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March 28,  2003

AMC takes steps to prevent battle fatigue

By Master Sgt. Karen Petitt
Air Mobility Command Public Affairs

SCOTT AIR FORCE BASE, Ill. (AMCNS) - As coalition forces advanced toward Baghdad during the opening week of Operation Iraqi Freedom, some media outlets questioned: "Are they getting any sleep?"

Although this may not seem as important as the latest gain in territory, it is one Air Mobility Command leaders take seriously because fatigue can be a formidable foe of mission accomplishment and safety.

"We want to make sure that we can answer 'Yes, our troops are getting the sleep they need' because history has shown the disastrous effects of not considering the human cost of doing business," said Lt. Col. David O'Brien, AMC chief of aerospace medicine. "Fatigue during long, sustained operations becomes even more of an issue because we want our aircrews, maintainers, medical folks and anyone supporting these operations to be able to perform at their highest levels. And, a key element for them to perform at their best is to get the proper rest they need."

Colonel O'Brien said that managing fatigue isn't something just for aircrews and maintainers in a deployed location, but for family members and civilians who provide support operations at the home station as well.

"Many times we press forward, working long hours because we have the adrenalin pumping, and we don't want to miss out on anything," he said. "But, if we're not careful we can hurt the operations if we don't remember to take care of our health. Excessive fatigue impairs judgment, problem solving, reaction time and motor skills . all critical to war fighting."

An example of debilitating fatigue in sustained operations comes from World War II paratroopers at Normandy who were so tired that upon arrival at the beachhead they were "unable to understand words, even if an order was clearly expressed." 

One captain in charge of a unit said he spoke "jerkily in phrases" because he could not remember the thoughts that proceeded what he just said. Many died that day because fatigue hampered their ability to react or press forward. The Air Force also reports that at least 200 aircraft mishaps in the past three decades and countless ground incidents have been related in part to fatigue.

Just like the paratroopers, airmen involved with bringing the forces to the fight and sustaining them with aerial refuelings, airlifting supplies and humanitarian relief, and transporting patients must take measures to combat fatigue. 

He said research has shown that after 17 hours of wakefulness people operate at the same level as if they had a blood alcohol content of .05. After 24 hours of sleep deprivation, the BAC equivalent is .10 - the equivalent of consuming two beers or other alcoholic drinks in the average adult. 

"Most of us know that with a BAC of .05 we wouldn't be considered legally drunk, but we know that our judgment and driving skills are significantly decreased," said Colonel O'Brien. "Imagine trying to do our duties under the same conditions as being legally drunk, which in most states is .08."

Some people feel they must keep working and moving because if not they would be seen as weak or unmotivated. Colonel O'Brien explained that fatigue is not due to a lack of motivation or attitude, but rather fatigue undermines motivation and causes bad attitudes, and that poor performance is the ultimate price when proper steps are not taken to reduce fatigue. 

"Just as our president is making preparation to 'pay the bill' for the war in terms of money and resources, we know that investing in our people's physical, mental and emotional welfare is another bill we must pay. We live in a day of 24-hour operations, and while we can initially go for a couple of days with just a couple hours of sleep, there will come a time that we must get that eight-hour 're-supply.' Without that re-supply and physiological restoration, fatigue accumulates with the inevitable threat to performance, safety and mission accomplishment."

For deployed troops, their challenges may come with jet lag and working long hours in harsh conditions, but they may actually have an advantage over those back home who are also working 12 to 14 hour shifts, yet return home to fulfill the roles of parent, spouse, church member or other roles.

Lt. Col. Brian Campbell, chief of the 375th Airlift Wing Life Skills Support Center and an AMC facilitator, said that in deployed locations, steps are taken to ensure there's an environment where one could sleep or relax.

"At least the individual can go to his or her tent to regroup," he said. "What I'm finding with the folks back home is that their biggest concern is how to balance all the roles they play. When they're stressing about how to be the war fighter, spouse, parent, community member, etc., that can affect sleep habits and result in fatigue."

To help on the home front, Colonel Campbell and his staff are educating people about building effective planning skills into their lives.

"Part of keeping balance is taking care of our physical, social, spiritual, mental and emotional aspects of our lives. Physical balance includes exercising, eating right and getting enough sleep. It's absolutely critical to keeping ourselves alert and ready to do our tasks."

He is a certified facilitator for Stephen R. Covey's "The 7 Habits of Highly Effective People" and "What Matter's Most," and in his classes, he's discovered that the topic of sleep hygiene receives the most attention.

"Commanders are very concerned with how to correctly manage the effectiveness of sleep habits for their units, and realize that it's just as important to 'reconstitute' our bodies instead of pushing through a task or a mission without even a thought to how fatigue could hamper the mission," said Colonel Campbell.

Fatigue management has received recent attention throughout the Air Force and has prompted the Surgeon General to issue a statement to ask installation and medical group commanders to take the lead in helping the war fighters maintain the highest levels of performance. 

Through an Endurance Management Program, leaders will continue to educate and train Air Force members, civilians and families on fatigue management, work with supervisors to evaluate and enhance scheduling techniques to help mitigate unnecessary fatigue, and ensure medical providers are alert to recognize and intervene in stress-related illnesses.

"Good sleep hygiene is a readiness issue," added Colonel Campbell. "And while leadership is addressing this issue with programs and information, it's still up the us to use these techniques to improve our own ability to perform. I consider the books mandatory reading because they teach the skills needed to be successful with organizing our lives and attending to our highest priorities, allowing us to get the rest we need."