Flight Attendant Fatigue, Part I: 

National Duty, Rest, and Fatigue Survey

Katrina Bedell Avers1

S. Janine King2

Thomas E. Nesthus1

Suzanne Thomas2

Joy Banks1

1

Civil Aerospace Medical Institute 

Federal Aviation Administration

Oklahoma City, OK 73125

2

Xyant Technology, Inc.

Oklahoma City,OK 73125

December 2009

Final Report

DOT/FAA/AM-09/24

Office of Aerospace Medicine

Washington, DC 20591

OK-10-0077
NOTICE

This document is disseminated under the sponsorship 

of the U.S. Department of Transportation in the interest 

of information exchange. The United States Government 

assumes no liability for the contents thereof.

___________

This publication and all Office of Aerospace Medicine 

technical reports are available in full-text from the Civil 

Aerospace Medical Institute’s publications Web site: 

www.faa.gov/library/reports/medical/oamtechreports
i 

Technical Report Documentation Page 

1. Report No. 2. Government Accession No. 3. Recipient's Catalog No. 

DOT/FAA/AM-09/24 

4. Title and Subtitle 5. Report Date 

Flight Attendant Fatigue, Part I: National Duty, Rest, and Fatigue Survey December 2009 

6. Performing Organization Code 

 

7. Author(s) 8. Performing Organization Report No. 

Avers KB,1 King SJ,2 Nesthus TE,1 Thomas S,2Banks J1 

9. Performing Organization Name and Address 10. Work Unit No. (TRAIS) 

 

11. Contract or Grant No. 

1

FAA Civil Aerospace Medical Institute 

P.O. Box 25082 

Oklahoma City, OK 73125 

2

Xyant Technology, Inc. 

Oklahoma City, OK 73125 

 

12. Sponsoring Agency name and Address 13. Type of Report and Period Covered 

Office of Aerospace Medicine 

Federal Aviation Administration 

800 Independence Ave., S.W. 

Washington, DC 20591 14. Sponsoring Agency Code 

15. Supplemental Notes 

Work was accomplished under approved task AM-A-08-HRR-521 

16. Abstract 

Today’s aviation industry is a 24/7 operation that produces a variety of challenges for cabin crew members 

including extended duty periods, highly variable schedules, frequent time zone changes, and increased passenger 

loads. While these operational requirements may be necessary, they are far from ideal with respect to the human 

body’s biological rhythms for managing sleep and alertness. In fact, acute sleep loss, sustained periods of 

wakefulness, and circadian factors resulting from this form of misalignment all contribute to fatigue and fatiguerelated mishaps (Caldwell, 2005; Rosekind et al., 1996). This survey study was conducted to identify the specific 

operational factors that may contribute to fatigue in cabin crew operations. A retrospective survey was 

disseminated to flight attendants representing 30 operators (regional = 17, low-cost = 7, and network = 6). The 

survey addressed 7 main topics: work background, workload and duty time, sleep, health, fatigue, work 

environment, and general demographics. Participants were 9,180 cabin crewmembers who voluntarily and 

anonymously completed the survey and met the criteria to be included in the report (i.e., active flight attendant 

that had flown the previous bid period with their current airline). This report outlines the results of this survey 

and provides specific recommendations regarding fatigue issues in cabin crew operations. 

 

17. Key Words 18. Distribution Statement 

 

 

Fatigue, Flight Attendant, Survey, Duty Time, Workload, 

Scheduling

Document is available to the public through the 

Defense Technical Information Center, Ft. Belvoir, VA 

22060; and the National Technical Information 

Service, Springfield, VA 22161 

19. Security Classif. (of this report) 20. Security Classif. (of this page) 21. No. of Pages 22. Price 

Unclassified Unclassified 23 

Form DOT F 1700.7 (8-72) Reproduction of completed page authorized 

iii 

Contents

Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Fatigue Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

 Nature of Fatigue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Flight Attendant Workload . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Flight Attendant Duty Time Regulations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

 Other Aviation Factors Contributing to Fatigue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Scope of the Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Participants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

 Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

 Data and Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

 Demographics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

 Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Work Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Workload and Duty Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Sleep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Fatigue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Work Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

 Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Fatigue in Cabin Crew Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Fatigue Factors Identified . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Scheduling Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

 Other Fatigue Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Shared Responsibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Fatigue Countermeasure Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

 Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

v 

Acknowledgment

Thank you to the many airlines, labor organizations, and flight attendants for your collaboration, 

support, and feedback.

vii 

Executive Summary

Today’s aviation industry is a 24/7 operation that 

produces a variety of challenges for cabin crew members including extended duty periods, highly variable 

schedules, frequent time zone changes, and increased 

passenger loads. While these operational requirements 

may be necessary, they are far from ideal with respect 

to the human body’s biological rhythms for managing 

sleep and alertness. In fact, acute sleep loss, sustained 

periods of wakefulness, and circadian factors resulting 

from this form of misalignment all contribute to fatigue 

and fatigue-related mishaps (Caldwell, 2005; Rosekind 

et al., 1996).This survey study was conducted to identify 

the specific operational factors that may contribute to 

fatigue in cabin crew operations.

A retrospective survey was disseminated to flight 

attendants representing 30 operators (regional = 17, 

low-cost = 7, and network = 6). The survey addressed 7 

main topics: work background, workload and duty time, 

sleep, health, fatigue, work environment, and general demographics. Participants were 9,180 cabin crewmembers 

who voluntarily and anonymously completed the survey 

and met the criteria to be included in the report (i.e., 

active flight attendant that had flown the previous bid 

period with their current airline).

The majority (84%) of cabin crewmembers indicated 

they had experienced fatigue while on duty in the previous 

bid period. When asked to indicate their level of agreement with a series of statements regarding fatigue, 93% 

agreed that they had experienced fatigue at work. The 

majority (93%) indicated that flight attendant fatigue 

represents a safety risk, and 91% agreed that fatigue was a 

common occurrence.Despite the frequency of occurrence 

and safety implications, only 35% of flight attendants 

received any type of training or information regarding 

fatigue from their airline. Of those who had received 

training, 79% reported that the training was helpful to 

a “limited extent” or “not at all.”

Fatigue factors identified by respondents included 

length of duty days, consecutive duty days, rest periods, 

nutrition, and others. The most frequently identified 

fatigue factors regarded length of duty day, consecutive 

duty days, missed meals, and lack of breaks. Scheduling 

factors made up 9 of the 10 most common operational 

change recommendations that flight attendants proposed 

to reduce flight attendant fatigue. The most common 

recommendations included: eliminate reduced rest, do not 

mix continuous duty overnight with early-morning report 

times, maintain consistent scheduling, limit number of 

flight segments/legs, limit number of duty hours allowed, 

start scheduled rest period on arrival at hotel, lengthen rest 

periods, do not schedule several-hour breaks or “airport 

sits” between flight segments/legs, schedule enough time 

between flight segments/legs for meals, and provide flight 

attendants with food and beverage on flights.

The data from cabin crewmembers also recommended improved fatigue management education and 

examination of scheduling practices. Education plays a 

critical role in any effort to address fatigue in aviation 

operations and can provide benefits to both the individual and the organization (Avers, Hauck, Blackwell, 

& Nesthus, 2009). Analyzing scheduling practices, 

identifying potential improvements, and implementing 

changes may result in reduced fatigue, as well as other 

benefits to operations.

1 

Flight Attendant Fatigue, Part I:

National Duty, Rest, and Fatigue Survey

Background

While substantial research has been conducted on 

human circadian processes as applied to scheduling and 

training of flight crews, relatively little research has been 

accomplished among cabin crews. Performance of cabin 

duties is critical to safety and security, and the literature 

suggests that all human performance is vulnerable to 

sleep loss and daily variations in physiological processes 

tied to underlying body-clock mechanisms.The extent of 

sleep loss and fatigue and its impact upon performance 

of duties among the cabin crew population and within 

the current duty regulations is unknown.

