Basic and applied science interactions in fatigue understanding and risk mitigation

Effects of Sleep Deprivation on Performance during a Change Signal Task with Adaptive Dynamics

Augmented cognition, which refers to real-time modifications to a human-system interface to improve performance and includes dynamic task environments with automated adaptations, can serve to protect against performance impairment under challenging work conditions. However, the effectiveness of augmented cognition as a countermeasure for performance impairment due to sleep loss is unknown. Here, in a controlled laboratory study, an adaptive version of a Change Signal task was administered repeatedly to healthy adults randomized to 62 h of total sleep deprivation (TSD) or a rested control condition. In the computerized task, a left- or right-facing arrow was presented to start each trial. In a subset of trials, a second arrow facing the opposite direction was presented after a delay. Subjects were to respond within 1000 ms of the trial start by pressing the arrow key corresponding to the single arrow (Go trials) or to the second arrow when present (Change trials). The Change Signal Delay (CSD)-i.e., the delay between the appearance of the first and second arrows-was shortened following incorrect responses and lengthened following correct responses so that subsequent Change trials became easier or harder, respectively. The task featured two distinct CSD dynamics, which produced relatively stable low and high error rates when subjects were rested (Low and High Error Likelihood trials, respectively). During TSD, the High Error Likelihood trials produced the same, relatively high error rate, but the Low Error Likelihood trials produced a higher error rate than in the rested condition. Thus, sleep loss altered the effectiveness of the adaptive dynamics in the Change Signal task. A principal component analysis revealed that while subjects varied in their performance of the task along a single dominant dimension when rested, a second inter-individual differences dimension emerged during TSD. These findings suggest a need for further investigation of the interaction between augmented cognition approaches and sleep deprivation in order to determine whether and how augmented cognition can be relied upon as a countermeasure to performance impairment in operational settings with sleep loss.

Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society

CITATION

Risks associated with fatigue that accumulates during work shifts have historically been managed through working time arrangements that specify fixed maximum durations of work shifts and minimum durations of time off. By themselves, such arrangements are not sufficient to curb risks to performance, safety, and health caused by misalignment between work schedules and the biological regulation of waking alertness and sleep. Science-based approaches for determining shift duration and mitigating associated risks, while addressing operational needs, require: (1) a recognition of the factors contributing to fatigue and fatigue-related risks; (2) an understanding of evidence-based countermeasures that may reduce fatigue and/or fatigue-related risks; and (3) an informed approach to selecting workplace-specific strategies for managing work hours. We propose a series of guiding principles to assist stakeholders with designing a shift duration decision-making process that effectively balances the need to meet operational demands with the need to manage fatigue-related risks.

Usability and Effectiveness of Immersive Virtual Grocery Shopping for Assessing Cognitive Fatigue in Healthy Controls: Protocol for a Randomized Controlled Trial

BACKGROUND

Cognitive fatigue (CF) is a human response to stimulation and stress and is a common comorbidity in many medical conditions that can result in serious consequences; however, studying CF under controlled conditions is difficult. Immersive virtual reality provides an experimental environment that enables the precise measurement of the response of an individual to complex stimuli in a controlled environment.

OBJECTIVE

We aim to examine the development of an immersive virtual shopping experience to measure subjective and objective indicators of CF induced by instrumental activities of daily living.

METHODS

We will recruit 84 healthy participants (aged 18-75 years) for a 2-phase study. Phase 1 is a user experience study for testing the software functionality, user interface, and realism of the virtual shopping environment. Phase 2 uses a 3-arm randomized controlled trial to determine the effect that the immersive environment has on fatigue. Participants will be randomized into 1 of 3 conditions exploring fatigue response during a typical human activity (grocery shopping). The level of cognitive and emotional challenges will change during each activity. The primary outcome of phase 1 is the experience of user interface difficulties. The primary outcome of phase 2 is self-reported CF. The core secondary phase 2 outcomes include subjective cognitive load, change in task performance behavior, and eye tracking. Phase 2 uses within-subject repeated measures analysis of variance to compare pre- and postfatigue measures under 3 conditions (control, cognitive challenge, and emotional challenge).

RESULTS

This study was approved by the scientific review committee of the National Institute of Nursing Research and was identified as an exempt study by the institutional review board of the National Institutes of Health. Data collection will begin in spring 2021.

CONCLUSIONS

Immersive virtual reality may be a useful research platform for simulating the induction of CF associated with the cognitive and emotional challenges of instrumental activities of daily living.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04883359; http://clinicaltrials.gov/ct2/show/NCT04883359.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/28073.

Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society

Risks associated with fatigue that accumulates during work shifts have historically been managed through working time arrangements that specify fixed maximum durations of work shifts and minimum durations of time off. By themselves, such arrangements are not sufficient to curb risks to performance, safety, and health caused by misalignment between work schedules and the biological regulation of waking alertness and sleep. Science-based approaches for determining shift duration and mitigating associated risks, while addressing operational needs, require: (1) a recognition of the factors contributing to fatigue and fatigue-related risks; (2) an understanding of evidence-based countermeasures that may reduce fatigue and/or fatigue-related risks; and (3) an informed approach to selecting workplace-specific strategies for managing work hours. We propose a series of guiding principles to assist stakeholders with designing a shift duration decision-making process that effectively balances the need to meet operational demands with the need to manage fatigue-related risks.