HRR - Risk - Risk of Performance Decrements and Adverse Health Outcomes Resulting from Sleep Loss, Circadian Desynchronization, and Work Overload

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Risk of Performance Decrements and Adverse Health Outcomes Resulting from Sleep Loss, Circadian Desynchronization, and Work Overload

Short Title: Sleep Last Published: 04/26/21 11:30:44 AM (Central)

Element: Human Factors and Behavioral Performance (HFBP)

Evidence: Report

Risk Master Logic Diagram: Diagram

Point of Contact: Erin Flynn-Evans

HRP Risk Status: Active [current research ongoing]

Risk Ratings and Dispositions per Design Reference Mission (DRM) Category

DRM Categories	Mission Type and Duration	Operations		Long-Term Health
DRM Categories	Mission Type and Duration	LxC	Risk Disposition *	LxC	Risk Disposition *
Low Earth Orbit	Short (<30 days)	3x2	Accepted with Optimization	3x1	Accepted
Low Earth Orbit	Long (30 days-1 year)	3x2	Accepted with Optimization	3x1	Accepted
Lunar Orbital	Short (<30 days)	3x2	Accepted with Optimization	3x1	Accepted
Lunar Orbital	Long (30 days-1 year)	3x2	Accepted with Optimization	3x1	Accepted
Lunar Orbital + Surface	Short (<30 days)	3x2	Accepted with Optimization	3x1	Accepted
Lunar Orbital + Surface	Long (30 days-1 year)	3x2	Requires Mitigation	3x1	Accepted
Mars	Preparatory (<1 year)	3x2	Requires Mitigation	3x3	Requires Mitigation
Mars	Mars Planetary (730-1224 days)	3x3	Requires Mitigation	3x3	Requires Mitigation
Note: LxC is the likelihood and consequence rating. The information above was last approved by the Human System Risk Board in 8/2019.

Risk Statement

Given that astronauts experience sleep loss, circadian desynchronization, and work overload, there is a possibility that performance decrements and adverse health outcomes will occur.

HSRB State of Knowledge

The Risk Context section in the HRR is no longer applicable for this risk based on the last updated date. The content is maintained within other sections of the HSRB risk record.

Mitigation Strategy

The risk mitigation strategy of the HFBP Element follows the larger strategy of the HRP "from Evidence to Deliverables” principle, with the involvement of Medical and Mission Operations to help determine the tools and technologies that are relevant for current and future spaceflight. Specific tasks are defined to address the gaps and provide clear, specific deliverables for long duration spaceflight, ensuring an evidence and operationally-based end item. Working with research and operational experts, HFBP systematically identifies the appropriate platform to address the gaps prior to validating in spaceflight. To ensure relevancy, stakeholders are engaged in the process from the beginning. Evidence gathered from HFBP research characterize Risk, inform Operations and Standards, and yield countermeasures for performance and behavioral health.

Current research on this risk involves multi-disciplinary studies to characterize how sleep loss, circadian misalignment, and work overload interact with other risks, and to develop appropriate monitoring and mitigation approaches.

Gaps (3)

Sleep-101: Given each crew member will experience multiple spaceflight hazards simultaneously, we need to identify and characterize the potential additive, antagonistic, or synergistic impacts of multiple stressors (e.g., Space Radiation, Altered Gravity, Isolation, altered immune, altered sleep) on crew sleep-wake cycles and/or circadian shifting, health and/or CNS/cognitive functioning to identify any identified adverse individual or team crew health, and/or operationally-relevant performance outcomes.

Responsible Element: Human Factors and Behavioral Performance (HFBP)

Status: Open

Description

Sleep is a vital physiological requisite for humans, needed for survival like air, water and food. Sleep loss, disruption of circadian rhythms, and work overload are critical fatigue-causing factors that can compromise safety and lead to increased errors and degraded performance and productivity. Evidence from spaceflight has demonstrated that sleep is generally reduced on orbit relative to sleep experienced by crew during mission training and post-mission as well (Flynn-Evans et al., 2015). Objective evidence from Shuttle and ISS demonstrates that average nightly sleep duration is around six hours; terrestrial studies have shown that chronically sleeping around six hours a night leads to decrements in vigilant attention typically seen after one night’s total sleep deprivation (Van Dogen et al., 2003; Belenky et al., 2004). Estimates of circadian phase on-orbit have also demonstrated that approximately 19% of sleep episodes were misaligned (Flynn-Evans et al., 2015). The intent of this gap is to characterize the potential moderating and/or mediating effects of sleep and circadian phase relative to other potential stressors (e.g. radiation exposure, altered gravity) and outcomes (e.g. cognitive performance, SANS). While there is a substantial evidence base which supports the intimate tie between sleep health, circadian physiology, and performance, the potential synergistic effects of these and other risk factors has not yet been established. Efforts are needed to further characterize these relationships and define potential impacts to risk mitigation strategies.

Target for Closure

Identification of integrated risk/threats relative to sleep and circadian phase.
Update to countermeasure approach.

