Military health and performance optimization: a circadian strategy in response to governmental policies

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In 2017, USS Fitzgerald and USS John S. McCain, both guided-missile destroyers, experienced underway collisions that resulted in the deaths of 17 Sailors and degradation of national defense as two warships were removed from the frontline. This incident garnered Congress’ attention leading to numerous fatigue management policies and working groups instituted at various levels across the Department of Defense. One policy of the Department of the Navy (3120.2A; Dec 11, 2020) specifically addressed risk mitigation factors for maritime operations occurring in the overnight and early morning hours around the circadian nadir or trough in alertness and vigilance. Despite these circadian challenges that come with mission demands of military service, there are many opportunities as outlined in the Department of Navy policy to reduce and/or eliminate the performance-related risks associated with circadian misalignment. In regard to actionable systems and processes aligned with these policies, the first step is to perform a risk assessment to identify circadian-related problems that could arise in response to conducting the military training exercise or operation. The second step is to integrate a means to monitor 24-hour physiology, mitigate performance risk through fatigue countermeasures, and/or re-align the circadian timing system of military personnel to enhance sleep, manage fatigue, and optimize performance. Most importantly, the approach is not a one size fits all. Each military operation will require unique adaption (re-alignment) to the environment and each military operation may require a unique countermeasure(s).