In 2005, a Congressional directive to the Civil Aerospace Medical Institute (CAMI) was given to address 

issues regarding flight attendant fatigue.CAMI contracted 

with the National Aeronautics and Space Administration 

Ames Research Center’s Fatigue Countermeasures Group 

to conduct literature and incident report reviews and 

examine a range of typical flight attendant schedules to 

assess potential vulnerability to fatigue. Nesthus, Schroeder, Connors, Rentmeister-Bryant, and DeRoshia (2007) 

concluded that some degree of fatigue-related performance 

impacts were likely under the current regulations and 

suggested 6 areas of research that would facilitate understanding and government-industry decision making.

The 6 recommendations included: 1) a survey of field 

operations; 2) field research on the effects of fatigue; 3) a 

validation of models for assessing flight attendant fatigue; 

4) a focused study of incident reports; 5) a review of 

international policies and practices; and 6) the potential 

benefits of training.

In 2008, Congress provided another directive for 

CAMI to conduct follow-on studies in each of the 6 

recommendation areas noted in the 2007 report. To accomplish this directive, CAMI researchers developed a 

project plan for completing each recommendation. To 

facilitate support for these projects and ensure participation, CAMI researchers coordinated with representatives 

of vested organizations (e.g., Air Transport Association, 

Regional Airline Association, Coalition of Flight Attendants, and non-unionized carriers) and provided them 

with the opportunity to review and comment on aspects 

of the project plan prior to commencement.

The current report provides specific details regarding 

the national survey of flight attendant field operations 

(recommendation #1). This report will be incorporated 

into CAMI’s consolidated report to Congress.

Introduction

In a recent Aviation Safety Reporting System (ASRS) 

report, a flight attendant reported “...We were supposed 

to get meals. No meals. During the flight, all 4 of us 

were dizzy and very fatigued. I sat down on my jump 

seat and started to fall asleep. My eyes were burning and 

I was extremely hungry. If an emergency had happened, 

I would not have been able to perform. I feel this was 

extremely unsafe due to the fact that all 4 of us could not 

rest before the flight” (ASRS report 785013). Fatiguerelated incident reports, like this one, began to increase 

following the events of 9/11 and have continued to increase 

with the onset of an economic recession and subsequent 

reductions in the flight attendant workforce (Holcomb et 

al., 2009). Following the events of 9/11, Brown (2009) 

surveyed 291 flight attendants and pilots and asked them 

if fatigue had ever affected their ability to perform their 

duties safely; 97% said that fatigue may “somewhat” 

affect their ability to perform duties safely; and 68% 

responded that fatigue would “greatly” affect their ability 

to complete their duties safely.The preliminary evidence 

suggests that flight attendants are experiencing fatigue, 

and their safety performance is at risk.

Fatigue Definition

Fatigue is a multi-dimensional construct that has been 

defined and interpreted in a number of ways (Åkerstedt 

et al., 2004; Dodge, 1982). Most commonly, fatigue is 

described as sleepiness or a general tired feeling resulting 

from extended wakefulness, insufficient sleep, or circadian 

disruption (Åkerstedt, 1995a; Dinges, 1995). Although 

this definition sufficiently describes fatigue in a general 

way, it inadequately represents the performance decrements associated with fatigue. In the aviation industry, 

it may be better to consider fatigue in terms of its symptoms such as forgetfulness; poor decision-making; slowed 

reaction time; reduced vigilance; poor communication; 

impaired mood; nodding off; or becoming fixated, apathetic, or lethargic (Rosekind et al., 1996). It is important to recognize that fatigue is more than sleepiness or 

tiredness. Fatigue has psychological, physiological, and 

emotional implications that can impact the performance 

of safety-related duties, particularly during non-routine 

and emergency events.
2 

Nature of Fatigue

Extended duty times, rotating shifts, night flights, and 

transmeridian travel can all contribute to fatigue and the 

subsequent performance, alertness, and well-being of 

personnel via 2 biologically-based mechanisms: 1) the 

body’s circadian rhythm or internal body clock, and 2) the 

homeostatic mechanism or recent sleep history (including 

the amount of time since the last sleep period and the 

amount of prior sleep) (Caldwell, 2005).

Circadian Rhythm. The circadian rhythm is the body’s 

24-hr internal clock that regulates bodily functions such 

as body temperature, hormone secretion, digestion, 

performance capabilities, and mood (Rosekind et al., 

1996). Most notably, the circadian rhythm controls sleep 

and wakefulness patterns based on naturally occurring 

light-dark cycles in the environment (Dinges, Graeber, 

Rosekind, Samel, & Wegmann, 1996). Humans are preprogrammed to respond to these cues. In other words, 

the body is programmed to be awake when it is light 

and asleep when it is dark (Caldwell, 2005). There are 

2 periods of circadian low or physiological sleepiness: in 

the early-morning hours from 0200 – 0700 and, to a 

lesser degree, during mid-afternoon from 1400 – 1700 

(Akerstedt, 1995b; Caldwell, 1997; Mitler et al., 1988; 

Rosekind et al., 1996). These rhythms coincide with 

shift worker performance models and indicate that shift 

workers have an increased number of errors and delayed 

reaction times during periods of circadian low (Shappell, Patterson, & Sawyer, 2007). The circadian rhythm 

cannot adjust immediately to changes in the work/rest 

schedule or time zone. When such changes occur, the 

circadian rhythm is desynchronized from the environment 

for a period of time, and individual rhythms are out of 

sync with one another. The evidence suggests that work 

schedules in conflict with the circadian rhythm can result 

in cognitive and psychomotor performance decrements 

(Caldwell, 2005).

Homeostatic Sleep Mechanism. The homeostatic sleep 

process represents the accumulated sleep debt that occurs 

with increasing time awake, which dissipates with sleep 

(Billiard & Kent, 2003). The homeostatic mechanism 

interacts with the circadian rhythm and can result in 

progressive deterioration in alertness and performance 

as homeostatic pressure increases. Homeostatic regulation involves 2 factors that influence one’s most recent 

sleep history: 1) quality and quantity of sleep prior to a 

performance period and 2) the amount of continuous 

wakefulness prior to a performance period (Caldwell, 

2005). Sufficient daily sleep is a critical component in 

the homeostatic regulation of alertness and is often one 

of the first casualties in aviation operations.The evidence 

suggests that aircrews suffer from work-related sleep 

disturbances in a manner comparable to industrial shift 

workers that complain about sleep patterns and lack of 

sleep (Costa, 1997). Sleep loss is measured by time awake 

(not time on duty) and is central to the homeostaticallybased drowsiness and inattention that is known to be 

problematic in work that involves non-standard schedules 

(Rosekind et al., 1996). In fact, 2 hours of sleep loss can 

result in performance and alertness decrements and an 

increased likelihood of error or accident (Carskadon 

& Roth, 1991; Mitler et al., 1988). A significant sleep 

debt can accumulate with 5 hours of sleep per night for 

7 consecutive nights and can result in increased stress, 

subjective fatigue, fatigue, mood disturbance, tension, and 

decreased psychomotor vigilance performance (Dinges et 

al., 1997).Alternatively, continuous wakefulness beyond 

17 hr can result in performance decrements comparable to an individual considered legally drunk (BAC = 

0.05–0.10) (Arnedt, Wilde, Munt, & MacLean, 2001; 

Lamond & Dawson, 1999; Maruff, Falleti, Collie, Darby, 

& McStephen, 2005).

Flight Attendant Workload 

Cabin crew fatigue is thought of primarily as a function 

of scheduling and workload (Nesthus et al., 2007; Samel, 

Wegmann, & Vejvoda, 1995).Technological advances in 

the last 20 years have enabled passenger planes to increase 

in size and capacity, fly longer distances, and fly longer 

non-stop flights. With these advances, duty times and 

flight attendant responsibilities have also increased. On 

average, a flight attendant arrives one to 2 hours before 

a flight to begin pre-flight duties, continues to work during flight, and finishes the flight with post-flight duties 

(Nesthus et al., 2007). At completion of the post-flight 

duties, a flight attendant will either prepare for the next 

flight or conclude the duty day and travel to rest accommodations. Examples of flight attendant activities 

performed while on-duty include:

Pre-flight duties: Check E-mail, attend a pre-flight 

briefing, stock the galley, check all emergency and other 

equipment, monitor passenger access and seating, assist 

with the stowage of luggage, arm doors, and fill out and 

provide the flight crew with relevant paperwork.

