Does the 'silent cockpit' reduce pilot workload?

The current top safety risk concern for commercial air travel in Europe is known as “Flight Upset”. This term, also known as “Loss of Control in Flight”, entails the flight crew suddenly finding themselves in an unexpected, complex, and even confusing situation that if not resolved quickly can lead to a major accident. Accidents such as AF447 and the two B737 Max accidents fall into this category. An undesirable aspect of such events is known as the “startle response”, wherein one or both flight crew, finding themselves in dire and dangerous conditions, may experience ‘startle’, which temporarily affects their cognitive functioning. This may only last half a minute, but its effect can have a severe impact on the survivability of such events. A Horizon 2020 research project called SAFEMODE, which aims to integrate Human Factors techniques into a unified framework for designers in aviation and maritime domains, is exploring the use of state-of-the-art flight simulation facilities to measure pilot performance in severe wake turbulence events, which can induce the startle effect. This is part of a broader use case within SAFEMODE to validate the design of a new Wake Vortex Air Traffic Alert for the Cruise phase of flight. A tactical short-term alert to the Flight Crew, ahead of the wake encounter, is seen as beneficial to reduce the startle effect and support the appropriate management of these conflicts. The envisaged risk-alerting logic relies on a ground-based predictor, connected to the Air Traffic Control system, displaying an alert to the En-route Air Traffic Controllers, who can then provide a cautionary advisory to the Flight Crew so they can take appropriate actions.The cockpit flight simulations involve type-rated flight crews in realistic and representative cruise flight conditions, using a Type VI Boeing 737-800 full flight motion-based simulator (also used for Upset Prevention and Recovery training programs). During the simulation runs, pilots are exposed to simulated wake vortex encounters, corresponding to a strong wake-induced upset (between 30 and 40 degrees of bank), with or without prior ATC wake caution, and varying the initial direction of roll between left and right to limit the simulation training effect.Human Factors measurements include workload, situation awareness, trust, acceptability-based user feedback, as well as psychophysiological measures such as eye-tracking and Electro-Dermal Activity (EDA). In particular, eye-tracking is expected to support the refined determination of the sequence of actions before and after detection, and the reaction of flight crews to the en-route ATC Wake alert.A cockpit flight simulation, via combining the analyses of psychophysiological measures, flight parameters, expert observations and subjective pilot feedback, enables evaluation of Flight Crews performance in preparing for, managing or avoiding wake encounter upsets with the new ATC wake alerts, showing the net safety benefits. Early results indicate that the simulations can indeed induce startle effect, and that repeated exposure enables flight crew to overcome it and manage the situation in a more measured and controlled fashion.

The perceived importance and utilization of “party line” information by air carrier flight crews was investigated through a survey and flight simulation study. The Importance, Availability, and Accuracy of party line information elements were explored through a survey of active air carrier pilots. The survey identified numerous party line information elements that were considered important. These elements were scripted into a full-mission flight simulation experiment that examined the utilization of party line information by studying subject responses to specific information element stimuli. Some party line information elements perceived as important were effectively utilized by flight crews. However, other party line elements stimulated little or no increase in situational awareness. The ability to assimilate and use party line information appeared to be greatest when the crew had time to monitor the party line and had clear authority to act on the information. The assimilation of party line information was lowest during high workload periods, such as during takeoff, and pilots were reticent to question air traffic control based on party line information alone. In addition, the results of both the survey and the simulation indicated that the importance of party line information appeared to be greatest for operations near or on the airport. This indicates that caution should be exercised when implementing datalink communications in tower and close-in terminal control sectors. © 1993 John Wiley & Sons, Inc.

