Mitigating fatigue on the flight deck: how is controlled rest used in practice?

Controlled Rest (CR) refers to a short, unscheduled, voluntary nap opportunity taken by pilots on the flight deck as a countermeasure to unanticipated fatigue in flight. This study explores the profile of CR use in a long-haul commercial airline. Forty-four pilots wore actiwatches and filled in an application-based sleep/work diary for approximately 2 weeks resulting in complete records from 239 flights. Timing of sleep periods and flight schedules were analyzed relative to home-base time. Pearson correlations were used to assess the influence of pilot demographics on CR use. A mixed-effects logistic regression was used to analyze the impact of schedule factors on CR. CR was taken on 46% (n = 110) of flights, with 80% (n = 106/133) of all CR attempts (accounting for multiple CR attempts on 23 flights) estimated by actigraphy to have successfully achieved sleep. Average sleep duration during successful rest periods was estimated as 31.7 ± 12.2 min. CR was more frequent on 2-pilot (69%, n = 83) vs. >2-pilot flights (23%, n = 27); return (60%, n = 71) vs. outbound flights (33%, n = 39); night (55%, n = 76) vs. day flights (34%, n = 34); and <10 h (63%, n = 80) vs. >10 h duration flights (27%, n = 30) (all p ≤ 0.001). There was no significant difference for direction of travel (eastbound: 51%, n = 57; westbound: 40%, n = 44; = .059). Of note, 22% (n = 26) of augmented flights contained both CR and bunk rest. Data from this airline show that CR is most commonly used on flights with 2-pilot crews (<10 h duration) and nighttime flights returning to base. Future studies are required to determine the generalizability of these results to other airlines.