Fatigue, Sleep, and Chronotherapy

  • Lakshmi Putcha
  • Thomas H. Marshburn

Early in the history of human space flight, scientists realized that several factors in the space environment might adversely affect human function and performance. Potential disturbances in circadian rhythms and the consequences of such disturbances on performance efficiency and the well-being of space crewmembers were among the principal concerns expressed [1]. In addition to environmental changes—e.g., microgravity and ultrashort light-dark cycles—several operational reasons were cited for the possible development of sleep disturbances and fatigue during space flight [2,3], including an abnormally long working period (the high-workload effect), continuing deviations in the sleep-wake schedule duration (the “migrating day” effect), phase shifting of sleep periods relative to Earthbased sleep time (the shift-work effect), and cyclic noise disturbances. The safety hazards associated with sleepiness and fatigue may have serious consequences for astronauts and cosmonauts as well as their supporting ground crews.

In the current space flight environment, imposed 24-h schedules often conflict with physiological and psychological rhythms of space crews, thereby changing their work-rest periods from their accustomed ground-based sleep-wake cycles. Although the consequences of this change remain largely unknown, this chapter is intended to provide a “snapshot” of trends in the assessment of sleep and fatigue, performance implications in space flight, and methods of monitoring and managing sleep and fatigue in operational settings. Also addressed are specific space flight issues related to risk assessment and to sleep and fatigue management strategies for current and future long-duration space flights.


Circadian Rhythm Sleep Duration Core Body Temperature Space Flight Space Shuttle 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Aschoff J. Timegivers of 24-hour physiological cycles. In: Schae-fer KE, (ed.), Man’s Dependence on the Earthly Atmosphere. New York, NY: MacMillan; 1962.Google Scholar
  2. 2.
    Shrughold H, Hale HB. (1975) Biological and physiological rhythms. In: Melvin Calvin (USA), and Oleg Gazenko (USSR) (eds.), Space as a Habitat. Vol. 1. Washington, DC: NASA Sci-entific and Technical Information Office; 1975:535-547. NASA SP-374. Calvin M, Gazenko OG, series eds., Foundations of Space Biology and Medicine.Google Scholar
  3. 3.
    Alyakrinskiy BS. Current status of space biorhythmology. Kosm Biol Aviakosm Med 1977; 2:1-13.Google Scholar
  4. 4.
    Carskadon MA, Dement WC. Norman human sleep. In: Kryer M, Roth T, Dement WC (eds.), Principles and Practice of Sleep Medicine. Philadelphia, PA: W.B. Saunders Co; 1989: 3-13.Google Scholar
  5. 5.
    Hauri P, Hawkins DR. Alpha-delta sleep. Electroencephalogr Clin Neurophysiol 1973; 34:233-237.PubMedGoogle Scholar
  6. 6.
    Carskadon MA (ed.), Encyclopedia of Sleep and Dreaming. New York, NY: Macmillan; 1993.Google Scholar
  7. 7.
    Aldrich MS. Sleep Medicine. New York, NY: Oxford University Press; 1999: 53:17-19.Google Scholar
  8. 8.
    Elsenbruch S, Harnish MJ, Orr WC. Heart rate variability during waking and sleep in healthy males and females. Sleep 1999; 22:1067-1071.PubMedGoogle Scholar
  9. 9.
    Dinges DF, Broughton RJ (eds.), Sleep and Alertness: Chrono-biological, Behavioral and Medical Aspects of Napping. New York, NY: Raven Press; 1989.Google Scholar
  10. 10.
    Carskadon MA, Roth T. Sleep restriction. In: Monk TH (ed.), Sleep, Sleepiness and Performance. Chichester, England: John Wiley & Sons, Ltd; 1991:151-167.Google Scholar
  11. 11.
    Bonnet MH. Sleep restoration as a function of periodic awaken-ing, movement, or electroencephalographic change. Sleep 1987; 10:364-373.PubMedGoogle Scholar
  12. 12.
    Levine B, Lumley M, Roehrs T, et al. The effects of acute sleep restriction and extension on sleep efficiency. Int J Neurosci 1988; 43:139-143.PubMedGoogle Scholar
  13. 13.
    Webb WB. The cost of sleep-related accidents: A reanalysis. Sleep 1995; 18:276-280.PubMedGoogle Scholar
  14. 14.