Routine flight duties: Attend to passenger safety and 

comfort. Flight attendants provide safety instructions; 

enforce safety rules; prepare and serve food and drinks; 

distribute pillows, blankets, and magazines; work audio 

and video equipment; collect trays, glasses, and newspapers; answer passenger questions; and communicate as 

needed with the flight crew.

Non-routine flight duties:Depending on the emergency, 

flight attendants must notify the flight crew of malfunctioning equipment or emergency situations, deal with ill 

or disruptive passengers, operate first-aid or other medical 

equipment, distribute medication, operate emergency 
3 

equipment, instruct passengers on emergency landings, 

direct the evacuation of passengers, and various other 

duties as needed.

Post-flight duties: Disarm doors, deplane passengers, 

check and tidy the cabin, report cabin discrepancies to 

the flight crew members, and report to operations for 

e-mail and other instructions.

As evidenced above, flight attendants engage in a 

number of physically demanding tasks and are always 

“on” as they interact continuously with passengers. The 

most challenging tasks, however, seem to be those related 

to ensuring safety and responding to non-routine situations.Unfortunately, previous research on flight attendant 

fatigue indicates that safety-related duties may be most 

susceptible to the effects of fatigue and circadian rhythm 

dysfunction (Nesthus et al., 2007).

Flight Attendant Duty Time Regulations 

The Code of Federal Regulations (CFR) is the codification of the general and permanent rules published in 

the Federal Register by the executive departments and 

agencies of the Federal Government, one of which is the 

FAA. Two sections of Title 14 of the CFR regulate flight 

attendant duty time and rest requirements (CFR, 2003a; 

CFR, 2003b).

The current regulations (14 CFR §121.467 & 

§135.273) require that flight attendants receive a 

minimum rest period of 9 consecutive hours following 

a scheduled duty period of 14 hr or less (CFR, 2003a; 

CFR, 2003b).This rest period may be reduced to 8 hr if 

the subsequent rest period is at least 10 consecutive hours.

Following a scheduled duty period of greater than 14 hr, 

but no more than 20 hr, a minimum rest period of 12 hr 

must be provided. This may be reduced to 10 hr if the 

subsequent rest period is at least 14 consecutive hours.

If the rest period is reduced to 10 hr, the flight attendant 

may not be scheduled for a duty period of greater than 

14 hr during the 24-hr period commencing after the 

beginning of the reduced rest period. Flight attendants 

may not be scheduled for duty if they have not had at 

least the minimum rest requirements. Furthermore, flight 

attendants must be relieved from duty for at least 24 hr 

during any 7 consecutive calendar days.

A 14-hr duty period may be extended up to 20 hr if 

the carrier schedules additional flight attendants above the 

minimum complement required. One additional flight 

attendant is required above the minimum complement to 

extend the scheduled duty hours to 16 hr. If 2 additional 

flight attendants are scheduled, the duty hours may be 

extended to 18 hr; and if 3 additional flight attendants 

are scheduled, the duty hours may be extended to no 

more than 20 hr. Table 1 summarizes the CFR as they 

relate to flight attendant schedules (Nesthus et al., 2007).

The CFRs, however, are limited in scope and do not 

take into account a number of operational issues that 

affect fatigue, such as time-zone transitions, layover and 

recovery, duty day start or end times, and the individual’s 

actual sleep need. In fact, existing fatigue research indicates 

that circadian disruption or circadian desynchrony are 

more important to fatigue concerns than simply “time 

on task” (Nesthus et al., 2007).

Several studies have examined the question of the 

amount of time a flight attendant has to be on duty 

before fatigue sets in. In one study (Simonson, 1984), 

the majority of flight attendants set the fatigue range 

at 6-10 hr of duty. However, 21% were not fatigued 

until completing 11-15 hr of duty. In another study 

(Galipault, 1980), the duty lengths that flight attendants 

thought induced tiredness ranged from 4 hr (10%), 5–6 

hr (51.1%), to 7–9 hr (27.6%). This study also found 

that short-duration flights with beverage or snack service 

produced large increases in end-of-duty fatigue.

Other Aviation Factors Contributing to Fatigue

Flight attendants are exposed to many other factors believed to contribute to or compound the risk of 

fatigue. Nesthus et al. (2007) conducted a literature 

review to identify the factors that influence fatigue in 

Table 1. Summarized Flight Attendant (FA) Rest Periods According to CFRs. 

Scheduled Duty 

Period 

(Hours) 

Normal Minimum 

Rest Period 

(Hours) 

Reduced Rest 

Period 

(Hours) 

Subsequent Rest 

Period 

(Hours) 

Number of FAs 

Required 

14 or less 9 8 10 Minimum 

14-16 12 10 14 Minimum + 1 

16-18 12 10 14 Minimum + 2 

18-20* 12 10 14 Minimum + 3 

*Applies only to duty periods with one or more flights that land or take off outside the 48 contiguous states and the 

District of Columbia. 

Note: Generally, rest periods begin no less than 15 min after the aircraft pulls into the gate and continues until 1 hr 

prior to a flight attendant’s next departure. 
4 

cabin crew operations. They collected and examined 99 

articles, websites, and other sources. The factors identified were: time pressure, high task demands, prolonged 

mental or physical exertion, extreme temperatures, time 

zone changes, personal demographics, nutrition and 

hydration, physical or medical problems, commuting, 

additional jobs, sleep environment, flight duration and 

type, and work environment. For a detailed discussion of 

these specific issues see: Enck, Muller-Sacks, Holtmann, 

and Wegmann, 1995; Ewing, 1999; Haugli, Skogstad, 

and Hellesoy, 1994; Hunt and Space, 1994; Nagda and 

Koontz, 2003; Rayman, 1997; Smolensky, Lee, Mott, 

and Colligan, 1982; Tashkin, Coulson, Simmons, and 

Spivey, 1983.

Scope of the Report

The present report will examine the frequency with 

which fatigue is occurring in cabin crew operations, the 

context in which it occurs (e.g., personal demographics, 

work environment, duty time), and the implications 

fatigue may have for cabin safety.

Method

Survey

A retrospective survey was disseminated to flight attendants representing 30 operators (regional = 17, low-cost 

= 7, and network = 6); see Table 2.The survey addressed 

each of the fatigue-related factors identified in a NASA

2007 literature review (Nesthus et al., 2007) and were 

broadly grouped into 7 main topics: work background, 

workload and duty time (including reserve status and 

rest periods), sleep demographics (including sleep at 

home and away from home), health, fatigue (including 

perceptions of fatigue, fatigue factors, fatigue effects, and 

coping strategies), work environment (including training 

and corporate attitudes), and demographic information.

The survey is available upon request.

Participants

Respondents to the survey were active flight attendants 

certificated by the FAA and listed in its Civil Aviation 

Registry. Using the Registry’s certification records, a 

random and representative sample was selected from 

each of the 30 operators included in this study. A total 

of 20,826 surveys were distributed. Flight attendants 

voluntarily and anonymously returned 10,550 completed 

surveys (online = 4,571; paper = 5,979), resulting in a 

51% overall response rate. Of those who responded, 

9,180 (online = 4,039; paper = 5,141) met the criteria 

for inclusion (i.e., were employed as an active flight attendant with their current airline for at least a month and 

had flown within the previous bid period), resulting in a 

44% adjusted response rate.

Administration

Flight attendants were mailed a survey package to 

the permanent address on file with the Civil Aviation 

Registry. Each survey packet included a paper survey, a 

postage-prepaid envelope addressed to the investigators, 

instructions for accessing the online survey (if desired), 

and a cover letter signed by the FAA’s Federal Air Surgeon.

To encourage accurate and forthright responses, the cover 

letter emphasized that participation was voluntary and 

anonymous. Flight attendants were instructed to either 

complete the survey and return it in the enclosed envelope or to access and submit the survey online. A unique 

identification number was provided to access the online 

survey, which enabled the researchers to verify that only 

one survey mode was submitted by each flight attendant.

