Introduction
snoring, fatigue, sleep loss
AVIATION ACCIDENT
In 2010, for the first time in an air crash investigation, a recording of snoring was
identified on a cockpit voice recorder (This is not an isolated instance of an aviation accident being attributed to fatigue.
In the last two decades, fatigue has been identified as the probable cause of 21–24%
of major aviation accidents, both in civil and military aviation (This definition identifies several possible causes of fatigue, with sleep loss
probably being the most notable. The optimal method of avoiding fatigue is to have
sufficient (night-time) sleep. However, this is often difficult to achieve,
especially during military deployments, because sleep in the field is often of
poorer quality and shorter duration than sleep at home (Regulations limiting flight times and suggesting optimal rosters have been
implemented by aviation authorities (Depending on the scenario, an alternative option is to prescribe stimulants, that is,
medications that increase vigilance and reduce fatigue. Although caffeine is widely
available, both in pills and beverages, aircrew members have reported that caffeine
supplements are ineffective, which might be due to the high daily caffeine
consumption of many (Modafinil is a relatively new wakefulness-promoting drug that has been approved as an
agent to counter fatigue by the air forces of Singapore, the United States, India,
and France (The present study aimed to determine the effect of a single dose of modafinil
(200 mg) on vigilance during a limited period of sleep deprivation compared with
those of placebo and a single dose of caffeine (300 mg). The period of sleep
deprivation was 24 h, and special attention was paid to the level of vigilance
during the WOCL. We expected both modafinil and caffeine to counteract the effects
of fatigue on vigilance compared with placebo, with the beneficial effects of
caffeine occurring earlier than those of modafinil due to the difference in