    Broughton RJ. Chronobiological aspects and models of sleep and napping. In: Dinges DF, Broughton RJ (eds.), Sleep and Alertness: Chronobiological, Behavioral and Medical Aspects of Napping. New York: Raven Press; 1989:71-97.Google Scholar
  15. 15.
    National Sleep Foundation. Excessive daily sleepiness. Gallup Survey: Sleepiness in America, 1997. Available at http://www.sleep-foundation. org/publications/SleepinessInAmerica.cfm(accessed October 15, 2003).
  16. 16.
    Dinges DF, Kribbs NB. Performing while sleepy: Effects of experimentally induced sleepiness. In: Monk TH (ed.), Sleep, Sleepiness and Performance. Chichester, England: John Wiley & Sons, Ltd; 1991:97-128.Google Scholar
  17. 17.
    Lavie P, Segal S. Twenty-four-hour structure of sleepiness in morning and evening persons investigated by ultrashort sleep-wake cycle. Sleep 1989; 12:522-528.PubMedGoogle Scholar
  18. 18.
    Horne JA. Sleep loss and “divergent” thinking ability. Sleep 1988; 11:528-536.PubMedGoogle Scholar
  19. 19.
    Haslam DR. Sleep loss, recovery sleep, and military perfor-mance. Ergonomics 1982; 25:163-178.PubMedGoogle Scholar
  20. 20.
    Horne JA. Dimensions to sleepiness. In: Monk TH (ed.), Sleep, Sleepiness and Performance. Chichester, England: John Wiley & Sons, Ltd; 1991:169-196.Google Scholar
  21. 21.
    Furlan R, Barbic F, Piazza S, et al. Modifications of cardiac auto-nomic profile associated with a shift schedule of work. Circula-tion 2000; 102:1912-1916.Google Scholar
  22. 22.
    Knutsson A, Akerstedt T, Johnsson BG, et al. Increased risk of ischaemic heart disease in shift workers. Lancet 1986; 2:89-92.PubMedGoogle Scholar
  23. 23.
    Samel A, Wegmann HM, Vejvoda M, et al. Two-crew operations: Stress and fatigue during long-haul night flights. Aviat Space Environ Med 1997; 68:679-687.PubMedGoogle Scholar
  24. 24.
    Samel A, Wegmann HM, Vejvoda M. Aircrew fatigue in long-haul operations. Accid Anal Prev 1997; 29:439-452.PubMedGoogle Scholar
  25. 25.
    Neville KJ, Bisson RU, French J, et al. Subjective fatigue of C-141 aircrews during Operation Desert Storm. Hum Factors 1994; 36:339-349.PubMedGoogle Scholar
  26. 26.
    Stanley N. Actigraphy in psychopharmacology. In: Hindmarch I, Stonier PD (eds.), Human Psychopharmacology. Chichester, England: John Wiley & Sons, Ltd; 1987:67-93.Google Scholar
  27. 27.
    Sadeh A, Alster J, Urbach D, et al. Actigraphically based auto-matic bedtime sleep-wake scoring: Validity and clinical applica-tions. J Ambul Monit 1989; 2:209-216.Google Scholar
  28. 28.
    Kripke DF, Mullaney DJ, Messin S. Wrist actigraph measures of sleep and rhythms. Electroencephalogr Clin Neurophysiol 1978; 44:674-678.PubMedGoogle Scholar
  29. 29.
    Monk TH, Buysse DJ, Rose LR. Wrist actigraphic measures of sleep in space. Sleep 1999; 22:948-954.PubMedGoogle Scholar
  30. 30.
    Frost JD, Shumate WH, Salmy JG, et al. (1974) Experiment M133. Sleep monitoring on Skylab. In: Johnston RS, Dietlein LF (eds.), Biomedical Results from Skylab. Washington, DC: NASA Scientific and Technical Information Office; 1977:113-126. NASA SP-377.Google Scholar
  31. 31.
    Berry CA. Summary of medical experience in the Apollo 7 through 11 manned spaceflights. Aerosp Med 1970; 41: 500-519.PubMedGoogle Scholar
  32. 32.
    Nicholson AN. Sleep patterns in the aerospace environment. Proc R Soc Med 1972; 65:192-193.PubMedGoogle Scholar
  33. 33.
