Fatigue in military aviation: an overview of US military-approved pharmacological countermeasures

Aviat Space Environ Med. 2005 Jul;76(7 Suppl):C39-51.


Uncomfortable working and sleeping environments, high operational tempos, sustained operations, and insufficient staffing make fatigue a growing concern. In aviation, where a single mistake can cost millions of dollars, it is essential to optimize operator alertness. Although behavioral and administrative fatigue countermeasures should comprise the "first line" approach for sustaining aircrew performance, pharmacological fatigue countermeasures are often required. Various components of the U.S. military have authorized the use of specific compounds for this purpose. Hypnotics such as temazepam, zolpidem, or zaleplon can mitigate the fatigue associated with insufficient or disturbed sleep. Alertness-enhancing compounds such as caffeine, modafinil, or dextroamphetamine can temporarily bridge the gap between widely spaced sleep periods. Each of these medications has a role in sustaining the safety and effectiveness of military aircrews. The present paper provides a short overview of these compounds as well as factors to be considered before choosing one or more to help manage fatigue.

MeSH terms

  • Acetamides / pharmacology
  • Acetamides / therapeutic use
  • Aerospace Medicine*
  • Anti-Anxiety Agents / pharmacology
  • Anti-Anxiety Agents / therapeutic use
  • Benzhydryl Compounds / pharmacology
  • Benzhydryl Compounds / therapeutic use
  • Circadian Rhythm / drug effects
  • Fatigue / prevention & control*
  • Humans
  • Hypnotics and Sedatives / pharmacology
  • Hypnotics and Sedatives / therapeutic use
  • Military Medicine*
  • Modafinil
  • Pyridines / pharmacology
  • Pyridines / therapeutic use
  • Pyrimidines / pharmacology
  • Pyrimidines / therapeutic use
  • Sleep / drug effects
  • Temazepam / pharmacology
  • Temazepam / therapeutic use
  • United States
  • Zolpidem


  • Acetamides
  • Anti-Anxiety Agents
  • Benzhydryl Compounds
  • Hypnotics and Sedatives
  • Pyridines
  • Pyrimidines
  • Zolpidem
  • Temazepam
  • Modafinil
  • zaleplon