Tasks (13)

Analog Team/Behavioral Medicine Data Mining

Task Book: Entry Unavailable
Principal Investigator: TBD

Short Title: Analog Team/Behavioral Medicine Data Mining

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

Funding Status: Planned-Funded - Task expected to be within budget

Procurement Mechanism(s):

Aims:
Characterization of association between Team and Fatigue-related outcomes in HERA (Human Exploration Research Analog), which includes data analysis evaluating the relationship between various team and fatigue outcomes.

Resources (None Listed)

Deliverables (1)

Assess Glymphatic Changes for Spaceflight

Task Book: Entry Unavailable
Principal Investigator: TBD

Short Title: Assess Glymphatic Changes for Spaceflight

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

Human Health Countermeasures (HHC) Element

Funding Status: Planned-Funded - Task expected to be within budget

Procurement Mechanism(s):

Solicited

Aims:

In their evaluation of rodents, researchers from the University at Rochester have recently discovered that cerebral spinal fluid moves quickly and deeply into the brain to flush out cellular waste and minimize neuronal plaque (the hallmark of Alzheimer's). This process appears to be approximately 80% more efficient when we sleep; more recent studies have shown that postural changes (e.g. sitting to supine) contributes to this effect as well.

The purpose of this task is to conduct a study using head-down-tilt that evaluates the relationship between fluid shifts experienced in spaceflight, sleep loss, and changes in the glymphatic system. Results from the study will inform the likelihood and consequence of this risk.

This task will contribute to gap closure by informing the key threats for behavioral health and performance for a future exploration missions.

Resources (Ground Analog)

Deliverables (1)

Cognitive Assessment and Prediction to Promote Individualized Capability Augmentation and Reduce Decrement

Task Book: Entry
Principal Investigator: Bracken, Bethany

Short Title: CAPT PICARD - SBIR2

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

Behavioral Health & Performance (BHP) Element

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:

Task design and related hardware and software impose cognitive and physical demands on an operator, and thus drive the workload associated with a task. Astronauts on long-duration missions will potentially have long periods of low workload and short bursts of high workload combined with reduced workload capacity that need to be taken into account for system and mission design. Both high task demand and reduced workload capacity at any phase of a flight may lead to performance errors, which could potentially compromise mission objectives, and consequently the mission. An unobtrusive workload tool is needed during system development to ensure that the use of the system is associated with acceptable workload, as well as during real-time use of systems, to drive schedule modifications or to adapt interfaces based on the current workload the astronaut is experiencing.

Based on the current state of the art and recommendations from the Phase1 effort develop a workload tool prototype to measure, assess, and predict astronaut workload unobtrusively.
Test and validate the tool. The technology should also be predictive of astronaut workload during long-duration operations.

The task will contribute to gap closure by providing an unobtrusive workload measurement tool for long-duration missions.

Resources (Ground Analog)

Deliverables (1)

Quantifying and Predicting Operationally-Relevant Performance in a Long-Duration Spaceflight Analog

Task Book: Entry
Principal Investigator: Strangman, Gary

Short Title: Operational Performance Measures: ROBoT

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

Funding Status: Active - Currently funded and in progress

Procurement Mechanism(s):

Solicited

Aims:

Aim 1: Characterize operational task performance changes during 45-day HERA missions, including the roles of time-in-mission, workload, sleep debt, and operational emergencies.

Aim 2: Characterize brain and systemic physiology changes during 45-day HERA missions, including the roles of time-in-mission, workload, sleep debt, and operational emergencies.

Aim 3: Identify physiological or behavioral variables that predict operational performance.

Aim 4: Quantify the influence of behavioral health countermeasures on both operational performance and (neuro)physiological measures.

Resources (Ground Analog)

Deliverables (1)

Real-Time Estimation of the Effects of a Simulated Long-Duration Exploration Mission on Flight Performance, Workload, and Situation Awareness

Task Book: Entry
Principal Investigator: Duda, Kevin

Short Title: Performance, Workload, and Situation Awareness

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

Funding Status: Active - Currently funded and in progress

Procurement Mechanism(s):

Solicited

Aims:

Study Aim: Characterize the behavioral health and performance effects of a simulated Long Duration Exploration Mission (LDEM) in HERA on flight performance, workload, and situation awareness during representative spaceflight operational tasks.

A series of experiments will be conducted using the simulated spaceflight scenarios and real-time metrics engine to quantify performance, workload, and situation awareness in each task during the HERA mission. Analysis will be conducted for each scenario and meta-analysis across scenarios will be conducted to determine commonalities and to determine absolute performance thresholds. These metrics will also be correlated to data collected as part of the BHP Standardized Measures, including sleep/wake cycle, actigraphy, and a cognitive battery.

Deliverables include the analysis of data collected during these HERA missions, in the form of publishable research results, that can be directly used to address the HRR Risks and Gaps.

Resources (Ground Analog)

Deliverables (1)

Psychomotor Vigilance Test (PVT) on ISS

Task Book: Entry
Principal Investigator: Dinges, David

Short Title: Reaction Self Test (Cognitive Performance/PVT)

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Directed

Aims:

1) To evaluate the extent to which PVT Self Test performance of astronauts is sensitive to fatigue from sleep loss and circadian disruption during ISS missions. This will include the following conditions evaluated individually and in aggregate: i) extended wake duration between 16 hours; ii) sleep restriction defined as total sleep time >0 and <6 hours per 24-hour period; and iii) circadian perturbation associated with night work and slam shifting.

