Comparative utility of instruments for monitoring sleepiness-related performance decrements in the operational environment


Thomas J. Balkin, Department of Behavioral Biology, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Room No. 2A26, Silver Spring, MD 20910, USA. Tel.: 301.319.9350; fax: 301.319.9979; e-mail:


As both military and commercial operations increasingly become continuous, 24-h-per-day enterprises, the likelihood of operator errors or inefficiencies caused by sleep loss and/or circadian desynchrony also increases. Avoidance of such incidents requires the timely application of appropriate interventions – which, in turn, depend on the ability to measure and monitor the performance capacity of individuals in the operational environment. Several factors determine the potential suitability of candidate measures, including their relative sensitivity, reliability, content validity, intrusiveness and cumbersomeness/fieldability. In the present study, the relative sensitivity (defined as the ratio of effect size to 95% confidence interval) of several measures to the effects of sleep loss was compared in a sleep restriction experiment, in which groups were allowed 3, 5, 7, or 9 h time in bed (TIB) across seven consecutive nights. Of the measures compared, the Psychomotor Vigilance Test was among the most sensitive to sleep restriction, was among the most reliable with no evidence of learning over repeated administrations, and possesses characteristics that make it among the most practical for use in the operational environment.