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Dr. Michael J. Breus

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Pilot Trouble in the Skies: Did Lack of Sleep Play a Role?

Posted: 04/24/2012 8:00 pm

This story of a veteran Jet Blue pilot's breakdown during a cross-country flight made headlines recently. Now we're learning more about the details of what happened during the flight, and about the investigation into this frightening and disturbing episode. It's no surprise that investigators are exploring the role that fatigue, depression, and possible use of medications -- including medications for sleep -- may have played in the incident.

The pilot, a captain and a 12-year veteran of the airline, who according to news reports had an exemplary professional record, is alleged to have begun behaving strangely in the cockpit early in the flight. After ranting and speaking incoherently to his co-pilot and air traffic controllers on the ground, the pilot left the cockpit. He is alleged to have run through the cabin, shouting about a possible crash and the threat of terrorist attack. At the co-pilot's request, passengers apparently restrained the pilot, and the New York to Las Vegas flight made an emergency landing in Texas, where the pilot was taken into custody.

This incident is sad, disturbing and scary all at once. Obviously this is a frightening story for any and all of us who fly. It's also sad story for a pilot who by all reports had an exemplary record of service and who has been described in news stories as a "consummate professional."

And it's disturbing because of the frequency with which we're seeing problems in the airline industry, especially those related to sleep, fatigue and mental health.

Ever-changing shift schedules, long hours, and short rest periods put pilots and other airline professionals at high risk for sleep deprivation, sleep disorders, and the health risks associated with chronic sleep problems, including mental health issues like depression and anxiety. The National Sleep Foundation in March released a survey that examines transportation workers' sleep. The results show transportation workers in the U.S. struggling to get adequate sleep -- and pilots among the most sleep challenged:

  • 23 percent of pilots surveyed reported that sleeplessness had affected their job performance within the past week.
  • 20 percent of pilots said they'd made a "serious" error as a result of sleepiness.
  • 50 percent of pilots reported rarely or never getting a good night's sleep on work nights.
  • 37 percent said their work schedule did not allow time for adequate sleep.
  • Only 6 percent of pilots surveyed work the same schedule every day.

Sleep deprivation causes fatigue, poor judgment, difficulty with memory and learning, and a slowing of reaction time. There's also increasing evidence of a link between sleep problems and depression, as well as anxiety. Recent research has explored the complicated relationship between sleep and depression. In particular, the connection between disruptions to circadian rhythms and the incidence of depression and other mental health problems may have particular relevance for those who work in the airline industry, as well as anyone who does shift work.

The lifestyle of the Jet Blue pilot involved in this incident seems to have been typically fragmented. He is reported to have shared a small New York City apartment with several other pilots -- these crash pads are places where pilots and other in-flight airline personnel grab what shut-eye they can during their off-duty hours.

The FAA has recently made some changes to its regulations for pilot rest and time off, raising the minimum time off between shifts to 10 hours, from the current eight-hour minimum. These regulations, however, will not take effect until 2014.

The FAA also has recently changed its regulations regarding the use of prescription medication for depression, allowing its pilots the use of four antidepressants. Permission to fly while taking these medications is granted on a case-by-case basis, and pilots must be under doctor supervision. Side effects of these medications -- rare but real -- can include hallucinations and panic attacks. Nearly all sleep medication is prohibited by the FAA for pilots -- but that doesn't mean that sleep medications aren't being used by pilots who may be self-medicating to ward against fatigue. Sleep medications have their own set of side effects, which can affect behavior. Sleep medications can be an important and effective tool, but they must be monitored in order to ensure they're working appropriately and without side effects that can be disruptive or dangerous.

The FAA has made changes in response to several incidents in recent years involving pilot fatigue:

  • In 2008, a flight to Minneapolis overshot the runway by 150 miles after pilots fell asleep at the controls.
  • Also in 2008, a charter jet crash in Minnesota that killed eight people was blamed in part on sleep deprivation of both pilot and co-pilot.
  • A crash of a commercial jet in Buffalo, N.Y. that killed all passengers and crew was ultimately blamed in part on pilot fatigue.

Of course, the problems of the airline industry are not confined to pilots. I wrote recently about ongoing issues with air traffic controllers sleeping on duty. This has been a recurring problem in the industry for years. As with pilots, the FAA has recently revised its rules for air traffic controllers -- raising minimum time off between shifts, limiting the ability to swap shifts, controlling overnight shift schedules -- in an effort to address the problem of sleep deprivation and fatigue.

What we're seeing is that the efforts made so far are not enough. We don't know what was behind the breakdown of this particular pilot in this latest incident -- and we may never know. What's clear is that there is a problem within the industry at large with regard to sleep, fatigue and the rigors of shift work that has yet to be fully and adequately addressed.

Sweet Dreams,
Michael J. Breus, PhD
The Sleep Doctor™
www.thesleepdoctor.com

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