Health Risks and Potential Predictors of Fatigue and Sleepiness in Airline Cabin Crew

Background: Aviation pilots and cabin crew regularly undertake shift work, and may experience circadian disruption, restricted sleep, sleepiness and impaired health. Research on aviation fatigue and sleepiness has focused on pilots, with less being known about cabin crew. This study aimed to identify likely predictors of fatigue, sleepiness, shift work disorder (SWD) and depression in cabin crew. Methods: An online anonymous survey was distributed to active cabin crew around the world. It measured sleepiness, fatigue, and screened for insomnia, depression and SWD. Information on individuals’ habits and work schedules were collected. Results: 930 valid responses were analysed. 63.5% of the sample had abnormal levels of fatigue and 46.9% experienced excessive daytime sleepiness. 68.0% were at risk for SWD, 57.7% screened positive for insomnia, and 40.0% for depression. Caffeine and use of alcohol and drugs for sleep were independently associated with insomnia and SWD (p < 0.05), whereas, type of route (international, domestic, both) and number of duty days per week predicted fatigue (p < 0.05). Conclusions: Cabin crew had a high prevalence of fatigue, sleepiness and elevated risk for SWD, insomnia and depression. Many cabin crew engaged in behaviours detrimental to good sleep hygiene, highlighting targets for future interventional studies.