By Mary Anne Dunkin
TUCSON, AZ—As of April 2026, U.S. forces had 
conducted more than 13,000 combat flights in the war 
against Iran, striking more than 12,300 targets within 
the first five weeks of the conflict. 
That has put a more intense spotlight on the issue 
of sleep deprivation among military pilots. Operations 
against Iran can exceed 34 hours, causing severe fatigue 
that increases risks of in-flight errors and reduced 
alertness.
In military aviation, sleep’s impact on performance 
and safety can be especially severe—impairing judgment, 
reaction time and decision-making in ways that are 
mission-critical and potentially life-threatening. Pilots 
routinely operate under conditions that increase fatigue 
risk, including extended duty periods, night operations 
and deployment environments that limit both sleep 
duration and quality. 
These factors contribute to cumulative sleep loss and 
circadian disruption, degrading cognitive function and 
situational awareness—core components of flight safety. 
In this setting, fatigue is not simply a matter of reduced 
efficiency but a direct threat to operational readiness.
A recent systematic review published in Cureus 
examined 
fatigue 
countermeasures 
in 
military 
pilots, highlighting a range of strategies spanning 
behavioral interventions, operational adjustments, 
and pharmacologic agents. Across these approaches, 
stimulant-based interventions—particularly caffeine 
and modafinil—demonstrated the most consistent 
evidence for improving alertness and short-term 
performance. However, a key finding of the review, 
which focused on military pilots in Saudi Arabia, is that 
no intervention fully restored performance to well-rested 
levels, underscoring the need for layered, multifaceted 
strategies.1
“Unlike civilian aviation, military pilots operate 
under conditions that inherently increase fatigue risk, 
including irregular and extended duty hours, night 
operations, high-altitude missions, and deployment 
environments with limited rest opportunities,” the 
authors wrote. “These factors compromise sleep quality 
and duration, leading to chronic fatigue accumulation. 
As U.S. Military Pilots Play a 
Central Role in the Iran War, 
Concerns Grow About  
Managing Their Fatigue 
Unlike in civilian aviation, military pilots face irregular 
and extended duty hours, night operations, high-
altitude missions and deployment environments 
with limited rest opportunities.  In the Iran War, for 
example, flight operations can exceed 34 hours, 
increasing the risk of in-flight errors and reduced 
alertness.  Countermeasures include behavioral 
interventions, operational adjustments and 
pharmacologic agents.  In many cases, multifaceted 
strategies are the most successful in helping to fully 
restore performance without adequate rest.
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