This document kes bee. opproved for public release May 1969Ond sale; its distribution is unlimited. Prepared for:Office. ProblemMilitary equipment capable of operating for 48 hours oe longer is now being developed.When t'is equipment becomes available, military personnel will be able to participate in sustained rvmbat for longer periods of time than has ever before been possible. While technological advances will eiable this equipment to perform reliably over extended time periods, little is known about the effects of sustained combat on the personnel who will operate the equipment. If they re unable to maintain a satisfactory level of performance, then the new equpment will not be able to function at its maximum potential. New training programs will need to be developed, or changes in military doctrine will be necessary.A review of the psychological literature and military records pertaining to prolonged performance was conducted at the request of the U.S. Army Combat Developments Command Armor Agency. The review yielded little information about men's ability to perform for 48 hours or longer, and the information that was available often contained contradictions.In order to obtain more reliable information on sustained performance, a research program was developed to determine how performing for 48 hours without sleep would affect the efficiency of the work produced. Also studied were the effects of starting to perform in the morning compared to starting in the evening, and the effects of job rotation when it provides no additional rest time. ApproachThe subjects were 142 enlisted men trained in armor who were assigned to one of fourexperimental conditions. In three of these conditions, subjects worked for 48 hours with a 15-minute break after every 1% hours of work and a one-hour meal break every six hours, but with no additional time provided for sleeping., Subjects in the fourth (control) condition performed according to the same schedule except during the night hours, when they were allowed to sleep.Subjects were assigned to two-man teams. One member of each team tracked a continuously winding road on a driving simulator; the other member worked on a target detection task-attempting to detect brief, infrequent light signals preser-ted on a large screen. In two of the four experimental conditions, the subjects remained at the same task throughout the experiment; in the other two conditions, they rotated jobs after each 11/2 -hour period. In three conditions, the experiment began in the evening; in the fourth, it began in the morning., By comparing the performance scores of subjects in different pairs of conditions, the effects of sleep deprivation, starting time, and job rotation on performance were determined. ResultsSubjects who worked for 48 hours without time allotted for sleep performed significantly worse on the driving task than the control subjects, who were allowed to sleep from 0200 to 0700 each night., The difference in the performances of the two groups on the target detection task approached st...

Purpose Many institutions deploy pharmacy residents to expand clinical pharmacy services, often in the form of overnight, in-house on-call programs. There is little published evidence regarding pharmacy resident sleep and sleepiness after a night of overnight, in-house on-call activity. A prospective observational cohort study was conducted to determine the relationship between overnight, in-house on-call programs and pharmacy resident sleep and sleep quality. Methods The cohort study included both postgraduate year 1 and postgraduate year 2 pharmacy residents. Each resident participated in 10 to 15 overnight on-call shifts. Sleep and sleep quality were assessed using devices worn on residents’ wrists on the nights prior to, during, and after on-call shifts. Resident sleepiness was assessed via the Epworth Sleepiness Scale (ESS) during specified baseline and postcall periods. Univariate and multivariate analysis were used to assess the relationship between measurements of sleep, sleep quality, and sleepiness. Results We enrolled a total of 23 residents in the study and recorded data on 269 on-call shifts. Frequently (42.6% of shifts) residents had no time to sleep during overnight on-call shifts. Among those who did have sleep time, the mean sleep time during an overnight, in-house on-call shift was 1.22 (SD, 1.56) hours. Additionally, ESS scores indicated a 2.4-fold increase in sleepiness on the morning after vs the morning before on-call shifts. Conclusion Residents often did not sleep while on call. Sleep periods overnight were short and of poor quality. Predictably, residents reported increased sleepiness after an overnight on-call shift. Residents received an average of approximately 10 clinical consultation calls per overnight shift.

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