The surveys were disseminated in 6 separate distributions over a one-month period beginning in November 

Table 2. Airline Classifications by Type of Operation. 

Low-Cost (N=7) 

Regional 

(N=17) 

Network 

(N=6) 

Air Tran 

Frontier 

JetBlue 

Southwest 

Spirit 

US Airways* 

Virgin America 

Air Wisconsin 

American Eagle 

Atlantic Southeast 

Chautauqua 

Comair 

Compass 

Executive 

ExpressJet 

Go Jet 

Horizon 

Mesa 

Mesaba 

Pinnacle 

PSA 

Republic 

Shuttle America 

Trans States 

Alaska 

American 

Continental 

Delta 

Northwest 

United 

* Classifications were obtained from the Bureau of Transportation Statistics. At the time 

of development, US Airways was classified as a low-cost operator. 
5 

2008. To improve the response rate, reminder postcards 

were mailed 2 weeks and 4 weeks following each survey 

distribution. The postcards encouraged participation 

and provided the participants with their original identification number to access the online survey. Following 

the postcards, a letter was sent to all non-responders to 

encourage participation. Eight weeks after the initial 

distribution of the surveys, a second survey package was 

sent to all non-responders. In total, survey packages were 

sent to 22,594 flight attendants representing each type of 

operation (regional, low-cost, network). Of those, 1,768 

surveys were deemed undeliverable for various reasons 

(e.g., deceased, undeliverable by the U.S. Postal Service, 

or no longer a flight attendant).

Data and Analysis

Data from the completed surveys were scanned using 

Snap Survey© software. Online responses were secured 

on a private Snap server and downloaded periodically.

Data were exported to Microsoft Access© tables for data 

processing. Subsequently, data were imported by SPSS©

for final analysis. Open-text numerical items were examined for outliers and classified as missing if the response 

was more than 2 standard deviations above or below the 

mean.Comments were transcribed and cleaned to remove 

any personal identification information.

Results

The results for this report combined all flight attendant responses and represent an analysis of the data 

overall. Subsequent reports will provide analysis of the 

data based on other factors such as seniority level and 

type of operation.

Demographics

Seventy-nine percent of the respondents were female, 

and respondents averaged 45.9 years of age, 5 ft 5 in of 

height, and 150 lbs. Most (83%) were satisfied with their 

job, overall.Over half (53%) reported an assigned domicile 

in the Eastern time zone, 24% in the Central, and 15% 

in the Pacific. Likewise, a majority (48%) reported living 

in the Eastern time zone, 26% in the Central, and 16% 

in the Pacific. Flight attendants reported using multiple 

modes of transportation to travel to their assigned domicile.The most frequently reported were personal vehicles 

(83%) and airplanes (28%).Commute times varied, with 

38% reporting more than 11⁄2 hr and 62% reporting less 

than 11⁄2 hr. The 15% that reported holding other jobs 

described spending an average of 39 hr per bid period 

working at them.

Health

Flight attendants were asked to rate their overall 

physical and mental health.Eighty-four percent indicated 

they were in “good” or “very good” physical health; 88% 

reported they were in “good” or “very good” mental health.

Fifty-three percent had been diagnosed by a physician with 

a medical condition that could contribute to fatigue. Of 

those diagnosed with a medical condition, 45% reported 

it had prevented them from flying a trip within the past 

year. The majority of flight attendants (82%) indicated 

they exercised at least once per week, 34% reported “1-2” 

times, 36% reported “3-4,” 10% “5-6” times, and 2% 

reported exercising 7 or more times in a week. Of flight 

attendants who reported routinely exercising, 68% exercised for 31 min or longer. Most flight attendants (75%) 

described their diet/eating pattern as “healthy” or “very 

healthy.” Half of flight attendants (51%) ate 2 meals in 

a 24-hr period, when on duty and only 33% drank 7 or 

more 8-ounce glasses of water.Thirteen percent of flight 

attendants reported using tobacco, with 11% indicating 

use of cigarettes. Of those who indicated tobacco use, 

69% used it 4 times or more in a 24-hr period. Fortyeight percent indicated that in a 24-hr period, they 

typically drank at least 1 serving of alcohol, while 90% 

drank at least 1 serving of a caffeinated beverage (e.g., 

coffee, tea, cola).

Work Background

The respondents reported working as flight attendants 

for a period of time ranging from 1 month to more than 

36 years in their careers: 32% reported “1 month to 5 yrs,” 

32% “6 to 15 yrs,” 21% “16 to 25 yrs,” and 16% “26 yrs 

or more.” The majority (73%) had worked for one airline 

throughout their career.Respondents represented the top 

one-third (41%), middle one-third (34%), and bottom 

one-third (26%) of the flight attendant seniority listing 

within their organization.Respondents were employed by 

airlines classified as “low-cost” (29%), “regional” (32%), 

“network carrier” (39%), and “other” (1%). Eighty-two 

percent of the respondents were represented by a union 

at their current airline.

The majority (64%) of flight attendants typically 

provided service on aircraft with a seating capacity of 50 

to 150 seats, and 24% provided service on flights with 

a seating capacity of 151 to 250. Flight attendants were 

personally responsible for a median of 50 passengers on 

a typical flight segment.The average flight attendant-topassenger ratio was somewhat skewed because when asked 

how many passengers they were personally responsible 

for on a typical flight, many flight attendants commented 

that service responsibilities were shared, while others 

reported personal responsibility for the safety of all passengers. Some examples of such comments include: “No 
6 

one is finished with their service unless everyone is finished” 

and “You are always responsible for all the pax [passengers], 

you may be the only one left.”

Flight attendants were asked a series of questions regarding their schedule. The average reported bid period 

was 28 days (including on duty, off duty, and training).

Respondents were asked to report the extent to which the 

previous bid period was their preferred schedule (or first 

choice bid request): 30% indicated “not at all” or “limited 

extent,” 25% “moderate extent,” 45% reported “considerable” or “great extent.” Flight attendants frequently trade 

trips to create a more preferred schedule, 42% indicated 

they were successful to a “considerable” or “great extent” 

in creating their preferred schedule.Thirty-eight percent 

voluntarily exchanged flight segments or trips with colleagues “1 to 2” times in the previous bid period; 14% 

exchanged “3-4” times. When asked how many times 

they were required to change their work schedule on 

short notice in the previous bid period, 51% reported 

“never,” while 35% were required to change “1 to 2” 

times. Fifty-five percent of flight attendants picked up 

extra (in addition to scheduled duty time) flying time at 

least once. Of those, 31% picked up “1 to 8 hr” of flying 

time, 34% picked up “9 to 16 hr,” 19% “17 to 24 hr,” 

9% “25 to 32 hr,” and 7% picked up “33 hr or more.” 

For the survey, a duty day was defined as a scheduled 

period of work including flight time, duty time, time spent 

“deadheading” (traveling to or from a flight assignment), 

and training. The number of flight segments/legs flown 

in a duty day ranged from 0 to 7, with an average of 2.8 

per day. Reported flight hours per segment/leg ranged 

from less than 1 hr to 7 hr or more: 2% reported flights 

“less than 1 hr,” 50% “1 to 2 hr,” 25% “3 to 4 hr,” 8% 

“5 to 6 hr,” and 16% “7 hr or more.” Nearly half of respondents (47%) reported that none of their flights went 

to countries outside of the United States, while about 

one-third (30%) indicated that up to 20% of their flights 

were outside the country, and 15% had flights outside 

the country more than 80% of the time. Respondents 

worked in each type of cabin service: on average 64% of 

the time in economy, 8% in business, 13% in first class, 

and 1% of the time in premium service.

Workload and Duty Time

Duty Time. Flight attendants reported flying an average 

of 3.9 duty days, on average, in a typical 7-day week with 

the average minimum number of duty days reported as 

3.1 days per week and an average maximum of 4.9 days 

per week. Cabin crewmembers were asked how many 

consecutive duty days they worked in a 7-day week; they 

reported an average of 3.9 days in a row and an average 

maximum of 4.7 days in a row. They reported working 

an average of 9.6 hr in a duty day, with an average range 

from 6.4 to 12.9 hr. In the bid period preceding the survey, flight attendants most commonly reported for duty 

in the early morning between 0400 and 0759 (M = 6.0 

times ). Fewer respondents indicated reporting for duty 

between 0800 and 1159 (M = 3.6 times), and between 

1200 and 1559 (M = 3.4 times). In contrast, duty end 

times were most commonly late at night, between 2000 

and 2359 (M = 5.1). Fewer duty days ended between 1600 

and 1959 (M = 4.3), and from 1200 to 1559 (M = 3.7).

