The Efficacy of Modafinil for Sustaining Alertness and Simulator Flight Performance in F-117 Pilots During 37 Hours of Continuous Wakefulness

Abstract : The present study determined whether modafinil (100-mgs after 17, 22, and 27 hours without sleep) attenuated the effects of fatigue on fighter-pilot alertness and performance. A quasi-experimental, single-blind, counterbalanced design was used in which 5 pilots from a previous F-117 fatigue study (in which no fatigue remedy was employed) were retested with modafinil. Their data were combined with the data from 5 newly-recruited F-117 pilots who were evaluated under modafinil and then placebo. Modafinil improved vigilance and tracking performance in a divided-attention task, CNS activation, oculomotor performance, and aspects of subjective mood. Flight performance decrements were mitigated on six of eight maneuvers. Benefits were most noticeable after 24 to 32 hours of continuous wakefulness. Although modafinil did not sustain performance at pre-deprivation levels, its numerous positive effects make it a useful adjunct to the currently-approved fatigue countermeasure dextroamphetamine. However, modafinil should not be considered a replacement for this older compound. A follow-on in-flight study is recommended.