was more restful than sleep with placebo. On the sleep interrupt night, triazolam was especially helpful in returning to sleep after the 00:30 flight. Of the 10 subjects tested, 8 were asleep in less than 10 minutes under triazolam, whereas 6 were still awake after 30 minutes under placebo. A point of operational significance is that the amount of time it took for subjects to awaken in the morning tended to be longer following triazolam than following placebo (7.7 vs. 5.9 seconds, respectively). Although this effect was not statistically significant due to the high variability among the subjects, it is a point of concern. Individual reactions to a sleeping aid should be assessed before a soldier is given a hypnotic and then required to awaken in the morning with only the usual wake-up cue. Of greater concern is the fact that some subjects responded very slowly to the midnight wake-up call after triazolam. It was expected that most people would react slowly to the early wake-up call because the drug should be near its peak approximately 2 hours postadministration. However, a few subjects were particularly slow, and one had to be awakened by the technician after the wake-up signal was sounded for 6 minutes. Because of this type of individual variability, test dosing for aviators is essential.
Two subjects were unable to recall the details of the mission flown at 00:30 hours following triazolam administration. Although they remembered having flown the simulator, they were not able to recall (on the next day) some of the portions of the 2 hours they were awake and performing tasks. This is a concern for the aviation community because the details of flight missions often must be reported to other unit members. Although every person who consumes triazolam does not experience this problem, it does occur with some people, particularly when awakened early after administration of triazolam. Once again, a test dose of the drug is imperative prior to relying on this or other medications in the operational environment.
Performance is degraded somewhat by triazolam administered 8 hours before a flight, although, curiously, it has almost no effects when administered 2 hours before a flight. It appears that aviators should be capable of flying missions after triazolam, but it should be noted that slight decrements observed in this well-practiced scenario may underestimate performance difficulties in a more unpredictable situation. Clearly, it is important to administer a test dose under controlled conditions, including a wake-up shortly following administration, to test for unusual effects from the drug such as amnesia or unusually long responses to a wake-up call. Further research is needed to determine responses to emergency situations.