 8.5 - 9.25 hours

Adults: 7-9 hours

Older Adults: 7-9 hours

I know people who perform well on less than the recommended 7-9 hours per night, any studies to support this?

Sleep experts say most adults need between seven and nine hours of sleep each night for optimum performance, health and safety. When we don't get adequate sleep, we accumulate a sleep debt that can be difficult to "pay back" if it becomes too big. The resulting sleep deprivation has been linked to health problems such as obesity and high blood pressure, negative mood and behavior, decreased productivity, and safety issues in the home, on the job, and on the road. So even if the effects of too little sleep aren't immediately noticeable, it's only a matter of time before they catch up to you.

Are health problems such as obesity, diabetes, hypertension, and depression related to the amount and quality of a person's sleep?


Isn't snoring a harmless problem?

Although snoring is harmless for most people, it can be a symptom of a life threatening sleep disorder called sleep apnea, especially if it is accompanied by severe daytime sleepiness. Sleep apnea is characterized by pauses in breathing that prevent air from flowing into or out of a sleeping person's airways. People with sleep apnea awaken frequently during the night gasping for breath. It can reduce blood oxygen levels, strain the heart and cardiovascular system, and increase the risk of cardiovascular disease. Snoring on a frequent or regular basis has been directly associated with hypertension. Obesity and a large neck can contribute to sleep apnea. Sleep apnea can be treated; men and women who snore loudly, especially if pauses in the snoring are noted, should consult a physician.

What should I do when I have difficulty falling asleep and/or staying asleep?

  • Don't use your bed for anything other than sleep or intimate moments. Your bed should be associated with sleep.
  • Consider your sleep environment. Make it as pleasant, comfortable, dark and quiet as you can.
  • Establish a regular, relaxing bedtime routine that will allow you to unwind and send a "signal" to your brain that it's time to sleep. Avoiding exposure to bright light before bedtime and taking a hot bath may help.
  • If you can't go to sleep after 30 minutes, don't stay in bed tossing and turning. Get up and involve yourself in a relaxing activity, such as listening to soothing music or reading, until you feel sleepy. Remember: Try to clear your mind; don't use this time to solve your daily problems.

Is it true, the older you get, the fewer hours of sleep you need?

Sleep experts recommend a range of seven to nine hours of sleep for the average adult. While sleep patterns change as we age, the amount of sleep we need generally does not. Older people may wake more frequently through the night and may actually get less nighttime sleep, but their sleep need is no less than younger adults. Because they may sleep less during the night, older people tend to sleep more during the day. Naps planned as part of a regular daily routine can be useful in reducing fatigue and promoting wakefulness.

Does your brain rest during sleep?

The body rests during sleep, however, the brain remains active, gets "recharged," and still controls many body functions (e.g., breathing). When we sleep, we typically drift between two sleep states, REM (rapid eye movement) and non-REM, in 90-minute cycles. Non-REM sleep has four stages with distinct features, ranging from stage one drowsiness, when one can be easily awakened, to "deep sleep" stages three and four, when awakenings are more difficult and where the most positive and restorative effects of sleep occur. However, even in the deepest non-REM sleep, our minds can still process information. REM sleep is an active sleep where dreams occur, breathing and heart rate increase and become irregular, muscles relax and eyes move back and forth under the eyelids.

When I wake up in the middle of the night, is it best to lie in bed, count sheep, or toss and turn until I eventually fall back asleep?


What foods can help me sleep?

We all know the idea behind turkey and sleepiness. Certain foods such as turkey contain an amino acid called tryptophan that causes sleepiness, potentially resulting in post-Thanksgiving dinner naps everywhere. There is some debate over whether or not this is true. Some believe turkey doesn't contain enough tryptophan to be effective. Were you aware that other foods, like popcorn, may have a similar effect? Examples of several foods that potentially increase sleepiness are a small slice of angel food cake topped with berries or half a cup of pasta topped with marinara sauce. The trick is to increase your carbohydrate intake. Carbs make tryptophan more available to the brain, which is why carbohydrate-heavy meals can make you drowsy. Proteins from the food we eat are the building blocks of tryptophan, which is why the best bedtime snack is one that contains both a carbohydrate and protein. Remember, don't eat or drink too close to bedtime.

What foods can help me stay awake?

There are plenty of foods and beverages that can keep you up at night, intentionally or not. The most widely known "pick me up" is caffeine. Caffeine is a stimulant that works by blocking the action of hormones in the brain that makes us feel sleepy. A strong dose of caffeine can stimulate the mind for a short time but also can cause an alertness crash as the effect wears off and consuming excessive amounts of caffeine may lead to increased tolerance. The best way to benefit from the stimulating effect of caffeine is to consume small amounts frequently throughout the day. Certain foods can be associated with reflux events, which can cause coughing or choking while sleeping or attempting to sleep. These foods include citrus fruits, chocolate, fatty and fried foods, garlic and onions, mint flavorings, spicy foods, or tomato-based foods, such as spaghetti sauce, chili and pizza. So stay away from that five-alarm chili, and remember not to eat or drink too much close to bedtime.