Event Abstract Back to Event Regulation of arousal and heart rate variability via biofeedback in severe traumatic brain injury. Jacqueline A. Rushby1*, Heather Francis1, Alana Fisher1 and Skye McDonald1 1 University of New South Wales, Psychology, Australia Background: Severe traumatic brain injury (TBI) is known to result in impaired emotion regulation and arousal. Heart rate variability (HRV) is an index of autonomic (dys)regulation, reflecting the balance between sympathetic and parasympathetic influences on the central nervous system. Biofeedback techniques have been found to regulate disrupted HRV and alleviate symptoms in disorders associated with impaired arousal. The present study aimed to examine, whether adults with severe TBI show: i) HRV dysregulation at rest; ii) improved HRV regulation via a biofeedback intervention; as well as how these relate to aspects of emotion regulation. Methods: Thirty adults with severe TBI (Mean posttraumatic amnesia = 49.10 days; Range: 2.00 - 180) and 30 age-, education-, and gender-matched controls participated. Participants completed self-report measures of mood, emotional and cognitive empathy, and trait alexithymia. Relative reports of emotion regulation were also provided for TBI participants. Participants’ HRV and skin conductance levels (SCL) were measured under two 5-minute conditions: i) ’free-breathing’ (resting baseline); ii) ‘biofeedback’ (paced at 6 breaths per minute). Results: Among TBI participants, emotional empathy levels (p = .026), cognitive empathy levels (p < 0.01), and ability to identify and describe one’s own feelings, were all significantly lower compared to controls (p < 0.01). On the autonomic measures, HRV and SCL, there were no differences between the TBI and Control groups, either at rest or during biofeedback (all p > 0.05). Biofeedback training lead to significant increases (improvement) on all HRV measures (p < 0.05) and SCL (p = 0.014) for both groups. Higher HRV during biofeedback, and higher SCLs at rest and during biofeedback, correlated negatively with trait alexithymia subscales in both the overall sample and separate groups (p < 0.05), but not empathy, nor relative reports of emotion regulation (p > 0.05). Conclusion: These results suggest that HRV shows promise as an index of impaired autonomic regulation in severe TBI. Biofeedback training may help normalise HRV in severe TBI; improved autonomic regulation may ameliorate impairments on emotional self-awareness. Keywords: Traumatic Brain Injury, Heart rate variability, social cognition, emotion, Arousal Conference: Australasian Society for Psychophysiology, Inc, Coffs Harbour, Australia, 26 Nov - 28 Nov, 2014. Presentation Type: Oral Presentation Topic: Psychophysiology Citation: Rushby JA, Francis H, Fisher A and McDonald S (2014). Regulation of arousal and heart rate variability via biofeedback in severe traumatic brain injury.. Conference Abstract: Australasian Society for Psychophysiology, Inc. doi: 10.3389/conf.fnhum.2014.216.00024 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 23 Oct 2014; Published Online: 02 Dec 2014. * Correspondence: Dr. Jacqueline A Rushby, University of New South Wales, Psychology, Sydney, Australia, j.rushby@unsw.edu.au Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Jacqueline A Rushby Heather Francis Alana Fisher Skye McDonald Google Jacqueline A Rushby Heather Francis Alana Fisher Skye McDonald Google Scholar Jacqueline A Rushby Heather Francis Alana Fisher Skye McDonald PubMed Jacqueline A Rushby Heather Francis Alana Fisher Skye McDonald Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Simultaneous Monitoring of ECG and EDA Using a Wearable Armband for Analyzing Sympathetic Nerve Activity

Flight crew are exposed to several potential occupational hazards. This study compares mortality rates in UK flight crew to those in air traffic control officers (ATCOs) and the general population. A total of 19,489 flight crew and ATCOs were identified from the UK Civil Aviation Authority medical records and followed to the end of 2006. Consented access to medical records and questionnaire data provided information on demographic, behavioral, clinical, and occupational variables. Standardized mortality ratios (SMR) were estimated for these two occupational groups using the UK general population. Adjusted mortality hazard ratios (HR) for flight crew versus ATCOs were estimated via Cox regression models. A total of 577 deaths occurred during follow-up. Relative to the general population, both flight crew (SMR 0.32; 95% CI 0.30, 0.35) and ATCOs (0.39; 0.32, 0.47) had lower all-cause mortality, mainly due to marked reductions in mortality from neoplasms and cardiovascular diseases, although flight crew had higher mortality from aircraft accidents (SMR 42.8; 27.9, 65.6). There were no differences in all-cause mortality (HR 0.99; 95% CI 0.79, 1.25), or in mortality from any major cause, between the two occupational groups after adjustment for health-related variables, again except for those from aircraft accidents. The latter ratios, however, declined with increasing number of hours. The low all-cause mortality observed in both occupational groups relative to the general population is consistent with a strong "healthy worker effect" and their low prevalence of smoking and other risk factors. Mortality among flight crew did not appear to be influenced by occupational exposures, except for a rise in mortality from aircraft accidents.