Flight attendants actually flew an average of 6.8 flight 

hours in a duty day, typically ranging from an average 

of 4.5 to 8.9 hr. A typical duty day included an average 

of 2.8 flight segments/legs, with an average minimum 

of 1.6 segments/legs and an average maximum of 4 segments/legs. These values are expected to vary by type 

of operation in future reports. Twenty-seven percent of 

flight attendants did not have the opportunity to leave 

the aircraft between flight segments/legs, 46% had the 

opportunity on “1-20%” of flight segments/legs, and 

14% had the opportunity on “21-40%” of flight segments/legs. For the 73% that had an opportunity to leave 

the aircraft between flight segments/legs, their average 

time away from the aircraft was 27 min (median = 20).

Twenty-four percent of flight attendants were scheduled

for regular breaks in their duty day. For respondents who 

were able to take their scheduled breaks, the average time 

on break was 82 min. The majority that took scheduled 

breaks (59%) were provided with crew rest facilities (e.g., 

chair, bed) “81-100%” of the time.

Ninety-three percent of flight attendants experienced 

some type of flight delay within their previous bid period: 62% experienced delays “1-20%” of the time, 20% 

experienced delays “21-40%” of the time, 7% reported 

“41-60%,” 3% “61-80%,” and 1% experienced delays on 

“81-100%” of their flights. When flights were delayed, 

the typical delay was 54 min (median = 45). At the end 

of the duty day (when the cabin door was opened), it 

took flight attendants an average 49 min to arrive at their 

rest accommodations.The average wait for transportation 

to accommodations was 16 min. Flight attendants, on 

average per bid period, stayed at “home” 11 times per 

bid period, a “hotel” 9 times, a “trailer” less than 1 time, 

an “airport lounge” 1 time, and “other” accommodations 

2 times. At the end of the duty day, during the required 

rest period, 18% of flight attendants were typically in 

their home time zone, 30% were “1” time zone away 

from home, 21% were “2” time zones away, 15% were 

“3” away, 5% were “4 or 5” time zones away, and 12% 

were “6 or more” time zones away.

Continuous Duty Overnight. In a typical bid period, 

30% of flight attendants flew at least one Continuous 

Duty Overnight (CDO).ACDO is a duty day that begins 

in the evening and runs all night or ends the following 
7 

morning.Although a break may be provided, it is less than 

the reduced rest period, and the flight attendant remains 

on duty between flight segments/legs. On average, flight 

attendants served on 3.2 CDOs that were “all night” and 

3.6 CDOs that were “night-into-day” in the previous bid 

period.The majority (87%) reported a CDO with “1 to 

2” flight segments/legs. During a CDO, 26% of flight 

attendants reported having no scheduled ground time, 

15% reported “less than 1 hr,” 16% reported “1 to 2 

hr,” 4% indicated “3 to 4 hr,” and 40% received “5 hr 

or more” scheduled ground time. Of the 74% of flight 

attendants that reported having scheduled ground time, 

31% indicated having no available ground time for sleep.

Of the 69% with available ground time for sleep, only 

7% reported not actually sleeping, while 16% indicated 

they slept “less than 1 to 2 hr,” 53% slept “3-6 hr,” and 

24% slept “7 hr or more” during that time. When on a 

CDO, 35% reported their airline provided “on board” 

crew rest periods. Of those who received “on board” rest 

periods, 95% reported that their airline provided specific 

facilities “on board” for crew rest.

On average while on CDO, flight attendants stayed 

in the following accommodations: at “home” (12%), a 

“hotel” (70%), a “trailer” (<1%), an “airport lounge” 

(4%), and “other” accommodations (13%). Overall, 

16% of flight attendants reported “good” or “very good” 

quality rest, 32% reported “fair” quality, and more than 

half (52%) reported “poor” or “very poor” quality of rest 

when on CDO.

Reserve Status. Twenty-two percent of flight attendants 

reported flying “on reserve” (on call) in the previous bid 

period. The majority of “on reserve” flight attendants 

(87%) were without a flying assignment for some percentage of their bid period. Thirty percent identified 

their reserve assignment as “NOT at the airport” and 

5% identified their reserve as “at airport.” Most (65%), 

however, indicated they were assigned “both on reserve 

NOT at the airport and on reserve at airport.” When 

on reserve at the airport, 51% were required to perform 

additional duties. Forty-three percent of flight attendants 

were notified an average of “1 to 2 hr” prior to report time 

while 27% were notified of “3 to 4 hr” prior to report 

time, 9% were notified “5 to 6 hr” prior to report time, 

and 20% were notified “7 hr or more” prior to report 

time. Many reserve flight attendants (44%) were able to 

get an average of “7 hr or more” of sleep prior to reporting 

for duty; 45% reported “5 to 6 hr” sleep; and 11% had 

4 hr or less of sleep prior to reporting for duty.

Rest Periods. Flight attendants most frequently (79%) 

reported the normal minimum rest period was “9hr or 

more.” The airline designated reduced rest period was most 

often (54%) reported as “8 hr”; 30% reported “9 hr or 

more.” On average, flight attendants were scheduled for 

normal minimum rest 6.8 times during the bid period 

and reduced rest 1.2 times in the previous bid period.

Flight attendants were required to take unscheduled 

reduced rest approximately 1 time in the previous bid 

period. When asked how frequently their 24-hr period 

free from duty was retroactively assigned as a required rest 

period, 84% percent reported none, 7% indicated that 

it occurred 1 time, and 9% indicated “2 or more” times 

in the previous bid period. Although regulations specify 

that flight attendants are required to have 24 hr of rest in 

7 consecutive duty days, 6% of flight attendants indicated 

they had worked 7 consecutive duty days without 24 hr 

of rest at least once in the previous bid period.

Sleep

Overall, the majority (87%) of flight attendants reported being “moderate,” “light,” or “very light” sleepers.

Most (66%) believed they needed “7 to 8” hr of sleep in 

a 24-hr period, and 26% felt they needed “9 to 10” hr.

At Home. The flight attendants presented a normal 

sleep profile, on average, sleeping 7.7 hr per night. They 

reported a median bedtime of 2200 hr, and a get out of 

bed time of 0730 hr on their days off.The frequency and 

range of go to bed times and get out of bed times can 

be seen in Figure 1. The majority reported an average 

sleep latency of 30 min or less (69%) and reported 1 to 

3 awakenings per night (75%). After awakening, 63% 

of respondents took 15 min or less to return to sleep.

They reported getting 15.6 nights of sleep at home, on 

average, within a bid period.

Respondents were asked the frequency with which 

they nap when at home: 31% reported taking “none,” 

49% reported napping “1-5 times,” 12% “6-10 times,” 

5% “11-15,” and 3% indicated “16 times or more.” Reporting the number of nights they experienced problems 

falling to sleep at home, 80% indicated they had problems 

falling asleep, while 20% indicated they did not have a 

problem falling asleep and did not use sleep aids. When 

at home, 20% of respondents used 2 or more sleep aids 

to help fall asleep. Twenty percent of respondents said 

they used prescription medication, 27% reported using 

over-the-counter medications, 20% indicated they used 

alcohol, and 9% used melatonin to help them sleep.

Flight attendants were asked to rate 22 factors and an 

“other” option on the extent to which each interfered with 

typical home sleep, using a 5-point scale from “1=not at 

all” to “5=great extent.” The responses for each factor were 

averaged (Figure 2). The top-5 factors interfering with 

sleep at home based on these averages were: stress (M = 

2.42, SD = 1.24), personal worries (M=2.37, SD=1.18), 

trips to the bathroom (M=2.15, SD=0.98), time zone 

changes or jet lag (M=2.11, SD=1.33), and readiness 

for sleep (M=2.08, SD=1.20). When asked to rate their 
8 

overall quality of sleep at home on a 5-point scale from 

“very poor” to “very good,” 56% reported “good” or “very 

good,” 35% reported “fair,” and 10% reported “poor” 

or “very poor.”