    Nicholson AN. Rest and activity patterns for prolonged extrater-restrial missions. Aerosp Med 1972; 43:253-257.PubMedGoogle Scholar
  34. 34.
    Mount FE, Adam S, McKay T, et al. Human Factors Assess-ment of the STS-57 SpaceHab-1 Mission. Houston, TX: NASA-Johnson Space Center; 1994. NASA TM 104802.Google Scholar
  35. 35.
    Wegmann HM, Herrmann R, Winget CM. ASSESSII: A simulated mission of Spacelab (medical experiment). Nature 1978; 275:15-19.Google Scholar
  36. 36.
    Kuklinski P. Biomedical investigations on payload specialist during spacelab simulation ASESS II [abstract]. Presented at the Annual Scientific Meeting of the Aerospace Medical Associa-tion, Washington, DC, 14-17 May 1979.Google Scholar
  37. 37.
    Klein KE, Wegmann HM. Significance of circadian rhythms in aerospace operations. Advisory Group for Aerospace Research and Development (AGARD) Conference Proceeding No. 247. London: NATO/AGARD Technical Editing and Reproduction; 1980.Google Scholar
  38. 38.
    Santy PA, Kapanka H, Davis JR, et al. Analysis of sleep on shuttle missions. Aviat Space Environ Med 1988; 59:1094-1097.PubMedGoogle Scholar
  39. 39.
    Monk TH, Buysse DJ, Billy BD, et al. Sleep and circadian rhythms in four orbiting astronauts. J Biol Rhythms 1998; 13:188-201.PubMedGoogle Scholar
  40. 40.
    Dijk D-J, Neri DF, Wyatt JK, et al. Sleep, performance, circa-dian rhythms, and light-dark cycles during two Space Shuttle flights. Am J Physiol Regulat Integr Comp Physiol 2001; 281: R1647-R1664.Google Scholar
  41. 41.
    Hart LK, Freel MI, Milde FK. Fatigue. Nurs Clin North Am 1990; 25:967-976.PubMedGoogle Scholar
  42. 42.
    Potempa K, Lopez M, Reid C, et al. Chronic fatigue. Image: J Nurs Scholarsh 1986; 18:165-169.Google Scholar
  43. 43.
    Grandjean E. Fatigue in industry. Br J Industr Med 1979; 36:175-186.Google Scholar
  44. 44.
    Dinges DF. An overview of sleepiness and accidents. J Sleep Res 1995; 4:4-14.PubMedGoogle Scholar
  45. 45.
    National Transportation Safety Board. Evaluation of U.S. Depart-ment of Transportation efforts in the 1990s to address operator fatigue. Washington DC: NASA; 1999:31-38. NASA SR-99-01. Available at Accessed November 24, 2003.
  46. 46.
    National Transportation Safety Board and NASA-Ames Research Center. Managing Fatigue in Transportation: Fatigue Symposium Proceedings. Beal J, Rosekind MR, chairs. November 1-2, 1995, Washington, DC. Available at November 24, 2003.
  47. 47.
    McDonald N. Fatigue, Safety and the Truck Driver. London: Taylor & Francis; 1984:104-115.Google Scholar
  48. 48.
    Moore-Ede MC, Sulzman FM, Fuller CA. The Clocks That Time Us. Cambridge, MA: Harvard University Press; 1982.Google Scholar
  49. 49.
    Minors DS, Waterhouse JM. Introduction to circadian rhythms. In: Folkard S, Monk TH (eds.), Hours of Work. Chichester, England: John Wiley & Sons, Ltd; 1985:1-14.Google Scholar
  50. 50.
    Minors DS, Waterhouse JM, Wirz-Justice A. A human phase-response curve to light. Neurosci Lett 1991; 133:36-40.PubMedGoogle Scholar
  51. 51.
    Kryger M, Roth T, Dement WC (eds.), Principles and Practice of Sleep Medicine, 2nd edn. Philadelphia: W.B. Saunders Co; 1994.Google Scholar
  52. 52.
    Schreuder OB. Medical aspects of aircraft pilot fatigue with special reference to the commercial jet pilot. Aerosp Med 1966; 37:1-44.PubMedGoogle Scholar
  53. 53.
    Longmeire I. Fatigue: How does it tie in with stress? Patient Care 1981; 15:238.Google Scholar
  54. 54.
