Prevalence and network analysis of internet addiction, depression and their associations with sleep quality among commercial airline pilots: A national survey in China

OBJECTIVE

Airline pilots are members of a unique occupational group that is often confronted with sleep routine disruptions, yet relatively few studies have examined their mental health status. This study assessed the prevalence and network structure of internet addiction, depression and sleep quality problems in commercial airline pilots.

METHOD

A total of 7055 airline pilots were included in analyses. Internet addiction and depression were measured with the Internet Addiction Test (IAT) and 9-item Patient Health Questionnaire (PHQ-9), respectively. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). The network model was constructed based on an Ising model and its association with sleep quality was evaluated using a flow procedure.

RESULTS

Internet addiction, depression and sleep quality were common among airline pilots. The prevalence of internet addiction was 8.0 % (95 % CI: 7.3-8.6 %), while the rates of depression and poor sleep quality were 23.3 % (95 % CI: 22.3-24.2 %) and 33.0 % (95 % CI: 31.9-34.1 %), respectively. In the depression and internet addiction network model, "Fatigue" (PHQ4; Expected Influence (EI): 2.04) and "Depressed/moody/nervous only while being offline" (IAT20; EI: 1.76) were most central symptoms while "Fatigue" (PHQ4; Bridge EI: 1.30) was also the most important bridge symptom. The flow network model of sleep quality with internet addiction and depression showed that "Appetite" (PHQ5) had the strongest positive association with poor sleep quality.

CONCLUSION

Internet addiction, depression and sleep quality were common among airline pilots and warrant regular screening and timely treatment. Strategies to improve sleep hygiene may be useful in preventing onsets or exacerbations in depression and internet addiction among airline pilots.

Sleep Patterns of Pilots: An Objective Assessment

Objectives Circadian dysregulation (jetlag), sleep loss (extended wakefulness), sleep deprivation (acute or chronic), fatigue (exhaustion), preexisting medical and mental conditions, and medication use can all affect the cognitive and behavioral performance of commercial aircraft pilots. This study evaluated the sleep habits of pilots and copilots flying short-haul flights in the Gulf region. Methods This cross-sectional study examined Airbus A320 pilots and copilots for one of Saudi Arabia's commercial airlines. Data such as age, sex, body mass index (BMI), employment position, work experience, flight hours, and rest time were collected. Each participant completed the Epworth Sleepiness Scale (ESS) for daytime sleepiness, the Pittsburgh Sleep Quality Index (PSQI), and the Fatigue Severity Index (FSI). Actigraphy equipment was used to perform objective sleep evaluations. Results Twenty-four participants were included. Actigraphy showed that 66.7% had an irregular sleep pattern and that 41.7% had poor sleep efficiency. We found that 12.5% had daytime sleepiness, 33% had poor sleep quality, and 29.2% had fatigue. We found a significant negative correlation between years of experience and time in bed; however, there was no significant difference in sleep time or sleep efficiency between pilots with different levels of experience. Conclusions We found that pilots and copilots are at risk of irregular sleep patterns, poor sleep efficiency, poor sleep quality, daytime sleepiness, and fatigue. This study emphasizes the need to instigate measures to minimize these risks.

Self-rated health (SRH), recovery from work, fatigue, and insomnia among commercial pilots concerning occupational and non-occupational factors

Background

This study investigated associations of self-rated health (SRH), recovery from work, fatigue, and insomnia with working conditions, the psychosocial work environment, lifestyle, and sense of coherence (SOC) among commercial pilots.

Methods

A standardized questionnaire was sent to all pilots in an airline company, of whom 354 (61%) responded. Associations were analyzed via ordinal and logistic regression with mutual adjustment.

Results

Overall, 21.8% of participants reported low SRH, 13.0% reported not recovering from work during their free time, 61.9% experienced fatigue, and 70.6% experienced insomnia symptoms. A high level of demand at work was associated with poor SRH and more fatigue, and low social support at work was associated with insomnia and poorer recovery from work. Habits surrounding exercise and BMI were associated with SRH. Part-time pilots and captains reported experiencing better recovery from work than their counterparts, while female pilots and younger pilots reported less fatigue. Amount of free time after work and the type of airplane operated were associated with experience of insomnia symptoms. Finally, having a strong sense of coherence was protectively associated with all health outcomes.

Conclusion

The psychosocial environment at work is essential for the health of pilots, and a strong sense of coherence can be protective. Occupational conditions may influence recovery from work, fatigue, and insomnia. Moreover, engaging in exercise, maintaining a healthy weight, working part-time, and having more free time after the working day could improve pilots' health.

Prevalence of sleep disorders in a large French cohort of aircrew members and risk of in-flight sleepiness

BACKGROUND

/objectives: Sleep disorders are a critical issue for flight safety. Previous studies have shown a high prevalence of sleep disorders and excessive sleepiness in the general population and some aircrews. The objectives of this study are to measure the prevalence of excessive daytime sleepiness and sleep disorders in aircrews, and to determine the risk factors of falling asleep during a flight.

METHODS

this is a monocentric study based on questionnaires, including all professional civilian and military aircrews examined in an aeromedical center between January and May 2021. The questionnaire, created for this study, included information about socio-demographic characteristics, aeronautical experience, lifestyle, sleep habits, an Epworth sleepiness scale, and screening tests for chronic insomnia, sleep apnea syndrome and restless legs syndrome.

RESULTS

749 aircrew members were included (86.2% male, 58.9% civilian, 74.1% pilot, mean age 43.4 ± 9.6 years), 45.9% of the population had at least one sleep disorder (chronic insomnia 39.5%, sleep apnea syndrome 10.5%, restless legs syndrome 4.1%), 15.5% had an excessive daytime sleepiness, and 24.6% reported in-flight sleep while on duty. Chronic insomnia, screen use before bedtime, use of sleeping pills, inadequate recovery time after a flight, female gender and civilian status were found as risk factors of in-flight sleep in the multivariate analysis.

CONCLUSION

this study emphasizes the need to improve the screening and prevention of sleep disorders in this particular population.