Away from home. The flight attendants presented a 

somewhat different sleep profile when sleeping away from 

home. On average, flight attendants reported sleeping 

6.5 hr per night away from home. Sixty-one percent 

reported an average sleep latency of 30 min or less, and 

68% reported 1 to 3 awakenings per night.After awakening, 51% of respondents took 15 min or less to return to 

sleep.They reported getting an average of 11.2 nights of 

sleep away from home within a bid period.

Respondents were asked the frequency with which 

they nap when away from home: 48% reported “none,” 

42% reported napping “1-5 times,” 7% “6-10 times,” 

2% “11-15,” and 1% indicated “16 times or more.” 

Reporting the number of nights they experienced problems falling to sleep away from home, 90% reported 

problems falling asleep, while 10% indicated they did 

not have a problem falling asleep and they did not use 

any type of sleep aids. When away from home, flight 

attendants had problems falling asleep an average of 

6 nights in a bid period. Thirty-nine percent of flight 

attendants reported using some type of sleep aid when 

away from home, with 13% using 2 or more methods.

Figure 1. Average "go to bed" and "get out of bed" times on days off.

0 500 1000 1500 2000 2500 3000 3500 4000 4500 5000

0000 thru 0159

0200 thru 0359

0400 thru 0559

0600 thru 0759

0800 thru 0959

1000 thru 1159

1200 thru 1359

1400 thru 1559

1600 thru 1759

1800 thru 1959

2000 thru 2159

2200 thru 2359

Time (0000 to 2359)

Number of respondents

Go to bed Get out of bed

 

Figure 1. Average “go to bed” and “get out of bed” times on days off. 

Figure 2. Factors that most interfere with sleep.

0

0.5

1

1.5

2

2.5

3

3.5

Home 1.89 2.06 1.8 2.11 2.08 2.15 2.37 2.42

Away 3.35 3.21 3.03 3 2.96 2.34 2.45 2.72

Random 

noise

Fear of oversleeping Temp Jet lag Ready for 

sleep

Restroom 

use

Personal 

worries Stress

Figure 2. Factors that most interfere with sleep. 
9 

Eighteen percent reported using a prescription medication to help them sleep while 24% reported using 

over-the-counter medications, 17% indicated they used 

alcohol, and 8% used melatonin.

Flight attendants were asked to rate 22 factors and 

an “other” option on the extent to which each interfered with typical sleep when away from home, using 

a 5-point scale from “1=not at all” to “5=great extent.” 

The responses for each factor were averaged.The top-5 

factors interfering with sleep away from home, based 

on these averages, were: random noises (M=3.35, 

SD=1.26), fear of oversleeping (M=3.21, SD=1.45), 

temperature (M=3.03, SD=1.23), time zone changes 

or jet lag (M=3.00, SD=1.37), and readiness for sleep 

(M=2.96, SD=1.32). When asked to rate their overall 

quality of sleep away from home on a 5-point scale 

from “very poor” to “very good,” 18% reported “good” 

or “very good,” 48% reported “fair” and 34% reported 

“poor” or “very poor.”

Fatigue

When asked if they experienced fatigue while on 

duty, 84% reported being fatigued in their previous 

bid period. More than half of the flight attendants 

who responded (52%) indicated they had “nodded 

off” while working on a flight segment/leg. Of those 

who reported being fatigued, 44% identified workload 

as a contributing factor, 42% indicated work pace, 

and 83% reported that work schedule contributed to 

fatigue. Flight attendants were given a list of 44 specific 

events (and an “other” option) believed to contribute 

to fatigue in aviation operations. They were asked to 

identify the frequency with which each event occurred 

(1=never, 2=rarely, 3=occasionally, 4=frequently, 5=always) and the extent to which each event contributed 

to their perceived fatigue (1=not at all, 2=limited extent, 

3=moderate extent, 4=considerable extent, and 5=very 

great extent). A total of 24 factors were identified that 

contributed to fatigue to a moderate extent or greater 

(including early-morning report, continuous duty 

overnight, jet lag, meals with poor nutrition, flying 4 

or more segments/legs in a day, and others). Figures 3 

through 7 show the distribution of factors by category, 

the effect each factor has on fatigue, and the frequency 

of occurrence. The 10 reported factors with the most 

impact on fatigue, shown in Figure 8, are: 14 hr or 

longer duty day, quick shift turnaround (less than 9 

hours), 10 to 13-hr duty day, 14 or more consecutive 

duty days, short layovers, no breaks, missed meals, long 

delays (3 hr or more), missed breaks, and 8-13 consecutive duty days. Examining the fatigue effect rating in 

conjunction with the frequency of occurrence, 4 of the 

top-10 factors received frequency ratings greater than 

“occasionally,” including: 10-13 hr duty day, missed 

meals, no breaks, and short layovers.

Of the flight attendants experiencing fatigue while 

on duty, 71% reported their safety-related performance 

was affected. Of those, 60% believed their ability to 

respond to passenger needs (including service and 

safety-related items) was compromised, 36% reported 

cabin safety performance (e.g., arming/disarming doors, 

verifying seatbelts fastened) was affected, 34% felt their 

vigilance regarding cabin security (e.g., passenger risk 

assessment) was impeded, and 14% indicated preflight 

safety briefings were affected.

Figure 3. Highest-rated fatigue factors associated with the work environment.

0

1

2

3

4

5

0

1

2

3

4

5

Effect 3.45 2.80 2.52 2.45 2.43 2.38 2.36 2.14 2.09 1.87

Frequency 2.68 2.22 3.05 1.59 2.61 1.82 2.38 2.62 2.67 3.34

Lack of 

crew rest 

Contamin. 

cabin air

Weather 

conditions

Faulty 

cabin 

High cabin 

temp

Severe 

turb

Loud 

noises

Low cabin 

temp

Moderate 

turb Light turb

Figure 3. Highest-rated fatigue factors associated with the work environment. 
10 

Figure 4. Highest-rated fatigue factors associated with health.

0

1

2

3

4

5

0

1

2

3

4

5

Effect 3.65 3.47 3.46 3.24 3.19

Frequency 3.34 2.78 3.39 2.77 2.65

Missed 

meals Jet lag Meals with 

poor nutrition

Personal 

health Dehydration

Figure 4. Highest-rated fatigue factors associated with health. 

Figure 5. Highest-rated fatigue factors associated with scheduling patterns.

0

1

2

3

4

5

0

1

2

3

4

5

Effect 4.19 3.77 3.74 3.58 3.56 3.48 3.39 3.38 3.35 3.13 2.75 2.63

Frequency 2.52 3.56 1.29 1.45 3.43 1.99 2.48 2.57 2.55 2.46 3.36 3.30

≥14 hr 

duty day

10-13 hr 

duty day

≥14 

cons. 

duty 

8-13 

cons. 

duty 

Early 

AM 

report

Cons. 

CDO

Long 

flights 

(> 5 hr)

Night 

flying 

Rotating 

sched

Unpred 

sched

≤7 cons. 

duty 

days

6-9 hr 

duty day

Figure 5. Highest-rated fatigue factors associated with scheduling patterns. 

Figure 6. Highest-rated fatigue factors associated with layovers and delays.

0

1

2

3

4

5

0

1

2

3

4

5

Effect 3.82 3.72 3.69 3.64 2.79 1.87

Frequency 2.56 3.08 3.31 2.39 3.10 2.79

Quick turns 

(<9 hr)

Short 

layovers No breaks Long delays (≤3 hr)

Short delays 

(15 min-2 hr)

Long 

layovers

Figure 6. Highest-rated fatigue factors associated with layovers and delays. 
11 

Figure 7. Highest-rated fatigue factors associated with workload.

