Efficacy of Temazepam for Improving Daytime Sleep and Night-Time Performance in Army Aviators

摘要

Army personnel are commonly rotated to a night shift, or reverse cycle, in order to have the 24-hour period manned at all times. Working reverse cycle presents problems to personnel due to the difficulty in maintaining alertness during the nighttime hours. This is especially difficult when the shift must be worked several consecutive nights, creating a cumulative sleep dept. Appropriate countermeasures are required to ensure that personnel obtain as much rest and sleep as possible during the time required to adjust to reverse cycle so they may perform their duties effectively. The first objective of this protocol was to determine whether a short-acting hypnotic, taken by an aviator before daytime sleep, would improve sleep quality as measured by objective and subjective means. The second objective was to determine whether improved daytime sleep would increase alertness, reduce fatigue, and mitigate the usual performance decrements which occur during a night shift, particularly when night duty extends over several nights. The third objective was to determine whether improved daytime sleep would affect the ability of the body's rhythm to adjust to reverse cycle more rapidly than when daytime sleep is left on its own. Sixteen U.S. Army aviators between the ages of 22 and 45 were recruited from Fort Rucker, Alabama, and other Army installations. Subjects were randomly assigned to either a temazepam or a placebo group with the constraint that only eight subjects per drug group were allowed. each subject completed several test sessions which consisted of cognitive batteries, flight simulation, sleepiness and electrophysiological evaluations, and mood state questionnaires. Subjects were tested during three baseline days, during three nights of reverse cycle, and during three days following return to day shift (recovery days).