Attention problems, such as attention deficit hyperactivity disorder (ADHD), have a significant impact on quality of life and academic achievement. Using Electroencephalogram (EEG), Heart Rate Variability (HRV), and Galvanic Skin Response (GSR), this literature review analyzes the use of Artificial Intelligence (AI) in Neurofeedback Therapy (NFT). Although artificial intelligence has begun to be integrated into NFTs, its use is still in its early stages and presents a few challenges. The lack of representative datasets for training AI models, the complexities of processing biometric data (EEG, HRV, GSR), and the high infrastructure costs required for implementation are the key barriers to widespread adoption. Additionally, the general adoption of this technology is restricted by concerns regarding patient security and data privacy. The paper emphasizes the role of artificial intelligence in preprocessing data, feature extraction, and AI model analysis by integrating current research findings. The authors propose a novel approach to enhance the efficacy of neurofeedback therapy by integrating artificial intelligence with EEG, HRV, and GSR data, even though most of the content is derived from previous research. The researchers achieved substantial results by employing CNN, SVM, and LSTM to identify EEG, HRV, and GSR signals. However, challenges such as overfitting, data noise, and ethical concerns persist. The objective of this review is to offer a fair evaluation of the current state of artificial intelligence in NFT, identify gaps in the literature, and propose future research directions. These directions include the development of robust AI algorithms, the integration of NFT with emerging technologies such as virtual reality, ethical and societal implications, and AI-powered NFT applications. Additionally, this review proposes a framework for the integration of AI into NFT. AI-powered NFT has the potential to revolutionize the treatment of attention disorders and enhance the outcomes for those who are affected by surmounting these obstacles.

Vehicular Ad Hoc Networks (VANETs) enable Vehicle-to-Vehicle (V2V) and Vehicle-to-Infrastructure (V2I) communications for enhancing road safety. However, reliable driver stress assessment remains challenging due to noisy sensing, inter-driver variability, and context dynamics. This paper proposes a Fuzzy-based Driver Stress Detection System (FDSDS) that employs an Interval Type-2 Fuzzy Logic System (IT2FLS) to model uncertainty. The FDSDS considers four complementary inputs—Heart Rate Variability (HRV), Galvanic Skin Response (GSR), Steering Angle Variation (SAV), and Traffic Density (TD)—to estimate Driver Stress Level (DSL). Extensive simulations (14,641 test points) show monotonic associations between DSL and the inputs, which reveal that physiological indicators dominate average influence (finite-difference sensitivity: GSR 0.357, SAV 0.239, TD 0.239, HRV 0.235). Under severe physiological conditions (HRV = 0.1, GSR = 0.9), the system consistently outputs high stress (mean DSL = 0.813; range 0.622–0.958), while favorable physiological conditions (HRV = 0.9, GSR = 0.1) yield low stress even in challenging traffic (range 0.044–0.512). The IT2FLS uncertainty bands widen for intermediate conditions, aligning with the inherent ambiguity of moderate stress states. These results indicate that combining physiological, behavioral, and environmental factors with IT2FLS yields interpreted, uncertainty-aware stress estimates suitable for real-time VANET applications.

The article presents the results of a study of the correlation of indicators of psychological and psychophysiological state, obtained by methods of psychological testing, bio electrography (gas-discharge visualization) and heart rate variability, galvanic skin response. Since the assessment of the bioenergetic status and the level of stress in the body by the method of gas discharge visualization is becoming more widespread, questions arise about the psychophysiological mechanisms of this method, including at the cellular and molecular levels. In the practice of researching the psychophysiological state of the inhabitants of the Far North, categories of people employed in extreme professions, including the military and athletes, it is important to use express methods for studying the psychophysiological state. This method is the method of gas discharge visualization, which makes it possible to assess the functional state of a person at a given moment in time under certain environmental conditions. In addition, it can be used outside a medical institution, it is convenient to use in the field, compact, mass-produced, and allows you to immediately get a conclusion on the functional state of the body, saving the data obtained for further research. The purpose of our study was to identify the general psychophysiological basis of psychological and psychophysiological express methods of gas-discharge visualization and the assessment of heart rate variability on the basis of conducting coupled studies of assessing the state of the body of children and adults. As a result of the study, multiple significant (p&lt;0.05) correlation coefficients were found between the indicators of psychophysiological state, obtained by bioelectrography, heart rate variability, galvanic skin response, and psychological indicators. The results of the correlation analysis show that the criteria for assessing the psychophysiological state using the gas-discharge visualization method reflect the contribution of autonomic regulation to heart rate variability, galvanic skin response, and psychological characteristics. The predominance of sympathetic regulation is reflected in the relationship between the values of indicators of gas discharge imaging and heart rate variability. The results of the study of the general psychophysiological basis of the gas discharge visualization method based on conjugated experiments using other methods for assessing the state of the human body are presented.