2) To evaluate the extent to which PVT Self Test performance of astronauts is sensitive to fatigue from work intensity during ISS missions. This will include the following conditions evaluated individually and in aggregate: i) extend work durations up to 16 hours per day; ii) more than 6 consecutive work days without a day off for rest; and iii) work requiring extravehicular activity (EVA).

3) To evaluate the extent to which PVT Self Test performance of astronauts declines with time in mission.

4) To explore the extent to which PVT Self Test performance of astronauts will be sensitive to the carry-over effects of medications for sleep (e.g., zolpidem, ramelteon, etc.) on ISS.

5) To evaluate the extent to which PVT Self Test performance feedback (via a graphical interface) is perceived by ISS astronauts as a useful tool for assessing performance capability. This will be addressed throughout the mission by astronaut ratings.

Resources (Flight)

Deliverables (1)

Psychomotor Vigilance Test (PVT) on ISS (Reaction Self-Test on ISS-12)

Task Book: Entry
Principal Investigator: Dinges, David

Short Title: Reaction Self-Test ISS-12

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Directed

Aims:
The purpose of this task is to provide objective data to help characterize fatigue and workload related effects over a one-year long duration spaceflight mission. The precursor to this study is an ISS study evaluating Reaction Self Test with an N of 24, 4- to 6-month flyers.

BHP is working through the Multilateral Human Research Panel for Exploration (MHRPE) to collaborate with the Russian Space Agency on this one-year ISS study.

Resources (Flight)

Deliverables (1)

The Impact of Objectively Measured Sleep Deficiency and Circadian Misalignment on Performance During Spaceflight

Task Book: Entry Unavailable
Principal Investigator: Barger, Laura

Short Title: Sleep and Performance

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

National Space Biomedical Research Institute (NSBRI)

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:

The intent of this task is to evaluate sleep data from the largest, most systematic assessment of sleep in space (Barger et al., 2014), relative to performance outcomes in space, such as cognitive performance and operational performance (if accessible).

Resources (None Listed)

Deliverables (1)

Team and Sleep Preliminary Literature Review

Task Book: Entry Unavailable
Principal Investigator: Driscoll, Sharon

Short Title: Team/Sleep Prelim Lit Review

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Directed

Aims:
This task will consist of a preliminary literature review, which should examine existing knowledge related to the Sleep Risk and the impact on teams and highlight any gaps or limitations in the literature. The PI will be conducting a preliminary literature review to identify the most important factors related to sleep and circadian factors and team outcomes.

Resources (None Listed)

Deliverables (1)

Cognitive Performance and Stress in a Simulated Space Environment

Task Book: Entry
Principal Investigator: Dinges, David

Short Title: Cognitive Performance/Stress

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Directed

Aims:

1. Test the usefulness of three brief validated software-based cognitive performance tests (PVT SelfTest, Digit Symbol Substitution Test and the Descending Subtraction Test), which will collectively be known as the Penn Neurobehavioral Test Battery. Data will be collected on crew members and mission support personnel. Findings from this aim will also inform Sleep1 and Bmed3 (development and validation of measurement tools).

2. Acquire saliva samples to assay for cortisol levels, as a physiological measure of stress. Salivary cortisol data will be collected on crew members and mission support personnel.

3. Acquire video of the face for assessing feasibility of optical computer recognition using the built in webcam in the laptop used for the cognitive performance tests. Findings from this aim will also inform Bmed (development and validation of methods to detect behavioral health decrements).

Resources (None Listed)

Deliverables (1)

Individualized Stress Detection System

Task Book: Entry
Principal Investigator: Mollicone, Daniel

Short Title: Individualized Stress Detection

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:

Develop a prototype software measure of stress based on physiological outcomes.

Given the extended duration of future missions and the isolated, extreme, and confined environments, there is the possibility that stress-related behavioral conditions and mental disorders (DSM-IV-TR) will develop. The overarching goal of this project is to deliver an integrated system that will track physiological signals (heart rate and heart rate variability) and behavioral signals (sleep wake patterns) to detect chronic stress, hyperarousal, and insomnia during space missions. This project will deliver both the sensor hardware and signal processing software needed for the real-time data collection and integration with other behavioral health monitoring systems (e.g., Individualized Fatigue Meter and Individualized Behavioral Health Meter).

This is an SBIR Phase 2 project and the third and final component of the Behavioral Health and Performance Dashboard Software (BHP-DS)

Resources (None Listed)

Deliverables (1)

Workload and Scheduling Tools for Long Duration Missions (Research Requirements)

Task Book: Entry Unavailable
Principal Investigator: Hancock, Peter

Short Title: Workload and Scheduling LDM RR

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

Space Human Factors Habitability (SHFH) Element

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:

This task will inform specific future research needs (if any) based on a thorough evidence review and an operational assessment on workload models, and fatigue models. Results could help inform whether the integration of various models is feasible, and how existing models supported by NASA and the military can support operations. The task contributes to gap closure by potentially yielding an enhanced mitigation strategy for future missions.