    Bisson RU, Lyons TJ, Hatsel C. Aircrew fatigue during desert shield C-5 transport operations. Aviat Space Environ Med 1993; 64:848-853.PubMedGoogle Scholar
  55. 55.
    Aronson LS, Teel CS, Cassmeyer V, et al. Defining and measur-ing fatigue. Image: J Nurs Scholarsh 1999; 31:45-50.Google Scholar
  56. 56.
    Stoner JD. Aircrew fatigue monitoring during sustained flight operations from Souda Bay, Crete, Greece. Aviat Space Environ Med 1996; 67:863-866.PubMedGoogle Scholar
  57. 57.
    French J, Hannon P, Brainard G. Effects of bright illuminance on body temperature and human performance. Ann Rev Chrono-pharm 1990; 7:37-40.Google Scholar
  58. 58.
    Gillot G, Kane-Toure N, Mahiddine S. Similarities between sus-tained sport performance and behavior in extended spaceflights. Adv Space Biol Med 1996; 5:331-339.PubMedGoogle Scholar
  59. 59.
    Christensen JM, Talbot JM. A review of the psychological aspects of space flight. Aviat Space Environ Med 1986; 57: 203-212.PubMedGoogle Scholar
  60. 60.
    Halberg F, Carandente F, Cornelissen G, et al. [Glossary of chro-nobiology (authors’ translation)]. Chronobiologia 1977; 4:1-189.PubMedGoogle Scholar
  61. 61.
    Winget CM, DeRoshia CW, Markley CL, et al. A review of human physiological and performance changes associated with desynchronosis of biological rhythms. Aviat Space Environ Med 1984; 55:1085-1096.PubMedGoogle Scholar
  62. 62.
    Rhoades RA, Tanner GA (eds.), Medical Physiology. Boston: Little, Brown, 1995.Google Scholar
  63. 63.
    Shanahan TL, Czeisler CA. Light exposure induces equivalent phase shifts of the endogenous circadian rhythms of circulat-ing plasma melatonin and core body temperature in men. J Clin Endocrinol Metab 1991; 73:227-235.PubMedGoogle Scholar
  64. 64.
    Vining RF, McGinley RA, Maksvytis JJ, et al. Salivary cortisol: A better measure of adrenal cortical function than serum cortisol. Ann Clin Biochem 1983; 20:329-335.PubMedGoogle Scholar
  65. 65.
    Shibasaki T, Imaki T. Corticotropin releasing factor, opioid and arousal in stress. In Mornex R, Jaffiol C, LeClere J (eds.), Progress in Endocrinology: Proceedings of the Ninth International Congress of Endocrinology, Nice, 1992. Carnforth, UK: Parthe-non Publishing; 1993:185.Google Scholar
  66. 66.
    Hanley J, Adey WR. Sleep and wake states in the Biosatellite III monkey: Visual and computer analysis of telemetered electroen-cephalographic data from earth orbital flight. Aerosp Med 1979; 42:204-213.Google Scholar
  67. 67.
    Hoshizaki T, Durham R, Adey WR. Sleep/wake patterns of a Macaca nemestrina monkey during nine days of weightlessness. Aerosp Med 1971; 42:288-295.PubMedGoogle Scholar
  68. 68.
    Fuller CA, Murakami DM, Sulzman FM. Gravitational biology and the mammalian circadian timing system. Adv Space Res 1989; 9:283-292.PubMedGoogle Scholar
  69. 69.
    Winget C, Vemikos-Danellis J, Cronin S, et al. Rhythms during hypokinesis. In: Ferin M, Halber F, Richart RM, et al., (eds.), Biorhythms and Human Reproduction. New York: Wiley & Sons; 1974:575-587.Google Scholar
  70. 70.
    Winget CM, Bond GH, Rosenblatt LS, et al. Quantitation of desynchronosis. Chronobiologia 1975; 2:197-204.PubMedGoogle Scholar
  71. 71.
    Winget C, Lymann J, Beljan J. The effect of low light inten-sity on the maintenance of circadian synchrony in human subjects. In: Holmquist R, Stickland A (eds.), Life Sciences and Space Research, Vol. XV. Oxford: Pergamon Press; 1976: 233-237.Google Scholar
  72. 72.
