Abstract

BACKGROUND: Fatigue is a well-known hazard in aviation. In military fighter communities, policies have evolved to allow for in-flight use of pharmacological vigilance aids to counteract the negative effects of fatigue. With limited objective evidence supporting the role of these medications in continuous flight operations, the present study seeks to evaluate whether use of modafinil is associated with pilot aircraft carrier landing performance.METHODS: A retrospective, observational study was completed following carrier-based flight operations in support of Operation Inherent Resolve. All graded landing passes were included in the analysis. Mixed-effect multivariate linear regression analysis was utilized for the primary outcome of landing signal officer grade of landing performance following combat sorties for events with reported in-flight use of modafinil.RESULTS: A total of 1122 sorties were flown by 79 different pilots with an average landing pass grade of 3.86. The primary outcome of modafinil use in-flight was not generally associated with landing performance. In a subset analysis of more senior ranked aviators, modafinil use appeared to offer a relative performance improvement back to baseline (+0.19). Secondary outcome analysis revealed landing performance was associated with advanced landing technologies (+0.25), sorties later in deployment (+0.05 per 30 d), total career carrier landings (+0.03 per 100 traps), and longer mission duration (-0.04 per hour).DISCUSSION: In the context of evidence supporting subjective benefits of vigilance aid use by aircrew, the results of this study provide ample objective support to the controlled use of modafinil in the operational environment.Schallhorn CS. Vigilance aid use and aircraft carrier landing performance in pilots of tactical aircraft. Aerosp Med Hum Perform. 2020; 91(6):518-524.

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