OBJECTIVES/SPECIFIC AIMS: Most incidents of partner violence occur when one or both partners have been drinking, however, the mechanism through which this association exists is unclear. The neural circuits that support self-regulation of emotion and social behavior, as well as autonomic influences on the heart, are co-localized in the brain and represent an integrated bidirectional regulatory system. These physiological regulatory processes are mediated by a neural substrate known as the central autonomic network which includes the peripheral autonomic nervous system. The central autonomic network modulates biobehavioral resources in emotion by flexibly responding to physiological arousal in response to changing situational demands, and serves a fundamental role in emotion regulation and goal-directed motor behavior, and this circuit can be indexed with heart rate variability (HRV). METHODS/STUDY POPULATION: In total, 17 distressed violent (DV) partners (11 females, 6 males) were matched to a sample of distressed nonviolent (DNV) partners (7 female, 6 males) were matched on age, sex, and relationship satisfaction and participated in a placebo-controlled alcohol administration study with an emotion-regulation task during which electroencephalography, HRV, and galvanic skin response (GSR) measures were collected. In the alcohol condition, participants were administered a mixture of 100 proof vodka and cranberry juice calculated to raise their blood alcohol concentration to 0.08%. In the placebo condition, participants consumed a volume of juice equivalent to that consumed in the alcohol condition, but without alcohol. Alcohol and placebo conditions were counter-balanced across participants as were the presentation the blocks of evocative and neutral partner stimuli and emotion-regulation condition (watch vs. do not react). RESULTS/ANTICIPATED RESULTS: Results show that DV partners show greater cortical arousal than DNV partners on measures event-related spectral perturbations, which are mean log event-loced deviations from baseline-mean power at each frequency of the electroencephalography power spectra, when intoxicated and viewing evocative partner stimuli in the “do not react” emotion regulation condition. Results also show a statistically significant 2 (alcohol vs. placebo)×2 (watch vs. do not react)×2 (DV partners vs. DNV partners) interaction of the respiratory sinus arrhythmia measure of HRV when viewing evocative partner behavior (F=7.102, p=0.019, partial η2=0.353). Findings indicate that DV partners have lower HRV than DNV partners across conditions, but particularly when acutely intoxicated and trying not to react to their partners’ evocative behavior. Similarly, results also show a statistically significantly 2 (alcohol vs. placebo)×2 (watch vs. do not react)×2 (DV partners vs. DNV partners) interaction on GSR (F=71.452, p=0.000, partial η2=0.749). GSR findings indicate that DV partners also have lower GSR when acutely intoxicated and trying not to react to their partners’ evocative behavior. DISCUSSION/SIGNIFICANCE OF IMPACT: These results suggest that increases in intimate partner violence under acute alcohol intoxication may be the result of dysfunction of the central autonomic network, especially when DV partners are trying to suppress a behavioral response to their partners’ evocative behavior in conflict. The neurophysiological patterns evidenced by DV partners is consistent with a state of vigilance to threat, and reduced ability inhibit prepotent, but inappropriate responses. They also suggest that HRV may be an important target for intervention with partner with a history of intimate partner violence. One method may be heart rate variability biofeedback which has been shown to increase parasympathetic nervous system functioning, autonomic stability, and emotion regulation.