0

1

2

3

4

5

0

1

2

3

4

5

Effect 3.62 3.45 3.22 3.04 2.97 2.88 2.76 2.62 2.60 2.21 2.12

Frequency 2.78 2.82 2.36 3.23 1.78 2.56 3.71 2.20 2.21 3.31 2.98

Missed 

breaks

Flying ≥4 

seg/leg 

Inadeq. 

staffing

Luggage 

handling

Emerg. 

situation

Unruly / 

hostile 

PAX

Food / 

bev carts

PAX with 

medical 

problem

Ineb. 

PAX

Flying ≤3 

seg/leg

Crew 

interact.

Figure 7. Highest-rated fatigue factors associated with workload.

Figure 8. Highest-rated fatigue factors overall and frequency of occurrence.

0

1

2

3

4

5

0

1

2

3

4

5

Effect 4.19 3.82 3.77 3.74 3.72 3.69 3.65 3.64 3.62 3.58

Frequency 2.54 2.56 3.56 1.29 3.08 3.31 3.34 2.39 2.78 1.45

≥14 hr 

duty day

Quick 

turns 

10-13 hr 

duty day

≥14 cons. 

duty days

Short 

layover No breaks Missed 

meals

Long 

delays

Missed 

breaks

8-13 cons. 

duty days

Figure 8. Highest-rated fatigue factors overall and frequency of occurrence. 
12 

Flight attendants utilize a number of coping strategies 

to cope with fatigue. The top-5 most commonly used 

coping strategies for “on duty” and “off duty” are shown 

in Figure 9. More flight attendants appear to utilize coping strategies when “off duty” than “on duty.” It should 

also be noted that the type of coping strategies flight 

attendants use “off duty” are not available for use “on 

duty” (e.g., nutritious meals, naps, walks).

Flight attendants were asked to provide suggestions 

and changes to reduce fatigue in cabin crew operations.

Figure 10 shows the 10 most commonly recommended 

operational changes to reduce fatigue, along with the 

number of times each change was cited. Three changes 

were recommended more often than the others: Begin 

rest period on arrival at hotel, avoid multiple-hour breaks 

between flights, and provide food and drink on flights.

Flight attendants echoed these recommendations in their 

comments. Some examples include: 

...[R]est time should start when we get to the hotel 

and not when we arrive at the gate on the plane. 

There are times that we are waiting for almost an 

hour for transportation and it’s completely out of our 

control as a crew.

Figure 9. Fatigue coping strategies used by flight attendants.

0

1000

2000

3000

4000

5000

6000

7000

8000

Eat nutritious

meals

Drink plenty of

water

Take vitamins Take naps Take walks Eat multiple

meals

Use caffeine

Coping Strategies

Number of Respondents

Figure 9. Fatigue coping strategies used by flight attendants.

Figure 10. Flight attendant recommendations for reducing fatigue.

0 1000 2000 3000 4000 5000 6000 7000

Eliminate reduced rest

Don't mix CDOs and early

morning report times

Maintain consistent

scheduling

Limit flight segments/legs

Limit duty hours

Begin rest period at hotel

Longer rest periods

Avoid multiple hour breaks

between flights

Schedule time for meals

between flights

Provide food and drink on

flights

Number of Respondents

Figure 10. Flight attendant recommendations for reducing fatigue.
13 

There are so many factors that happened between 

arrival and closed hotel doors. Late shuttles, figuring 

out meet time, finding food, and just relaxing and 

unwinding...you can not do all this in an 8 hour 

rest... and you can’t fall asleep that fast either.

The long sit times over 3-4 hr do create huge fatigue 

for flight attendants and pilots.

To have to work these long days with nothing nutritious to eat and some time to have a break without 

interruption, is very difficult... Either the airline 

should provide a nutritious meal or give us the ability 

to store and cook food we have had to prepare and 

bring to work. Traditionally, the airline has carb. 

loaded food available, which causes drowsiness.

Work Environment

The majority of flight attendants indicated they were 

satisfied with their job overall (83%) and satisfied with 

the kind of work they do (91%). Despite these high 

levels of satisfaction, 25% reported that they frequently 

thought of quitting. When asked to what extent the 

airline shows concern for employees’ overall health, only 

18% indicated “considerable extent” or “great extent.” 

Similarly, only 9% of flight attendants perceived the 

airlines adjusting schedules to minimize fatigue to a 

“considerable extent” or “great extent.” That said, airlines do appear to be providing flight attendants with 

some type of fatigue training.Thirty-five percent of flight 

attendants reported receiving training or information 

regarding fatigue from their airline. The majority of 

flight attendants (79%) who received training, however, 

indicated it was only helpful to a “limited extent” or 

“not at all.” In fact, the results suggest little consistency 

between airlines regarding the coping strategies they are 

suggesting to employees.The most frequently reported 

recommendations were to drink plenty of water (30%) 

and eat nutritious meals (26%). Given the benefits of 

fatigue countermeasure training in other industries, 

the evidence seems to suggest that a more standardized and scientifically based, fatigue countermeasure 

training is needed in flight attendant operations. Avers 

et al. (2009) provides a detailed evaluation of fatigue 

training programs with recommendations on specific 

components required for effective development and 

implementation.

Discussion

Limitations

Before turning to the broader implications of the present report, certain methodological limitations and conceptual issues should be noted. Survey studies, in particular, 

are methodologically limited by the subjective nature of 

the data.Responses depend on perceptions, memory, and 

respondent understanding of the question. To mitigate 

the potential for error in these areas, three preventative 

measures were taken for this survey: 1) the survey questions were beta-tested with flight attendants and revised 

if commonly misunderstood; 2) flight attendants were 

primarily asked to answer questions that referenced their 

previous bid period (~30 days) to optimize the accuracy 

of memory; and 3) numerous response options were 

quantified to minimize interpretation using descriptors 

(e.g., “very rarely”: “1 to 2 times in previous bid period”).

In addition to the methodological limitations associated 

with surveys, research has demonstrated that individual’s 

subjective perception of their sleep is discrepant from 

physiological measures (Sasaki, Kurosaki, Mori, & Endo, 

1986). Self-assessed estimates of sleep latency times, sleep 

durations, awakenings, and other parameters are often 

inaccurate. The subjective responses to sleep questions 

are typically underestimated and provide a conservative 

approximation of objective measures (e.g., Hall, Johnson, 

& Watson, 2001).Nevertheless, interpretation of the findings should allow for the limitations of subjective data.

Fatigue in Cabin Crew Operations

Even bearing these limitations in mind, however, we 

believe that the results obtained in the present study have 

some noteworthy implications for understanding fatigue 

in cabin crew operations. Overall, responses indicated 

that flight attendants consider fatigue to be a significant 

issue. According to reports from the surveyed flight attendants, most have experienced fatigue while at work 

and agree that it is a common experience. Further, a 

great majority of cabin crew members consider fatigue a 

safety risk. Most indicated safety-related aspects of their 

performance such as cabin safety (e.g., arming/disarming 

doors), cabin security (e.g., passenger risk assessment), 

and attending to passenger needs (including service and 

safety-related duties) were affected by fatigue.

More than half of flight attendants reported that they 

had nodded off (i.e., micro-sleep) during flight during the 

previous bid period. Despite the numerous indicators of 

fatigue occurrence and fatigue risk in cabin crew operations, only about one-third of flight attendants reported 

they received training about fatigue from their airline.
14 

Fatigue Factors Identified

Responses from flight attendants corroborated many of 

the fatigue issues that are typically reported anecdotally.

Holcomb et al. (2009) provides evidence of flight attendant 

ASRS reports that highlights the significance of fatigue and 

possible safety-related issues.This survey found that long 

duty days, consecutive duty days, length of layovers, long 

delays, breaks, and nutrition were reported as concerns.

Of the fatigue factors that had the most effect on fatigue, 

the most frequently identified factors were length of duty 

day, number of consecutive duty days, missed meals, lack 

of breaks, and short layovers as significant.