    Wegmann HM, Herrmann R, Winget CM. Bioinstrumentation for evaluation of workload in payload specialists: Results of ASSESS II. Acta Astronautica 1980; 7:1307-1321.PubMedGoogle Scholar
  73. 73.
    Wegmann HM, Herrmann R, Winget CM. Effects of irregu-lar work schedules in a space mission simulation (ASSESSII). In: Reinberg A, Vieux N, Andlauer P (eds.), Night and Shift Work: Biological and Social Aspects. Oxford: Pergamon Press; 1981:117-124.Google Scholar
  74. 74.
    Gander PH, Macdonald JA, Montgomery JC, et al. Adaptation of sleep and circadian rhythms to the Antarctic summer: A question of zeitgeber strength. Aviat Space Environ Med 1991; 62:1019-1025.PubMedGoogle Scholar
  75. 75.
    Putcha L. Assessment of sleep dynamics in a simulated space station environment. In: Lane HW, Sauer RL, Feedback DL (eds.), Isolation— NASA Experiments in Closed-Environment Living (Advanced Human Life Support Enclosed System Final Report). San Diego, CA: American Astronautical Society, Uni-velt; 2002:131-139. Science and Technology Series no. 104.Google Scholar
  76. 76.
    Leach CS, Johnson PC, Jr. Fluid and electrolyte control in simu-lated and actual spaceflight. Physiologist. 1985; 28(6 Suppl): S34-S37.PubMedGoogle Scholar
  77. 77.
    Strollo F, Strollo G, More M, et al. Space flight induces endo-crine changes at both the pituitary and peripheral levels in the absence of any major chronobiological disturbances. In: Sahm PR, Keller MH, Schiewe B (eds.), Proceedings of the Norderney Symposium on Scientific Results of the German Spacelab D-2. 14-16 March 1994. Koln: Wissenschaftliche; 1995:743-750.Google Scholar
  78. 78.
    Adey WR, Kado RT, Walter DO. Computer analysis of EEG data from Gemini flight GT-7. Aerospace Med 1967; 38:345-359.PubMedGoogle Scholar
  79. 79.
    Gundel A, Nalishiti V, Reucher E, et al. Sleep and circadian rhythm during a short space mission. Clin Investig 1993; 71:718-724.PubMedGoogle Scholar
  80. 80.
    Gundel A, Polyakov VV, Zulley J. The alteration of human sleep and circadian rhythms during spaceflight. J Sleep Res 1997; 6:1-8.PubMedGoogle Scholar
  81. 81.
    Wever R. Bright light affects human circadian rhythms. Pfluger Arch 1983; 396:85-87.Google Scholar
  82. 82.
    Wever R, Boelens R, De Boer E, et al. The photoreactivity of the copper-NO complexes in cytochrome c oxidase and in other cop-per-containing proteins. J Inorg Biochem 1985; 23:227-232.PubMedGoogle Scholar
  83. 83.
    Wever R. Light effects on human circadian rhythms: A review of recent Andechs experiments. J Biol Rhythms 1989; 4:161-185.PubMedGoogle Scholar
  84. 84.
    Honma K, Honma S, Wada T. Phase-dependent shift of free-running human circadian rhythms in response to a single bright light pulse. Experientia 1987; 43:1205-1207.PubMedGoogle Scholar
  85. 85.
    Honma K, Honma S, Wada T. Entrainment of human circa-dian rhythms by artificial bright light cycles. Experientia 1987; 43:572-574.PubMedGoogle Scholar
  86. 86.
    Czeisler CA, Kronauer R, Allan J, et al. Bright light induction of strong (Type 0) resetting of the human circadian pacemaker. Science 1989; 244:1328-1333.PubMedGoogle Scholar
  87. 87.
    Eastman CI, Miescke KJ. Entrainment of circadian rhythms with 26-h bright light and sleep-wake schedules. Am J Physiol 1990; 259:R1189-R1197.PubMedGoogle Scholar
  88. 88.
    Lewy AJ, Wehr TA, Goodwin FK, et al. Light suppresses mela-tonin secretion in humans. Science 1980; 210:1267-1269.PubMedGoogle Scholar
  89. 89.
    Campbell S, Dawson D. Enhancement of nighttime alertness and performance with bright ambient light. Physiol Behav 1990; 48:317-320.PubMedGoogle Scholar
  90. 90.