AimThis study aims to explore the effect of hypnosis on dentists’ physiological stress management.MethodsThe study included 20 dentists (mean = 30, SD = 7.37) from the Dental Clinic of the University of Padua. Stress assessment was performed by recording several physiological parameters, including heart rate (HR), heart rate variability (HRV), electrodermal activity (EDA), skin conductance responses (SCRs), and the administration of the psychological stress perceived stress scale (PSS-10). Following hypnosis induction, participants were led to recall and relive a previously agreed-upon, pleasant experience, while the related psycho-physiological changes were monitored. The hypnosis session was planned on a regular working day. Physiological parameters were recorded using the Empatica E4 wristband and eSense galvanometer. Measurements were taken at baseline, during hypnosis, and after dehypnotization.ResultsParticipants exhibited moderate stress levels before hypnosis (mean PSS-10 = 17.1 ± 8.1). After hypnosis, a significant and large decrease in SCRs (T-test = 3.24, DF = 19, p = 0.002, as shown also by Cohen’s d = 0.724) and an increase in EDA (Wilcoxon = 50, DF = 18, p = 0.00355) were recorded, while HRV did not show significant changes. Friedman ANOVA for repeated measures models, and Nemenyi post-hoc correction indicated that the condition (basal, hypnosis, and post-hypnosis) significantly affected SCR levels (p = 0.00008), especially in the pre vs. post (p = 0.012313) and in the hypnosis vs. post comparisons (p = 0.00005819). Friedman ANOVA for repeated measures models and Durbin–Conover indicated that conditions (basal, hypnosis, or post-hypnosis) also influenced EDA levels, while HRV did not show any significant change (tested with ANOVA repeated measures). Pearson’s correlation showed that PSS-10 levels were inversely correlated with SCRs in hypnosis (p = 0.019, DF = 18, R = −0.51). A linear regression model fitting delta SCRs (post-pre physiological activation) showed that SCR-pre explained part of the outcome (R = 0.647, R^2 adj = 0.386, AIC = 99.6, F = 13, RMSE = 2.51, p = 0.002). Regarding subjective perception, 18/20 participants reported feeling better, 2 reported no difference χ2 = 29.2, p = 0.00000047, df = 2. Furthermore, the Bayesian paired samples T-test comparing SCR-pre vs. post showed a BF+₀ = 20.7, error % = 0.000824, which strongly indicates the superiority of the effectiveness of training in comparison to null hypotheses (>20 times probable than an effect than no effect).ConclusionOur data suggest that hypnosis could be a valuable resource for stressed dentists. Longitudinal controlled studies and larger samples are necessary to corroborate our results and to check the durability of effects over time. Anyway, our results suggests that a short session of hypnosis (or perhaps, self-hypnosis) during a regular working day may help relieve the sympathetic stress response.

BackgroundPrevious studies on dental anxiety have examined the psychophysiological responses evoked in dentally anxious subjects by dental-related stimuli, but not during a real-life dental examination, which was achieved in the present study.MethodsThe heart rate, skin conductance level, and heart rate variability of 25 subjects with dental anxiety and 25 healthy controls were examined. Anxiety was determined by the Modified Dental Anxiety Scale and the Dental Anxiety Scale–Revised. The psychophysiological reactions of the two groups were compared during exposure to dental-related pictures, dental-related sounds, and an actual examination in a dental surgery.ResultsAll the dental-related stimuli provoked an increase in heart rate, i.e. visual stimuli (p<0.001; 95% CI 0.98–3.95 bpm), auditory stimuli (p<0.001; 95% CI 1.34–4.99 bpm), and a dental examination (p<0.001; 95% CI 1.26–5.39 bpm). Dental-related pictures provoked inferior skin conductance level changes compared to dental-related sounds and the dental examination (visual modality vs auditory p<0.001; 95% CI 0.039–0.152; visual modality vs examination p<0.001; 95% CI 0.083–0.275). Heart rate variability manifested in a complex pattern of responses to the dental examination. However, when exposed to all three dental-related stimuli presentation conditions, the heart rate (F = 0.352, p = 0.556), skin conductance level (F = 0.009, p = 0.926), and heart rate variability parameters of subjects with dental anxiety did not differ in comparison to the healthy controls.ConclusionsThis pilot study represents an evaluation of psychophysiological reactions during a real-life dental examination compared to single modality stimuli, and shows that a real-life dental examination provokes an increase in heart rate, heart rate variability and skin conductance level. Additionally, autonomic responses did not differ between the experimental and control groups. The key issue for future studies is the effect of real-life situations on the physiological and psychological state of the subjects, which should be considered when planning new research and studied in depth.