Scheduling Factors

Scheduling factors made up 8 of the top-10 factors 

contributing to fatigue (see Figure 8). Several specific 

issues concerning cabin crew scheduling practices were 

identified through responses to questions on CDOs, 

flying reserve, duty report times, length of layovers, and 

breaks. Flight attendants reported average work days of 

9.6 hr, with an average minimum of 6.4 hr and an average 

maximum of 12.9 hr. Of the top-10 contributors, length 

of duty day (10 – 13 hr) was the most frequently cited 

factor contributing to fatigue. Duty days longer than 

14 hr were identified as most contributing to perceived 

fatigue.The most commonly recommended operational 

change to reduce the risk of fatigue in cabin crew operations was to start the scheduled rest period on arrival at 

the hotel or sleep accommodation. Three other top-10 

recommendations related to limiting duty hours, eliminating reduced rest, and extending rest periods.

Continuous duty overnights (CDO) involve flying 

during much of the night and sleeping during the day, 

especially when CDOs are scheduled consecutively.

Approximately one-third of flight attendants reported 

working CDOs in the previous bid period. Most airlines 

provide accommodations, usually hotels, for flight attendants flying CDOs. However, the majority of flight 

attendants working CDOs are receiving less than their 

average home sleep. Almost one-third of the respondents 

who had scheduled ground time during a CDO indicated 

there was no time available for sleep during that time.This 

suggests that flight attendants working CDOs may have 

started early-morning flight segments with a substantial 

sleep loss, regardless of the sleep they may have had later 

in the day. This sleep loss may magnify the performance 

decrements that normally would occur during the early 

morning circadian low. CDOs contributed to fatigue 

more than a moderate extent (M = 3.48). One of the 

top-10 recommendations made by flight attendants was 

to eliminate CDOs combined with early morning reports 

in the same duty period or sequence.

The approximately 20% of flight attendants who reported flying reserve may face another set of challenges.

The nature of flying on reserve means that they must 

be on call either “on reserve NOT at airport” or “on 

reserve at airport” and respond when called for duty.

The unpredictability associated with reserve status can 

lead to sleep loss – for instance, if a call for duty occurs 

when a sleep period was planned. Most flight attendants 

on reserve (56%) reported getting less than 7 hr of sleep 

before reporting for duty, when the average sleep for flight 

attendants was reported as nearly 8 hr when at home.

In addition to sleep loss, flying reserve may result in an 

increased workload, since the majority who flew reserve 

were required to perform other duties when “on reserve” 

at the airport. However, the top-10 flight attendant 

recommendations for reducing fatigue did not include 

changes to reserve practices – likely because less than half 

of the respondents fly reserve.

Early-duty report times are another scheduling factor 

that may contribute to sleep loss among flight attendants.

The most common report times were between 0400 and 

0759, according to responses. Early-morning start times 

may shorten the normal sleep period and result in sleep 

loss, so to accommodate an early report time, crewmembers may attempt to go to sleep earlier than normal to 

get their usual amount of sleep. The natural tendency 

of the circadian rhythm, however, could physiologically 

prevent anyone from falling asleep earlier. Of concern, 

the type of sleep lost during early-morning reports is 

most likely to be REM sleep, which occurs for greater 

duration during the early mornings and is often credited 

with the restoration of cognitive functions. Early-duty 

report times were not identified by flight attendants as a 

top-10 contributor to fatigue but should be considered, 

given our understanding of circadian rhythms and the 

early-morning effects on shift workers (e.g., Cruz & 

Della Rocco, 1995).

The amount of time between flight legs, including short 

layovers, was identified as one of the top-10 contributors 

to fatigue that occurred frequently. Interestingly, 2 issues 

seem to be associated with layover length: first, short layovers that do not allow for meals or breaks; and second, 

extended waits between flight segments may contribute 

to long duty days with little flight time. Therefore, 2 of 

the top-10 recommendations to reduce fatigue were: allow 

time for meals between flights and avoid multiple-hour 

breaks between flights.

Finally, the availability of breaks accounted for 2 of the 

top-10 contributors to fatigue that occurred frequently.

The majority of flight attendants do not receive scheduled 

breaks. Almost a third of flight attendants did not have 

the opportunity to leave the airplane in the previous bid 
15 

period, and almost half rarely left the airplane (1-20% 

of the time). Workload and time on task are known 

contributors to fatigue in other industries.Thus, it is not 

surprising that flight attendants reported missed breaks 

or no breaks as being strong contributors to fatigue.

Other Fatigue Considerations

Although 8 of the 10 highest-rated factors contributing 

to fatigue were clearly scheduling factors, the remaining 2 

factors seem to be inherently tied to scheduling or organizational policy. Missed meals was one of the strongest 

contributors to fatigue and occurred frequently in cabin 

crew operations.Lack of food and dehydration are known 

contributors to fatigue (e.g., Nesthus et al., 2007) and 

appear to be an issue of substantial concern among flight 

attendants. Two of the top-10 recommendations were 

for airlines to provide food and drinks on flights and to 

allow enough time between flights for meals.

Shared Responsibility

The key fatigue issues identified in this study, for the 

most part, seem to be managed by regulators and/or airlines – though examination of commuting and second-job 

impact remains to be examined. Even so, it should be 

noted that the issue of fatigue is a shared responsibility 

amongst flight attendants, regulators, and airlines. For 

example, more restrictive duty time limitations or risk 

management driven scheduling may provide longer rest 

periods. While this may be a solution, it can only be 

effective if flight attendants commit to getting the sleep 

they need to be safe and fit for duty. In turn, flight attendants may need fatigue countermeasure education 

to effectively manage fatigue and be prepared for duty.

In other words, effective fatigue management cannot be 

successful without everyone’s commitment (government, 

airline, flight attendant).

Fatigue Countermeasure Education

Although the results of this study indicated that fatigue 

training was considered of limited effectiveness, it is most 

likely a function of the inadequacy or inconsistency of the 

current fatigue training materials used in this industry.

Education plays a significant role in managing fatigue 

whether the fatigue factors concern regulations, flight 

schedules, physiological needs, or personal sleep habits 

(e.g., Co, Gregory, Johnson, & Rosekind, 1999; Caldwell, 

2005). If all industry members were equipped with basic 

information concerning fatigue, its causes, and its consequences for aviation safety and security, it could improve 

attention toward more effective fatigue management in 

cabin crew operations. Recent research indicates that 

flight attendants and pilots may benefit from additional 

training on fatigue countermeasures, including strategic 

caffeine use, how to create a suitable sleep environment 

at home and on trips, and how to develop good sleep 

habits (see Avers et al., 2009).

Recommendations

Flight attendants identified a number of fatigue factors 

in their responses. Some of these factors can be easily 

resolved, while others may require more effort. The primary factors can be broadly categorized as deriving from 

2 key areas: scheduling and physiological requirements.

Scheduling factors accounted for 8 of the highest-rated 

fatigue factors and 9 of the strongest recommendations 

by participants for reducing fatigue. An overall review 

of scheduling practices may be an important part of 

any attempt to address fatigue. An examination of duty 

duration, continuous-duty overnights, reserve practices, 

reduced rest, breaks, rest periods, and duty report times 

may be warranted. Identification of ways to improve 

schedules from a science-based fatigue standpoint, while 

meeting operational and economic needs of the airlines, 

would be constructive and may be possible in the form 

of fatigue risk management.

Missed meals accounted for the other key fatigue factor 

that was commonly identified by flight attendants. To 

some extent, this issue may be addressed by both flight 

attendants and by airlines. For example, airlines might 

provide fresh, healthy meals when flights have food service.

Flight attendants, in turn, could plan ahead and generally 

bring healthy snacks on board (although this is difficult 

during reduced rest conditions with limited access or 

time to purchase food). Similarly, airlines could provide 

beverages, or flight attendants could bring some bottled 

water or other non-caffeinated beverage, but the issue of 

missed meals seems to be inherently tied to missed breaks 

or no breaks. In other words, preparation of a healthy 

meal can only be beneficial if the flight attendant has the 

opportunity to eat the meal.

Fatigue countermeasure training does not appear to 

be widely used and provides limited value to flight attendants in its current form.The use of a comprehensive, 

science-based fatigue countermeasure training program 

may prove to be more beneficial to both flight attendants 

and airlines and is documented in a companion report 

(see Avers et al., 2009).
16 

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