Resources (None Listed)

Deliverables (1)

Measuring Transcutaneous Partial Pressure of Carbon Dioxide (PCO2) to Estimate Arterial PCO2 during Spaceflight

Task Book: Entry Unavailable
Principal Investigator: TBD

Short Title: Transcutaneous CO2 - ISS

Responsible HRP Element: Human Health Countermeasures

Collaborating Org(s):

Funding Status: Planned-Funded - Task expected to be within budget

Procurement Mechanism(s):

TBD

Aims:

1. To determine if PtcCO2 levels compare and track with end-tidal PCO2 (PetCO2) during quiet breathing at rest before and during spaceflight.

2. To determine the range of PtcCO2 levels in crewmembers during spaceflight during various crew activities.

3. To compare daily and nightly PtcCO2 levels with outcomes related to sleep, cognitive performance, and SANS findings.

Resources (Flight)

Deliverables (1)

Sleep-102: We need to identify and develop an integrated, individualized suite of scheduling tools that predict the effects of sleep-wake cycles and light on performance, with validated countermeasures and on-board systems to monitor, prevent and/or treat chronic partial sleep loss, work overload, and/or circadian shifting in spaceflight.

Responsible Element: Human Factors and Behavioral Performance (HFBP)

Status: Open

Description

Countermeasures to mitigate sleep loss, circadian misalignment, and resulting performance effects include lighting recommendations, medications, and caffeine. The timing of these countermeasures however is fundamental to their success. Biomathematical models of performance using sleep-wake data to provide estimates of performance capability, are currently being used by the military and commercial aviation industry. These models potentially could serve as a means for more autonomous crews to self-assess relative to their performance capability, and plan for appropriate implementation of certain countermeasures, such as caffeine and lighting, relative to upcoming operational requirements. Additional efforts are needed to refine model predictions and enhance (as more data comes onboard) with countermeasure implementation. These tools could aid both flight and ground crews in managing fatigue and establishing revised schedules in real time to help mitigate risk.

Target for Closure

Validated tools for performance capability prediction and countermeasure implementation;
Standards and guidelines for implementing fatigue-related countermeasures in exploration.

Tasks (16)

Validation of model predictions of alertness, performance, and sleepiness

Task Book: Entry Unavailable
Principal Investigator: Flynn-Evans, Erin

Short Title: Biomathematical model validation

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

National Space Biomedical Research Institute (NSBRI)

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Directed

Aims:

The purpose of this task is to validate model predictions against laboratory and field data.

Resources (None Listed)

Deliverables (1)

Category: Technology or Tool
Subcategory: Computational Models or Simulations

Description:

The validation of the models will provide a comprehensive understanding of the capabilities and limitations of each model as well as an understanding of how the model predictions compare to another frequently used commercial model. Findings will be outlined in a final report. In addition, a presentation will be prepared to summarize the findings and to brief operational personnel prior to deployment of any of the models. The findings from the model validation will contribute to risk mitigation because they will ultimately lead to a countermeasure that can inform spaceflight scheduling decisions in real time. This task, therefore, helps to close the gap by validating tools (i.e., biomathematical models) for informing scheduling decisions.

Internal Customers:
Human Factors and Behavioral Performance
External Customers:
SMOD - Space Medicine Operations Division
Is a Customer-Supplier Agreement (CSA) Required? Yes

Testing solid state lighting countermeasures to improve circadian adaptation, sleep, and performance during high fidelity analog and flight studies for the International Space Station

Task Book: Entry
Principal Investigator: Brainard, George

Short Title: Lighting Effects

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

Funding Status: Active - Currently funded and in progress

Procurement Mechanism(s):

Solicited

Aims:
Currently, the fluorescent-based “General Luminaire Assemblies” (GLAs) on the International Space Station (ISS) are reportedly dim and burning out. Crewmembers have complained about the lack of intensity in these lights, and their dim and static nature may be associated with circadian misalignment and sleep loss experienced on orbit.

As a result of a multi-disciplinary effort based out of the Johnson Space Center, in 2010 the ISS Program agreed to fund a new LED-based lighting system, called the Solid State Light Assemblies (SSLAs), for the ISS vehicle. This system will enable crewmembers to quickly adjust brightness and wavelength of the lights so lighting can support crew vision and provide a crew health countermeasure for circadian entrainment, sleep shifting, enhancing alertness and performance. Specifically, crewmembers will be able to toggle between a high intensity light enriched in the “blue” portion of the spectrum for the morning, night time operations and schedule shifting (“Phase Shift”); a crisp daytime light to support visual acuity (“General Vision”); and a low intensity, non-blue enriched light in the evening (“Pre Sleep”).

The requirements for this lighting system were based on the best available scientific evidence, as well as technical constraints of the ISS vehicle (e.g., no wireless configuration)

The purpose of this task is to evaluate on the ISS whether the proposed lighting protocols using the SSLAs on orbit lead to their intent of maintaining circadian alignment and promoting sleep at night and performance during the day, and, as needed, during night time operations. A preliminary ground analog study in a high-fidelity laboratory analog will precede the flight portion of this investigation.

