The Navy fought sleep with Benzedrine and strong coffee; now it's trying a new approach
By JOHN WILKENS | The San Diego Union-Tribune | Published: April 9, 2021
SAN DIEGO (Tribune News Service) — Sleep has often been considered the enemy of America's armed forces, something to be conquered with caffeine, prescription drugs, or willpower. Now that may be changing.
The Pentagon released a report last month calling for a "culture shift" that recognizes adequate sleep as "a key component of readiness," not an impediment. It recommended improvements in work schedules and battle plans, as well as the use of specialists known as "sleep trainers," wearable sleep trackers, and behavioral counseling to ensure service members get enough shut-eye.
"It's no longer a question of whether sleep-deprivation is a problem," said Kevin "Bud" Couch, the San Diego-based director of operational safety for the Navy's surface fleet. "It's what do we do about it?"
A turning point for the Navy came in 2017, when a series of mishaps, including separate fatal collisions involving the destroyers Fitzgerald and John S. McCain, were attributed in part to fatigued crews working without enough sleep.
The Fitzgerald collided with a cargo ship off Japan in June of that year, killing seven sailors. Two months later, the McCain collided with an oil tanker off Singapore and 10 sailors died.
A review of the mishaps found a variety of factors contributed to the sleep deficit, including staff shortages, erratic schedules and a "can do" culture that pushed aside the need for more time in the rack. Some sailors were working 100-hour weeks.
"Crews are safety conscious, but when it comes to assessing their own fatigue, their perceptions tend to be reactive, often complacent and dominated by unsubstantiated optimism that motivation on caffeine can replicate the cognitive and physical prowess of a well-rested crew," the report said.
New sleep guidelines went into place following the report. They were updated in December. They instruct commanders to use watch rotations based on circadian rhythms, allowing sailors to work at the same time every day and to go to sleep at the same time.
The guidelines also minimize disruptions caused by meals, announcements and other activities that in the past have been too rigidly scheduled in the morning or at night.
"You would never consciously skip a planned maintenance check on your gear," John P. Cordle, a Navy human factors engineer, said in a release announcing the new instructions. "Our daily maintenance check on our body is sleep. Skipping that is just as bad as not maintaining your equipment."
Badge of honor
In the general U.S. population, about 28 to 37 percent of adults report getting less than seven hours of sleep each night. In the military, it's double that, 55 to 76 percent, according to the Pentagon report.
It's never been easy for service members to get a good night's sleep during deployment — noise, makeshift beds, uncertainty about possible combat — but scholars cite World War II as a time when the difficulties expanded. A lot more things happened in the dark then.
U.S. forces encountered Japanese fighters practiced in nocturnal combat. Improvements in radar and communication technologies enabled planes to fly at night in both the European and Pacific theaters. Technological advances meant tanks, ships and other machines could operate for longer periods of time, keeping troops on the move — and on their feet.
Going without sleep wasn't just seen as necessary. It became a virtue, a badge of honor, a patriotic duty.
"Sharing a problem like chronic sleep deprivation helped to forge stronger bonds of solidarity in the ranks," Penn State University Professor Alan Derickson wrote in a 2013 paper for the Journal of Social History. "Sustained fighting, long marches, or simply scanning the horizon all night became tests of strength that built group cohesion. Those who passed these tests gained a cherished sense of brotherhood."
Tales of battlefield bravery invariably included references to wakefulness. Charles Kelly, who received the Medal of Honor, talked about the "fierce pride" he and his comrades took in "not sleeping at all for days and nights," according to Derickson's article.
Military leaders recognized a strategic advantage in having fighters who could work beyond the normal limits of human endurance. "To win a battle," wrote David Grant, the Army Air Corps' top medical officer, in 1944, "striking power must be supported by staying power." They encouraged sleeplessness through a variety of methods.
They made strong coffee readily available and gave Coca-Cola an exemption from sugar rations. They experimented with Benzedrine and other amphetamines. They used peer pressure, branding tired fighters as "sleeping babies." (Research in this area continued well past the end of the war, with the hope of creating fighters who could go a week without sleeping.)
People on the home front learned to sacrifice slumber, too, as America's war machine worked around the clock to build planes, tanks and other equipment. Factories provided gallons of coffee and tea to keep the workers alert, ushering in what we routinely know now as the coffee break.
"Overall, the war deepened American society's tendency to promote sleeplessness," Derickson wrote. "The very nature of the conflict — a necessary struggle for survival against tyrannous aggressors — linked manly sleepless perseverance to a righteous cause and to fundamental societal values. On the practical level, the war introduced new ways to cheat sleep and reinforced old ones."
You could say that Rachel Markwald got a kick out of sleep. Now she makes her living from it.
When she was a soccer player, she noticed how sleep — or the lack of it — affected her performance on the field. That led her to become a circadian rhythm physiologist, studying sleep for the Naval Health Research Center in San Diego.
She and other researchers recently spent a couple of weeks aboard the Essex, an amphibious assault ship. Using wrist and ring sensors that measure heart rate, temperature, movement and other variables, they monitored the sleep patterns and fatigue levels of several hundred crew members.
Part of it was to educate the sailors, showing them what the sensors recorded about their sleep and endurance and offering tips on how to improve them, she said.
Part of it was to collect data, too, that could help shape future policies and practices.
In the past, researchers have relied heavily on surveys, which are usually done after the fact and might be misleading. Nobody wants to admit they were too tired to do the job properly. The sensors, in theory, could provide real-time information to ship doctors and commanders about fatigue levels and illnesses that may be developing.
"We're learning more about what we can measure and how to do it," said Couch, the director of operational safety.
Key issues surrounding the technology still need to be resolved, he said, including whether service members will go along with wearing the monitors. The research on the Essex was done with volunteers.
There are the institutional hurdles, too. The Pentagon report noted that although service members report high rates of sleep deprivation, only a minority of them admit that it affects their effectiveness.
"Culturally and operationally, a service member's ability to maintain maximum performance while being sleep deprived has been lauded as a key skill for military personnel and has been perceived to demonstrate toughness," the report says. "Among military commands, attitudes toward sleep may range from viewing sleep as a controlled ration to asserting that a need for sleep is a sign of weakness."
Even those who want to sleep can find it difficult.
"It's like being in a factory that's running 24/7 and is in motion," Markwald said. "Everything is metal, so it's noisy. There are lights and smells and temperature issues, a lot of challenges that can interfere with healthy sleep."
"I got a feel for what they go through," she said, sounding a little, well, sleepy in a phone interview the morning after she got back from sea. "It definitely impacts you."
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