    Badia P, Myers B, Boecker M, et al. Bright light effects on body temperature, alertness, EEG and behavior. Physiol Behav 1991; 50:583-588.PubMedGoogle Scholar
  91. 91.
    Edelson M, Tirney S, Gaddy F, et al. Effect of light intensity on oral, rectal, and tympanic temperature and full body activity (abstract). Sleep Res 1991; 20:454.Google Scholar
  92. 92.
    Gaddy JR, Edelson M, Stewart K, et al. Possible retinal spatial summation in melatonin suppression. In: Holick M, Kligman A (eds.), Biological Effects of Light. Berlin: Walter de Gruyter & Co; 1992.Google Scholar
  93. 93.
    Weaver RA. The Circadian System of Man: Results of Experiments under Temporal Isolation. New York: Springer-Verlag; 1979:1-276.Google Scholar
  94. 94.
    Kryger M, Roth T, Dement WC (eds.), Principles and Practice of Sleep Medicine, 3rd edn. Philadelphia, PA: W.B. Saunders Co; 2002.Google Scholar
  95. 95.
    Espiritu R, Kripke D, Ancoli-Israel S, et al. Natural light exposure of adults 40-64 years old (abstract). Sleep Res 1992; 21:374.Google Scholar
  96. 96.
    Czeisler CA, Chiasera AJ, Duffy JF. Research on sleep, circadian rhythms and aging: Applications to manned spaceflight. Exp Gerontol 1991; 26:217-232.Google Scholar
  97. 97.
    Putcha L, Berens KL, Marshburn TH, et al. Pharmaceutical use by U.S. astronauts on Space Shuttle missions. Aviat Space Environ Med 1999; 70:705-708.PubMedGoogle Scholar
  98. 98.
    Boivin DB, Czeisler CA. Resetting of circadian melatonin and cortisol rhythms in humans by ordinary room light. Neuroendocrinology 1998; 9:779-782.Google Scholar
  99. 99.
    Stewart K, Eastman C. Circadian phase-shifting for manned spaceflight missions. Presented at the Fifth International Conference of Chronopharmacology and Chronotherapeutics, Amelia Island, Florida, 12-16 July 1992.Google Scholar
  100. 100.
    Stewart KT, Hayes BC, Eastman CI. Light treatment for NASA shiftworkers. Chronobiol Int 1995; 12:141-151.PubMedGoogle Scholar
  101. 101.
    Strollo F. Hormonal changes in humans during spaceflight. Adv Space Biol Med 1999; 7:99-129.PubMedGoogle Scholar
  102. 102.
    Gundel A, Dresher J, Maas H, et al. Sleepiness of civil airline pilots during two consecutive night flights of extended duration. Biol Psychol 1995; 40:131-141.PubMedGoogle Scholar
  103. 103.
    Wesenten NJ, Balkin TJ, Davis HQ, et al. Reversal of triazolam and zolpidem-induced memory impairment by flumazenil. Psychopharmacology 1995; 121:242-249.Google Scholar
  104. 104.
    Penetar D, McCann U, Thorne D, et al. Caffeine reversal of sleep deprivation effects on alertness and mood. Psychopharmacology (Berl) 1993; 112:359-365.Google Scholar
  105. 105.
    Kamimori GH, Penetar DM, Thorne DA, et al. Effect of caffeine on cognitive performance, mood, and catecholamine response in sleep deprived males. Med Sci Sports Exerc 1994; 26:S213.Google Scholar
  106. 106.
    Caldwell JA, Caldwell JL, Crowley JS, et al. Sustaining helicopter pilot performance with dexedrine during periods of sleep deprivation. Aviat Space Environ Med 1995; 66:930-937.PubMedGoogle Scholar
  107. 107.
    Caldwell JA, Caldwell JL. An in-flight investigation of the efficacy of dextroamphetamine for sustaining helicopter pilot performance. Aviat Space Environ Med 1997; 68:1073-1080.PubMedGoogle Scholar
  108. 108.
    Whitson PA, Putcha L, Chen Y, et al. Melatonin and cortisol assessment of circadian shifts in astronauts before flight. J Pharm Sci 1995; 18:141-147.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Lakshmi Putcha
    • 1
  • Thomas H. Marshburn
    • 1
  1. 1.NASA Johnson Space CenterHoustonUSA

Personalised recommendations