Findings will be relevant for the Space Human Factors and Habitability (SHFH) Element vehicle and habitat development, and will inform medical protocols for using light as a non-pharmaceutical countermeasure for circadian desynchronization on orbit.

Resources (Flight, Other)

Deliverables (1)

Evaluation of the validity, acceptability and usability of bio-mathematical models to predict fatigue in an operational environment

Task Book: Entry
Principal Investigator: Flynn-Evans, Erin

Short Title: Operational Fatigue Modeling Validation

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

Funding Status: Active - Currently funded and in progress

Procurement Mechanism(s):

Solicited

Aims:

Software using mathematical models can help inform assessments related to work-rest schedules and implementation of fatigue countermeasures. Branches of the military, for example, use the Sleep, Activity, Fatigue and Task Effectiveness (SAFTE) model to predict performance effectiveness relative to sleep-wake history. Other relevant modeling efforts have included the development of the Circadian Performance Simulation Software (CPSS) by Brigham and Women’s Hospital, and the Individualized Fatigue Meter by Pulsar Informatics. NASA, the National Space Biomedical Research Institute, and other agencies have supported the development of such software solutions to provide predictions of performance capability relative to sleep-wake history. Software solutions can inform real-time task scheduling decisions and aid implementation of countermeasures such as caffeine and lighting – especially important, given that the proper scheduling of such countermeasures is essential to their effectiveness.

Mathematical models can therefore be used operationally in future space exploration missions, to inform the scheduling of mission-related tasks and the timing of fatigue-related countermeasures. This topic is soliciting proposals to evaluate the use of such a tool, as a means through which autonomous crews in a simulated spaceflight mission can appropriately implement fatigue-related countermeasures, and for understanding how a crew medical officer (who would be a participant in the study) and/or an individual crewmember will use the information to make countermeasure recommendations and real-time scheduling changes.

This task seeks to assess, in an operational environment (the Habitat Exploration Research Analog, or HERA, at Johnson Space Center), the acceptability, usability, and overall feasibility of sleep-wake models and associated software, to make informed decisions for long-duration space exploration missions (LDEMs), when ground support will be minimized and crews will function more autonomously.

Resources (Ground Analog)

Deliverables (1)

LumosTech Smart Sleep Mask for Circadian Realignment in Space and on Earth

Task Book: Entry Unavailable
Principal Investigator: Burns, Vanessa

Short Title: Smart Sleep Mask

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

National Space Biomedical Research Institute (NSBRI)

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:
The primary objective for LumosTech is to develop and commercialize the LumosTech smart sleep mask, a wearable device to monitor an individual’s circadian phase and rapidly realign the circadian rhythm of the user to their local environment. With this technology, LumosTech's goal is to help astronauts optimize their sleep schedules in the absence of natural light, assist ground crew adjusting to work-related sleep changes, and increase alertness after wake-up.

This is an NSBRI Industry Forum/SMARTCAP Award.

Resources (None Listed)

Deliverables (1)

Effects of Transdermal Vagal Nerve Stimulation (tVNS) on Cognitive Performance Under Sleep Deprivation Stress

Task Book: Entry
Principal Investigator: McKinley, Richard

Short Title: Transdermal Vagal Nerve Stimulation

Responsible HRP Element: Human Factors and Behavioral Performance

Collaborating Org(s):

Funding Status: Active - Currently funded and in progress

Procurement Mechanism(s):

Solicited

Aims:

The purpose of this study is to evaluate the efficacy of transdermal vagal nerve stimulation (tVNS) to mitigate the effects of fatigue induced by sleep deprivation on aspects of cognition including attention, arousal, multitasking, and memory in populations of DoD subjects.

Aim 1: The primary aim is to demonstrate a >20% improvement in at least one cognitive skill during sleep deprivation stress when compared to the control population.

Aim 2: The secondary aim is to assess effects of tVNS on subjective mood.

Resources (Other)

Deliverables (1)

Countermeasures for Performance Deficits from Sleep Loss and Workload in Space Flight

Task Book: Entry
Principal Investigator: Dinges, David

Short Title: CM Workload Sleep Loss and PVT

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

National Space Biomedical Research Institute (NSBRI)

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:
1. The proposed research will use a laboratory-based study to acquire critically-needed information on the effects on performance of high cognitive workload and sleep restriction.

2. The study hypothesizes that as sleep restriction accumulates, it will potentiate the performance-impairing effects of higher cognitive workload. Another key goal of the study is to provide astronauts with an objective way to identify performance changes and the need for countermeasures for fatigue from sleep restriction and high workload. To this end, the project will complete validation of the sensitivity of the 3-minute PVT SelfTest to high workload and sleep restriction. PVT SelfTest feedback interfaces will also be evaluated, and the task will be tested in analog operations to establish its technical feasibility.