What are some healthy sleep habits?

We all have moments where we just can't sleep, and some of us suffer from disorders or problems that make it near impossible to get a good night's rest. But regardless of what's causing your sleep problems, it is important to establish and maintain healthy sleep habits. Think of these habits as ground rules that should always apply, like shutting off the power before changing a light bulb or looking both ways before crossing the road.

Here are five healthy habits that can help you sleep well:

  • Use the bed and bedroom for sleep and sex only.
  • Establish a regular bedtime routine and a regular sleep-wake schedule.
  • Do not eat or drink too much close to bedtime.
  • Create a sleep-promoting environment that is dark, cool and comfortable.
  • Avoid disturbing noises — consider a bed-side fan or white-noise machine to block out disturbing sounds.

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Sleep Aids and Other Drugs Questions and Answers

Caffeine doesn't seem to affect me at all — in fact, if I don't have a coffee before bed, I wake up with a headache. Why is that?

Caffeine is only effective when used strategically. People who regularly drink caffeine will not get the same level of stimulation as people who only drink caffeine when they are tired and need a kick. Caffeine is addictive. Regular caffeine drinkers who suddenly stop often experience headaches, dizziness, and/or nausea. If you wake up with a headache when you don't have a coffee before bed, it may mean that your body is over-dependent on caffeine.

I drink coffee in the morning to wake-up, how does caffeine affect my sleep?


Caffeine is a stimulant. In moderate doses, it can:

  • Increase alertness
  • Reduce fine motor coordination
  • Cause insomnia
  • Cause headaches, nervousness and dizziness

It has also been known to result in:

  • Anxiety
  • Irritability
  • Rapid heartbeat
  • Excessive urination
  • Sleep disturbance
  • A "caffeine crash" once the effects wear off

I sometimes have a night-cap to help me fall asleep, how does alcohol affect my sleep?

Many people use beer, wine, or other alcoholic beverages at bedtime to help them fall asleep. This is unfortunate considering that alcohol is a poor sleep aid. Alcohol may help you to relax and fall asleep in the short term, but it disrupts sleep over the course of the night. It can keep you from entering the deeper stages of sleep and cause you to wake up feeling tired despite spending an adequate amount of time in bed.

Would you encourage the use of sleeping pills as an aid to getting enough sleep?

If you cannot sleep at all, or have a lot of difficulty getting to sleep, sleeping pills can be an effective strategy to retrain your body to sleep. However, you shouldn't use them over the long term because you can develop a dependency on sleeping pills after just one week. Long-term use of sleeping pills can cause irritability, headaches, nausea, depression, muscle loss, and increased appetite. You should use them only for short periods.

How do energy drinks affect fatigue and sleep?

Based solely on the advertising campaigns, you would think that energy drinks have the power to turn mortal men into superheroes. In reality, most energy drinks are made with caffeine, essential amino acids, and loads of sugar. Rather than give you wings, these ingredients may increase sleepiness after an initial short-lived alerting affect. There is no magic drink on the market that will allow you to safely skimp on sleep. The only effective way to combat fatigue is to get adequate sleep on a regular basis.

How should I use caffeine to help me when I'm fatigued?

The best way to benefit from the stimulating effect of caffeine is to consume small amounts frequently throughout the day when necessary to avoid the effects of fatigue. Be careful not to consume caffeine too close to bedtime as its effect may persist for several hours.

I'd like to keep track of my sleep, what do you recommend?

A sleep log will help you keep track of your actual sleeping hours and often reveals that people don't get as much sleep as they thought.

Fill out this Sleep Log (PDF) for the previous day and night no more than 3 hours after waking up. Estimations are okay, because detailed accuracy is not essential. You may also try this Interactive Sleep Log (MS Excel).

We all overestimate our actual hours of sleep. AMTS are vulnerable to having poor sleep habits because of shiftwork and long commutes to work. You may not recognize the connection between insufficient sleep and fatigue during your duty period, but it is a common problem in today's society.

To help you accurately track your sleep and assess your sleep habits, we have developed this interactive sleep log to total your sleep each day and calculate your average sleep period, number of awakenings, and sleep ratings per week.

To begin, you must input your daily bedtime and wake-time in week 1.

For more information on how to improve your sleep habits/hygiene, view Sleep Hygiene and learn the essentials (e.g., personal habits, sleeping environment, getting ready for bed, getting up in the middle of the night, watching TV, and other factors).

Can smoking a cigarette before bedtime help me sleep?

Cigarettes are likely to keep you awake because nicotine is a stimulant. Smoking a cigarette can have effects similar to drinking a cup of coffee.

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