A Head-to-Head Comparison of the 2B-Alert Caffeine Optimization Algorithm Versus Standard Caffeine Dosing on Performance During Sleep Deprivation
Abstract
Lack of sleep is a common part of military life. Intense training schedules, long work hours, travel across multiple time zones, and high operational tempo during combat or other military operations often prevent Warfighters from maintaining an ideal sleep schedule. The reality of military operations is that there will be times when mission requirements will supersede individual needs for sleep. Unfortunately, lack of sleep can prove dangerous, as it slows reaction time, impairs alertness, and can lead to degraded mental flexibility and decision-making. In some military contexts, even a brief lapse of attention can mean the difference between life and death, and even complete mission failure. Therefore, it is vital that Warfighters have options available to help sustain their alertness and performance during periods where they may be lacking sleep but must remain awake due to the requirements of the mission. During prolonged periods of wakefulness, most people rely on caffeine containing products to bolster their alertness and performance. Caffeine is an effective, relatively safe, and widely used stimulant that can temporarily increase alertness and mental performance. Military research over the past two decades has validated that up to 200 mg of caffeine (about the same amount of caffeine as an extra-large cup of strong coffee) consumed every 2 hours during an overnight operation can sustain alertness significantly better than placebo. After numerous scientific studies, this recommendation for repeated dosing of 200 mg every 2 hours during sleep deprivation has become widely accepted as an easy and standard rule-of-thumb for temporarily sustaining performance of military personnel. However, there are also large inter-individual differences among people in terms of their sensitivity to caffeine and how they are affected by sleep loss. Some people can function effectively on very little sleep, while others have great difficulty sustaining normal levels of functioning. Similarly, some people become jittery and anxious with small doses of caffeine, while others can consume large quantities with little noticeable effect. To address this issue, military researchers have developed a computerized mathematical model that learns from a person’s own sleep/wake patterns from a smartwatch and scores on a few reaction time tests to accurately predict individual performance during a period of prolonged sleep loss. Recently, this model was further refined to incorporate individual information about caffeine use. Building on this model, the Army has now developed a simple smartphone app, called 2B-Alert, that learns over time to predict individual performances and can make recommendations for when and how much caffeine to consume to temporarily restore performance close to normal levels. This is critical, as it can optimize the amount and timing of caffeine so that a person will perform within their optimal range without consuming excess caffeine, thus avoiding the jitters, nausea, and difficulty falling asleep later when a rest opportunity arises. The 2B-Alert Caffeine Optimization algorithm has been validated using existing data, and our team recently completed a laboratory study to show how well it works in real time when dosing recommendations are made on-the-fly. Nonetheless, for the 2B-Alert app to be widely used in the military, it will also need to be proven to be more effective at sustaining alertness and minimizing side effects than the standard rule-of-thumb approach that is widely used in the military already (i.e., take 200 mg every 2 hours). Therefore, consistent with the FY21 PRMRP Clinical Trial Award Topic Area of Sleep Disorders and Restriction, which focuses on Research on the prevention and/or mitigation of sleep disorders and restriction, we propose to conduct the largest and most comprehensive study to date to determine the effectiveness of the 2B-Alert app relative to the standard dosing recommendations. A to
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2210862
Entities
People
- William D. Killgore
Organizations
- United States Army
- University of Arizona