3. Tertiary goals of the project include identification of biobehavioral predictors of differential vulnerability to the cognitive effects of sleep restriction and high workload

4. Development of individualized biomathematical models that predict performance on the PVT SelfTest during high workload

Resources (None Listed)

Deliverables (1)

Countermeasures to Neurobehavioral Deficits from Cumulative Sleep Deprivation During Space Flight: Dose-Response Effects of Recovery Sleep Opportunities

Task Book: Entry
Principal Investigator: Dinges, David

Short Title: Sleep Dose Recovery

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

National Space Biomedical Research Institute (NSBRI)

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:
The primary aim is to determine the sleep dose-response effects of an acute change in sleep duration that occurs between two periods of chronic sleep restriction, on neurocognitive performance functions, subjective states, and waking and sleep physiology. Findings will help indicate the relationship between the varying durations of time in bed and recovery of waking neurobehavioral and physiological outcomes, following chronic partial sleep deprivation.

Resources (None Listed)

Deliverables (1)

Designing Individual Countermeasures to Reduce Sleep Disruption and Improve Performance and Alertness in Space

Task Book: Entry
Principal Investigator: Klerman, Elizabeth

Short Title: Mathematical Model Harvard

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

National Space Biomedical Research Institute (NSBRI)

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:

(1) Replace the current assumption that an individual sleeps when scheduled to sleep, with probabilities of sleep and wake during those times

(2) Improve daily assessment of sleep and sleep disruption using actigraphy data

(3) Add statistical features including confidence limits to the predictions

(4) Update the software per astronaut and ground crew requests for specific features and reports

Resources (None Listed)

Deliverables (1)

Development of a Software and User Interface to Support Scenario Modeling of Astronaut Schedules to Aid in the Selection of Fatigue Countermeasures within the Behavioral Health and Performance Dashboard (BHP-DS)

Task Book: Entry
Principal Investigator: Mollicone, Daniel

Short Title: CPSS Dashboard Integration

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

National Space Biomedical Research Institute (NSBRI)

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Directed

Aims:

The overarching objective of this project is to integrate the Circadian Performance Simulation Software (CPSS) biomathematical model developed by the Harvard Biomathematical Modeling Unit (Dr. Elizabeth Klerman, Ph.D.) with the Behavioral Health and Performance Dashboard Software tool (BHP-DS) to support scenario modeling of astronaut schedules (inputs related to sleep, duty, and light exposure) to aid in the selection of fatigue countermeasures within the Behavioral Health and Performance Dashboard (BHP-DS). This project has 4 specific objectives:

1. Develop engineering requirements for a software module and user interface to scenario modeling of astronaut schedules within the BHP-DS.
2. Develop user interface mockups.
3. Implement the software within the BHP-DS platform.
4. Develop a blueprint for future development.

Resources (None Listed)

Deliverables (1)

Diet as a sleep/circadian countermeasure (Research Requirements)

Task Book: Entry Unavailable
Principal Investigator: Fuller, Patrick

Short Title: Diet Sleep/Circadian CM (Research Requirements)

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:
The purpose of this task is to evaluate the evidence related to the relationship between food (nutritional content and timing) and circadian and sleep physiology.

BHP is seeking collaboration with HHC/Nutrition and SHFH/Advanced Food Technology on this task.

Resources (None Listed)

Deliverables (1)

Individualized Fatigue Meter for Space Exploration (SBIR Phase II)

Task Book: Entry
Principal Investigator: Mollicone, Daniel

Short Title: IFM

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:
This aim of this planned task is to develop prototype software of the individualized fatigue meter. The fatigue meter will provide immediate feedback about alertness or fatigue levels so that astronauts can select fatigue countermeasures. The fatigue meter will incorporate data points from the Actiwatch data, PVT Self Test and NASA scheduling software to provide performance predictions based on validated mathematical models.

Resources (None Listed)

Deliverables (1)

Mathematical Modeling of Circadian/Performance Countermeasures

Task Book: Entry
Principal Investigator: Klerman, Elizabeth

Short Title: CPSS Modeling Harvard

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

National Space Biomedical Research Institute (NSBRI)

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:

Specific Aim 1: Develop and refine the current circadian, neurobehavioral performance and subjective alertness (CNPA) model with melatonin as a marker rhythm to accurately predict phase and amplitude of the circadian pacemaker.

Specific Aim 2: Refine and validate the current model by using data from chronic sleep restriction protocols.

Specific Aim 3: Refine the current model to incorporate wavelength of light information.

Specific Aim 4: Develop Schedule Assessment and Countermeasure Design Software using the amended CPNA model from Specific Aims 1, 2 and 3 to evaluate schedules and design and test appropriate countermeasures.

Resources (None Listed)

Deliverables (1)

Physiologically-Based Modeling of Sleep-Wake Scheduling and the Effects of Pharmaceuticals (NSBRI Postdoctoral Fellowship)

Task Book: Entry
Principal Investigator: Phillips, Andrew

Short Title: Modeling Sleep/Meds/Wake

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

National Space Biomedical Research Institute (NSBRI)

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:
1.Develop a combined model of sleep/wake and circadian rhythms
2. Incorporate the effects of pharmaceuticals: achieve a working model of the phase-shifting effects of melatonin, and intend to next include the hypnotic effects of melatonin. Once this is complete, the model will be validated against forced desynchrony data in which subjects were administered melatonin or placebo. Similar methodologies can then be used to model the effects of other drugs, including caffeine and modafinil (since BWH also has forced desynchrony data for both of these).

