Caldwell John A, Caldwell J Lynn, Schmidt Regina M
Archinoetics, LLC, Topa Financial Center, Honolulu, HI 96813, USA.
Sleep Med Rev. 2008 Aug;12(4):257-73. doi: 10.1016/j.smrv.2008.01.002. Epub 2008 Mar 21.
This review addresses the problem of fatigue (on-the-job-sleepiness) attributable to sleep loss in modern society and the scientifically proven strategies useful for reducing fatigue-related risks. Fatigue has become pervasive because many people work non-standard schedules, and/or they consistently fail to obtain sufficient sleep. Sleep restriction, sleep deprivation, and circadian desynchronization produce a variety of decrements in cognitive performance as well as an array of occupational and health risks. A number of real-world mishaps have resulted from performance failures associated with operator sleepiness. In some cases, fatigue/sleepiness is unavoidable, at least temporarily, due to job-related or other factors, but in other cases, fatigue/sleepiness results from poor personal choices. Furthermore, some individuals are more vulnerable to the effects of sleep loss than others. Fortunately, fatigue-related risks can be mitigated with scientifically valid alertness-management strategies. Proper work/rest scheduling and good sleep hygiene are of primary importance. If sleep time is available but sleep is difficult to obtain, sleep-inducing medications and behavioral circadian-adjustment strategies are key. In fatiguing situations such as when sleep opportunities are temporarily inadequate, limiting time on tasks, strategic napping, and the potential use of alertness-enhancing compounds must be considered. To optimize any alertness-management program, everyone must first be educated about the nature of the problem and the manner in which accepted remedies should be implemented. In the near future, objective fatigue-detection technologies may contribute substantially to the alleviation of fatigue-related risks in real-world operations.
本综述探讨了现代社会中因睡眠不足导致的疲劳（工作时困倦）问题，以及经科学验证的有助于降低与疲劳相关风险的策略。疲劳现象已普遍存在，因为许多人工作时间不规律，和/或始终无法获得充足睡眠。睡眠限制、睡眠剥夺和昼夜节律失调会导致认知能力出现多种下降，以及一系列职业和健康风险。一些现实世界中的事故是由与操作员困倦相关的操作失误导致的。在某些情况下，由于工作相关或其他因素，疲劳/困倦至少在短期内是不可避免的，但在其他情况下，疲劳/困倦是个人选择不当造成的。此外，有些人比其他人更容易受到睡眠不足的影响。幸运的是，通过科学有效的警觉性管理策略，可以减轻与疲劳相关的风险。合理的工作/休息安排和良好的睡眠卫生至关重要。如果有睡眠时间但难以入睡，助眠药物和行为昼夜节律调整策略是关键。在诸如睡眠机会暂时不足的疲劳情况下，必须考虑限制任务时间、策略性小睡以及潜在使用提高警觉性的化合物。为了优化任何警觉性管理计划，首先必须让每个人了解问题的本质以及应如何实施公认的补救措施。在不久的将来，客观的疲劳检测技术可能会对减轻现实世界操作中与疲劳相关的风险做出重大贡献。
