Too Sleepy to Drive? How Can You Really Know?
We've all been there: That moment behind the wheel when your head snaps upright and you realize you just dozed for a brief second.
- What if that sleepy operator were the pilot of the plane taking you from New York to San Francisco?
- What if it's the driver of the semi truck barreling toward you with a full load of flammables on board?
- What if it's the driver of a tank during wartime, disoriented and trying to figure out where the front line—and the enemy—are?
Most researchers studying sleep examine disorders such as narcolepsy, apnea, or insomnia. Only four research centers in the nation examine the effects of sleep on performance primarily in "normals"—the people with no known sleep disorder who make up the vast majority of the population.
One of these four centers is at WSU Spokane.
Dr. Gregory Belenky examines these critical questions of sleep and performance in normal people going about their everyday lives. He works closely with basic science colleagues in Pullman; the Spokane sleep medicine community; and sleep and human performance researchers joining him at WSU Spokane to create a full spectrum, integrated program in sleep ranging from basic laboratory science through applications of the discoveries there to clinical research.
Their work could change the way we view—and manage—our sleep: as the critical performance resource it really is.
How do we study sleep and performance?
The technology to conduct these studies has been developed over the past 20 years at the Walter Reed Army Institute of Research, where Dr. Belenky previously conducted his research.
He holds the patent on the system and method for predicting human cognitive performance using two devices:
- the sleep watch actigraph, an unobtrusive device worn on the wrist that measures arm movement, from which a sleep/wake history can be obtained over months of continuous recording;
- a Palm Pilot or equivalent personal data assistant (PDA) used to administer cognitive tests by which performance can be measured daily for months as well.
The combined use of these devices enables the objective measurement of sleep and of performance and the tracking of the impact of varying amounts of sleep on performance over time.
This method enables the identification of high-risk schedules on the one hand, and contributes to the development of mathematical models to predict performance on the basis of prior sleep on the other—mathematical models that will be critical to any effort to effectively manage sleep to sustain performance.
Studies are being developed in a variety of populations:
- crews flying refueling missions from Fairchild Air Force Base;
- patrol officers in the Spokane Police Department;
- medical interns and residents in the University of Washington residency programs in Spokane;
- workers pulling long shifts in an FDA-approved manufacturing plant (Hollister-Stier).
Supplemented by in-residence laboratory studies, these studies will break new ground in the study of sleep and performance, bringing the science of sleep and sleep medicine to bear on operational and clinical populations and elucidating the true impact of sleep restriction on performance and subsequent recovery.
The effect of sleep restriction and recovery on performance in normal people is a major focus of funding efforts in sleep in the next five years at the National Institutes of Health, as well as at the Department of Defense, Department of Transportation, and Department of Justice; it is also of interest to the Department of Health and Human Services.
More about Gregory Belenky
Before coming to WSU Spokane to launch the Sleep and Performance Research Initiative—the first focus area of the Spokane Alliance for Medical Research—Gregory Belenky held the rank of colonel in the U.S. Army Medical Corps, and served as director of the Division of Neuroscience at the Walter Reed Army Institute of Research (WRAIR).
Dr. Belenky's research ranges from basic to applied and includes sleep, sleep deprivation, and continuous operations; combat stress reactions and post-traumatic stress disorder; and the neurobiology of human behavior and adaptation. His work has been funded by the Department of Defense, Department of Labor, and other sources.
During Dr. Belenky's stewardship at WRAIR, the program grew in national and international stature, producing groundbreaking research and publications in the areas of brain imaging in sleep and sleep deprivation, the performance effects of stimulants and sleep-inducing drugs, and the effects of chronic sleep restriction on performance. Dr. Belenky received his M.D. from Stanford University, studying with the "father of sleep research" himself, Dr. William Dement, and a B.A. in psychology from Yale University. He is a Fellow of the American Psychiatric Association; a member of the American Academy of Sleep Medicine, the Sleep Research Society, and the European Sleep Research Society; and serves on the Board of Directors of the National Sleep Foundation.
Dr. Belenky pioneered the development of non-invasive ambulatory sleep/wake monitoring techniques and Palm OS-based performance tests such as the Palm Pilot Psychomotor Vigilance Task, for the first time making possible studies of sleep and performance in normal (and clinical) populations going about their daily lives. He holds several patents on the Sleep Watch, the core of the U.S. Army's developing Sleep Management System, a tool to enable commanders to effectively manage sleep to sustain performance in the operational environment.
During the Gulf War (1990-91), he served as regimental psychiatrist for the U.S. Army's Second Armored Cavalry Regiment. In addition to authoring over 100 journal articles, book chapters, and technical reports, he has edited two books on combat psychiatry: Contemporary Studies in Combat Psychiatry (Greenwood Press, 1987) and The Gulf War and Mental Health: A Comprehensive Guide (Praeger Press, 1996).
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