Critical research issues in development of biomathematical models of fatigue and performance.

This article reviews the scientific research needed to ensure the continued development, validation, and operational transition of biomathematical models of fatigue and performance. These models originated from the need to ascertain the formal underlying relationships among sleep and circadian dynamics in the control of alertness and neurobehavioral performance capability. Priority should be given to research that further establishes their basic validity, including the accuracy of the core mathematical formulae and parameters that instantiate the interactions of sleep/wake and circadian processes. Since individuals can differ markedly and reliably in their responses to sleep loss and to countermeasures for it, models must incorporate estimates of these inter-individual differences, and research should identify predictors of them. To ensure models accurately predict recovery of function with sleep of varying durations, dose-response curves for recovery of performance as a function of prior sleep homeostatic load and the number of days of recovery are needed. It is also necessary to establish whether the accuracy of models is affected by using work/rest schedules as surrogates for sleep/wake inputs to models. Given the importance of light as both a circadian entraining agent and an alerting agent, research should determine the extent to which light input could incrementally improve model predictions of performance, especially in persons exposed to night work, jet lag, and prolonged work. Models seek to estimate behavioral capability and/or the relative risk of adverse events in a fatigued state. Research is needed on how best to scale and interpret metrics of behavioral capability, and incorporate factors that amplify or diminish the relationship between model predictions of performance and risk outcomes.