Resources (None Listed)

Deliverables (1)

Software Enabled Therapeutics for Psychiatry, Neurology, and Pain

Task Book: Entry
Principal Investigator: McCann, Corey

Short Title: Software Therapeutics for Improved Sleep

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

National Space Biomedical Research Institute (NSBRI)

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:
Pear Therapeutics is developing combination therapies for a variety of brain-related disorders including pain, sleep disturbances, depression, and anxiety. eFormulations are comprised of a software access code on the product packaging that provides access to Pear’s health apps. The patient takes the supplement or prescribed medication and simultaneously uses Pear’s games and apps, increasing efficacy, improving side effects, and enhancing compliance. This SMARTCAP project will develop a software product to enhance sleep initiation in hypervigilant chronic sleep restricted subjects and compare the use of zolpidem alone to the zolpidem plus software for sleep initiation time and sleep quality and duration.

Resources (None Listed)

Deliverables (1)

Spaceprint: Development and Validation of a Tool to Predict, Evaluate, and Mitigate Excessive Workload Effects

Task Book: Entry
Principal Investigator: Sebok, Angela

Short Title: Workload Meta-Analysis

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

NASA Ames Research Center (ARC)

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:

Conduct a Literature Review and Meta-Analysis to identify the parameters that impact operator performance for long-duration mission operations by using formal meta-analysis methods. In the meta-analysis include workload issues that span the spectrum of micro- to macro-levels of analysis and how workload builds from discrete task performance into long-duration task performance. Also consider the relationship between workload and circadian rhythm that arise when workload extends beyond discrete tasks.
Develop a model-based tool to predict astronaut performance in long-duration missions.
Empirically validate the model-based tool to address major gaps in the meta-analysis.

Risk Mitigation/Partial Mitigation:

This research will partially mitigate the Risk of Inadequate Critical Task Design by addressing concerns about performance decrements in a long duration mission environment caused by astronauts experiencing fatigue and poor sleep.

Resources (Other)

Deliverables (2)

Category: Technology or Tool
Subcategory: Computational Models or Simulations

Description:
Interim:
Apr 2013 - Literature Review and Meta-Analysis Report and Annual Report Apr 2014 - Annual Report

Final:
Apr 2015 - Space Performance Research Integration Tool (S-PRINT) tool and user manual (Tools/Computational Models-Software)

Internal Customers:
Space Human Factors and Habitability
External Customers:
None Is a Customer-Supplier Agreement (CSA) Required? No

Category: Study Results
Subcategory: Customer Requested Study or Analysis

Description:
Apr 2015 - Final report with recommendations for update to HIDH

Internal Customers:
Space Human Factors and Habitability
External Customers:
None Is a Customer-Supplier Agreement (CSA) Required? No

Workload and Scheduling Tools for Long Duration Missions (Research Requirements)

Task Book: Entry Unavailable
Principal Investigator: Hancock, Peter

Short Title: Workload and Scheduling LDM RR

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

Space Human Factors Habitability (SHFH) Element

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:

Resources (None Listed)

Deliverables (1)

Sleep3: Does sleep loss continue on long duration spaceflight or is there adaptation? What is the nature of circadian desynchronization, extended wakefulness and work overload over long duration missions? (Closed)

Responsible Element: Behavioral Health and Performance (BHP)

Status: Closed

Description

This knowledge gap as addresses the need to characterize the nature of sleep, circadian desynchronization, extended wakefulness and work overload, over the course of a long duration mission in space. Anecdotal reports indicate that many crew members often do not sleep for the duration of their scheduled sleep period. Causes of reduced sleep may be due to mission requirements, which require shifts in sleep/wake schedules, and various environmental factors, such as noise levels and temperature. In order to assess accurately the degree to which sleep is disrupted, and the degree to which circadian shifting, work overload and extended wakefulness occur in flight, objective measures are needed.

The Actiwatch protocol currently on Shuttle and ISS serves as a research monitoring tool, collecting sleep data throughout the course of a mission; this measure also provides important operational feedback for flight surgeons regarding crew member sleep. More precise monitoring tools that provide useful feedback in real time are needed to optimally support teams in future missions.

Target for Closure

No Target for Closure Available.

Tasks (3)

Sleep-Wake Actigraphy and Light Exposure During Spaceflight

Task Book: Entry
Principal Investigator: Czeisler, Charles

Short Title: Sleep Long (Actigraphy)

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Solicited

Aims:
1) characterizing sleep and sleep disruption over shuttle and long duration missions

2) determining whether sleep disruption leads to subjective dissatisfaction with sleep and daytime alertness

3) characterizing the relationship between sleep and sleep medication use

4) determining the feasibility of the Actiwatch protocol as a monitoring technology in flight

Resources (Flight)

Deliverables (1)

Techwatch for Sleep Monitoring Technologies for Long Duration Spaceflight

Task Book: Entry Unavailable
Principal Investigator: TBD

Short Title: Sleep Monitoring Technologies Techwatch

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Directed

Aims:
The aim of this task is to identify monitoring technologies that are more precise and unobtrusive than the current Actiwatch used in flight.

