Circadian rhythm desynchronosis in military deployments: a review of current strategies

The combined problems of changing work schedules and work places are not uncommon in military operations. For example, during the Persian Gulf War, many military units underwent short notice transmeridian deployment with immediate commencement of 24-h operations upon arrival. Some of these individuals likely suffered from circadian desynchronosis, blunting their effectiveness. The United States Air Force approved limited use of one short acting hypnotic medication to assist aircrew sleep disorders in the operational theater and, until recently, one stimulant medication to enhance alertness. Multiple theoretical strategies for circadian rhythm management are available. However, many U.S. Air Force flight surgeons are not trained on how best to use medications in combination with other circadian rhythm strategies. We present a condensed review of current human circadian rhythm coping strategies pertinent to military operations.