Recurrent On-Duty Sleepiness and Alertness Management Strategies in Long-Haul Airline Pilots.

INTRODUCTION: We examined whether long-haul airline pilots without recurrent on-duty sleepiness obtain more prior sleep and use more effective in-flight alertness management strategies than their colleagues with recurrent on-duty sleepiness. METHODS: There were 51 pilots who flew at least twice from Helsinki to Asia. Of them, 44 flew at least twice back to Helsinki following 1 local night. On-duty sleepiness was measured by the Karolinska Sleepiness Scale (KSS), alertness management strategies by a diary, and sleep by a diary and activity monitor. Pilots who rated KSS ≥ 7 on each, some, or none of the flights were classified as "regularly", "sometimes", and "never" sleepy, respectively. This classification was performed separately for the outbound and inbound flights. RESULTS: On the outbound flights, 22% of the pilots were "never", 54% "sometimes", and 24% "regularly" sleepy. For the inbound flights, the respective distribution was 25%, 48%, and 27%. Compared to the "regularly" sleepy group, the "never" sleepy group obtained 54 min more night sleep prior to the outbound flights. For the inbound flights, the respective difference was 1 h 23 min. Also, the "never" sleepy pilots slept 31 min more between days off than the "regularly" sleepy pilots. The results of the in-flight alertness management strategies were mixed. DISCUSSION: The study demonstrates that pilots without recurrent on-duty sleepiness obtain more sleep than their colleagues with recurrent on-duty sleepiness. The result emphasizes the need to investigate whether the sleep of recurrently sleepy pilots can be increased and whether this increase would reduce their on-duty sleepiness.Sallinen M, Åkerstedt T, Härmä M, Henelius A, Ketola K, Leinikka M, Kecklund G, Sihvola M, Tuori A, Virkkala J, Puttonen S. Recurrent on-duty sleepiness and alertness management strategies in long-haul airline pilots. Aerosp Med Hum Perform. 2018; 89(7):601-608.

Shifting of attentional set is inadequate in severe burnout: Evidence from an event-related potential study.

Individuals with prolonged occupational stress often report difficulties in concentration. Work tasks often require the ability to switch back and forth between different contexts. Here, we studied the association between job burnout and task switching by recording event-related potentials (ERPs) time-locked to stimulus onset during a task with simultaneous cue-target presentation and unpredictable switches in the task. Participants were currently working people with severe, mild, or no burnout symptoms. In all groups, task performance was substantially slower immediately after task switch than during task repetition. However, the error rates were higher in the severe burnout group than in the mild burnout and control groups. Electrophysiological data revealed an increased parietal P3 response for the switch trials relative to repetition trials. Notably, the response was smaller in amplitude in the severe burnout group than in the other groups. The results suggest that severe burnout is associated with inadequate processing when rapid shifting of attention between tasks is required resulting in less accurate performance.

Job burnout is associated with dysfunctions in brain mechanisms of voluntary and involuntary attention.

Individuals with job burnout symptoms often report having cognitive difficulties, but related electrophysiological studies are scarce. We assessed the impact of burnout on performing a visual task with varying memory loads, and on involuntary attention switch to distractor sounds using scalp recordings of event-related potentials (ERPs). Task performance was comparable between burnout and control groups. The distractor sounds elicited a P3a response, which was reduced in the burnout group. This suggests burnout-related deficits in processing novel and potentially important events during task performance. In the burnout group, we also observed a decrease in working-memory related P3b responses over posterior scalp and increase over frontal areas. These results suggest that burnout is associated with deficits in cognitive control needed to monitor and update information in working memory. Successful task performance in burnout might require additional recruitment of anterior regions to compensate the decrement in posterior activity.

Alterations in attention capture to auditory emotional stimuli in job burnout: an event-related potential study.

Job burnout is a significant cause of work absenteeism. Evidence from behavioral studies and patient reports suggests that job burnout is associated with impairments of attention and decreased working capacity, and it has overlapping elements with depression, anxiety and sleep disturbances. Here, we examined the electrophysiological correlates of automatic sound change detection and involuntary attention allocation in job burnout using scalp recordings of event-related potentials (ERP). Volunteers with job burnout symptoms but without severe depression and anxiety disorders and their non-burnout controls were presented with natural speech sound stimuli (standard and nine deviants), as well as three rarely occurring speech sounds with strong emotional prosody. All stimuli elicited mismatch negativity (MMN) responses that were comparable in both groups. The groups differed with respect to the P3a, an ERP component reflecting involuntary shift of attention: job burnout group showed a shorter P3a latency in response to the emotionally negative stimulus, and a longer latency in response to the positive stimulus. Results indicate that in job burnout, automatic speech sound discrimination is intact, but there is an attention capture tendency that is faster for negative, and slower to positive information compared to that of controls.

Fast determination of MMN and P3a responses to linguistically and emotionally relevant changes in pseudoword stimuli.

We developed a new multi-feature mismatch negativity (MMN) paradigm with two improvements: Firstly, the standard tone, a pseudoword /ta-ta/ was presented with equal probability to the nine linguistically relevant deviants, reducing the recording time by 45%. Secondly, three rare, emotionally valenced stimuli: happy, angry, and sad utterances of the standard pseudoword were included in the sequence. MMN signals reflecting the perceptual properties of the sounds were observed for all stimuli. In addition, P3a signals were observed for the rare emotionally uttered pseudowords. This 28-min paradigm allows a multi-dimensional evaluation of central speech-sound representations (MMN), and attention allocation (P3a) to emotional information content of speech. We recommend this paradigm for studies on subject groups with impairments in language or emotional information processing, such as autism spectrum disorders, attention disorders, and alexithymia.