167 Psychophysiological measures of mental workload in laboratory and flight

The study of the autonomous nervous system (ANS) has played an important role, over the last years, in prognostic and diagnostic of cardiac diseases, as well as, in the assessment of psychological stress. The most common techniques to evalute the balance of the ANS are invasive and unable to provide a continuous monitoring of the patients. The advances in technology and the development of wearable sensors have provided new alternative methods to study the ANS. The analysis of Heart Rate Variability (HRV) and Electrodermal Activity (EDA) are nonivasive methods to assess the ANS with wearables devices. The wearable device used provides information about HRV with the acquisition of photoplethysmography signals from the wrist and EDA from the fingers. The processing of the biosignals was performed by submitting the participants to a mental arithmetic stress test. The results showed that the participants exhibited two distinct response during stress - “Flight or Fight”. These responses were classified using machine-learning techniques. The constructed models were able to predict how the subjects will respond in a situation of stress, based only on baseline features. The accuracy of the models using only HRV baseline features was of approximately 80% and the accuracy using simultaneously HRV and EDA baseline features was of 77%, when assigning the correct response during stress to the participant.

Wrist-worn wearables, with sensors to measure physiological responses such as heart rate variability (HRV) and electrodermal activity (EDA), have been increasing and have the potential to be used for continuous monitoring. These devices have been used to detect responses in workers’ physical and cognitive demands; however, the accuracy of wrist wearables for distinguishing these demands is unknown, especially since many every day and work activities frequently require motion. The objective of this study was to evaluate the effectiveness of a wrist-worn wearable in measuring physiological changes during different demand conditions. Participants (n = 20 college students) completed a multi-factor laboratory study that considered task (cognitive/physical), difficulty (easy/hard), and motion (motion/no motion). N-back tasks and stationary bike tasks were used to represent cognitive and physical demands, respectively. Metrics of HRV and EDA were measured using reference-standard devices and a validated wrist-wearable. Significant differences between task, motion, and difficulty were observed from HRV measurements from the reference-standard and wrist-worn devices. Wrist wearables are sensitive to detecting workplace demands and may be used as an alternative to reference-standard sensors for continuous health and activity monitoring for worker health and wellness. Findings in this study can provide guidelines on task and conditions that affect the use and interpretation of wrist-worn devices for measuring cognitive and physical demands in healthcare systems. HIGHLIGHTS Applications for noninvasive, wrist-worn sensors can be used for continuous health and exercise monitoring HRV and EDA metrics obtained from wrist-worn device are sensitivity in detecting changes in task, difficulty, and motion HRV metric from wrist-worn device had agreement with reference-standard device Wrist-wearables has potential for ubiquitous health monitoring of individuals

Piloting an aircraft is a complex multitasking activity that involves managing information in a nonautomatic way and generates a high workload (psychological, cognitive, and physical) for the pilot. The excess of these demands can result in decreased performance and may impair flight safety. Heart rate variability (HRV) has been used in recent studies as a method to investigate operator's workload in complex environments. This measure can assess the stress and recovery ability of the autonomic nervous system. However, a better understanding of flight influence on the pilot's autonomic modulation is necessary. Therefore, this scoping review aims to systematically map the studies related to changes in the autonomic modulation in military pilots during flight, in order to characterize their workload at different times and flight profiles. A literature search was conducted using MEDLINE (by PubMed), SCOPUS, and LILACS databases. Recent records (2002-2022) that analyzed HRV in military pilots during flight were included. Meanwhile, studies in which piloting activity was not performed were excluded. The study was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline extension for Scoping Reviews and the Updated Methodological Guidance for the Conduct of Scoping Reviews. A total of 298 records were obtained, of which 19 were included in the scoping review. The studies analyzed flights performed in high- and low-performance aircrafts, helicopters, and flight simulators, using time domain, frequency domain, and nonlinear HRV indices. Real and simulated flights produced significant autonomic changes. Some flights elicited autonomic nervous system responses that persisted up to 5 h after landing. During real flight, the most sensitive indices for identifying variations in pilot workload were root mean square of successive differences between normal heartbeats, standard deviation of interbeat interval of normal sinus beat (SDNN), ratio of low-frequency to high-frequency power, and Poincaré plot standard deviation perpendicular to the line of identity (SD1), whereas the interbeat interval (RR), SDNN, SD1, and Poincaré plot standard deviation along the line of identity (SD2) were the most sensitive indices when comparing segments of simulated flight with different levels of difficulty. This scoping review provided insight into the influence of flight on autonomic modulation in military pilots. Some key themes were highlighted: Increased sympathetic activity during flight, sensibility of different domains of HRV to flight demands, and autonomic changes during recovery time. Future research efforts may allow us to enhance the understanding of pilot's workload limits and to elucidate the optimal postflight recovery time.