Resources (None Listed)

Deliverables (1)

Transition Actiwatch Protocol to Medical Operations

Task Book: Entry Unavailable
Principal Investigator: TBD

Short Title: Actiwatch TMP

Responsible HRP Element: Behavioral Health and Performance

Collaborating Org(s):

Funding Status: Completed - Task completed and produced a deliverable

Procurement Mechanism(s):

Aims:
The aim of this planned task is to transition the Actiwatch protocol to Medical Operations. The anticipated deliverable following this task will be a monitoring technology.

Resources (None Listed)

Deliverables (1)

Related Risks (4)

Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders

Common Item(s)
	Analog Team/Behavioral Medicine Data Mining
	Assess Glymphatic Changes for Spaceflight
	Cognitive Assessment and Prediction to Promote Individualized Capability Augmentation and Reduce Decrement
	Countermeasures for Performance Deficits from Sleep Loss and Workload in Space Flight
	Designing Individual Countermeasures to Reduce Sleep Disruption and Improve Performance and Alertness in Space
	Evaluation of the validity, acceptability and usability of bio-mathematical models to predict fatigue in an operational environment
	Individualized Fatigue Meter for Space Exploration (SBIR Phase II)
	Mathematical Modeling of Circadian/Performance Countermeasures
	Measuring Transcutaneous Partial Pressure of Carbon Dioxide (PCO2) to Estimate Arterial PCO2 during Spaceflight
	Psychomotor Vigilance Test (PVT) on ISS
	Psychomotor Vigilance Test (PVT) on ISS (Reaction Self-Test on ISS-12)
	Quantifying and Predicting Operationally-Relevant Performance in a Long-Duration Spaceflight Analog
	Real-Time Estimation of the Effects of a Simulated Long-Duration Exploration Mission on Flight Performance, Workload, and Situation Awareness
	Sleep-Wake Actigraphy and Light Exposure During Spaceflight
	Software Enabled Therapeutics for Psychiatry, Neurology, and Pain
	Team and Sleep Preliminary Literature Review
	Testing solid state lighting countermeasures to improve circadian adaptation, sleep, and performance during high fidelity analog and flight studies for the International Space Station
	The Impact of Objectively Measured Sleep Deficiency and Circadian Misalignment on Performance During Spaceflight
	Workload and Scheduling Tools for Long Duration Missions (Research Requirements)

Risk of Performance and Behavioral Health Decrements Due to Inadequate Cooperation, Coordination, Communication, and Psychosocial Adaptation within a Team

Common Item(s)
	Analog Team/Behavioral Medicine Data Mining
	Team and Sleep Preliminary Literature Review

Risk of Spaceflight Associated Neuro-ocular Syndrome (SANS)

Common Item(s)
	Assess Glymphatic Changes for Spaceflight
	Measuring Transcutaneous Partial Pressure of Carbon Dioxide (PCO2) to Estimate Arterial PCO2 during Spaceflight

Risk of Adverse Outcome Due to Inadequate Human Systems Integration Architecture

Common Item(s)
	Cognitive Assessment and Prediction to Promote Individualized Capability Augmentation and Reduce Decrement
	Evaluation of the validity, acceptability and usability of bio-mathematical models to predict fatigue in an operational environment
	Spaceprint: Development and Validation of a Tool to Predict, Evaluate, and Mitigate Excessive Workload Effects
	Workload and Scheduling Tools for Long Duration Missions (Research Requirements)

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Risk Approach Plan

NASA Developer: Daniel Febus Responsible NASA Official: Susan Torney Contact HRP for a 508 compliant PDF Budgets, Strategic Plans, and Accountability Reports Equal Employment Opportunity Data Posted Pursuant to the No Fear Act Information-Dissemination Policies and Inventories Freedom of Information Act President's Management Agenda Privacy Policy & Important Notices Inspector General Hotline Contact HRP Human Health and Performance DIR Johnson Space Center USA.gov ExpectMore.gov

Ground-Based Flight Analogs	Controlled Research Analog, Short Duration (2 months or less) – isolated and confined with spaceflight mission scenario [e.g., HERA, NEEMO]
Number of Subjects	16

Ground-Based Flight Analogs	Controlled Research Analog, Short Duration (2 months or less) – isolated and confined with spaceflight mission scenario [e.g., HERA, NEEMO]
Number of Subjects	32

Ground-Based Flight Analogs	Controlled Research Analog, Short Duration (2 months or less) – isolated and confined with spaceflight mission scenario [e.g., HERA, NEEMO]
Number of Subjects	32

Ground-Based Flight Analogs	Controlled Research Analog, Short Duration (2 months or less) – isolated and confined with spaceflight mission scenario [e.g., HERA, NEEMO]
Number of Subjects	16

Ground-Based Flight Analogs	Bedrest [e.g., envihab, other bedrest facilities]
Number of Subjects	0