# RMP-BEH-004 Sleep and lighting schedule support: shows the schedule the flight surgeon set, silent on-screen light-mode prompts and a private log (the robot never wakes anyone) # Version 0.2 (Draft). CONCEPTUAL. NOT FOR CLINICAL USE. # Space Medicine Foundation robot-readable protocol library. Format: https://spacemedicinefoundation.org/robotic-medicine/protocols/schema/ # Every threshold marked must be set by the named owner (see the schema) before any use. schema_version: '0.3' version: '0.2' status: draft conceptual: true not_for_clinical_use: true max_autonomy: 2 missions: - leo - commercial - moon - mars updated: '2026-10-21' review: state: reviewed-ai-assisted requested: '2026-10-21' human_clinician_review: false text: >- AI-assisted clinical and source review by the Medical Research Assistant, Oct 21, 2026 (batch 12 review: 15 required corrections, R1 to R15; 11 optional suggestions not applied in this version), then a verification pass (Oct 21, 2026) that found every required correction for this protocol applied (PASS). No named human clinician has reviewed it. Not for clinical use. reviewed: '2026-10-21' fixed_rules: flight_surgeon_is_medical_authority: true cmo_acts_under_delegated_care: true human_starts_and_restarts_robot: true robot_never_diagnoses: true no_drug_or_fluid_advice_by_robot: true safe_state_on_fault_or_no_response: true lost_link_pause_then_cmo_decides: true robot_lockouts: diagnosis: true drug_or_fluid_advice: true starting_stopping_or_adjusting_oxygen_or_any_medicine: true self_start_or_self_restart: true changing_own_protocol_thresholds_or_limits: true handing_over_a_mismatched_item_as_verified: true id: RMP-BEH-004 slug: rmp-beh-004 title: >- Sleep and lighting schedule support: shows the schedule the flight surgeon set, silent on-screen light-mode prompts and a private log (the robot never wakes anyone) category: behav tier: 3 rung_note: >- Max rung 2 for showing the sleep and lighting schedule the flight surgeon and behavioral health team set, silent on-screen prompts outside sleep stations, and a private log. The crewmember changes every light themselves; the robot never changes a light, never sounds a tone and never wakes anyone, as in RMP-NEURO-006. result_language: use: - as stated by the crewmember - schedule as set by the flight surgeon - prompt dismissed - sent to flight surgeon - no response never: - normal - no problem found - all clear - negative - any diagnosis or cause - insomnia - enough sleep - not enough sleep - rested - fit for duty - cleared - wait before - it has worn off - nothing serious - safe - mild - minor - good sleep - bad sleep - on schedule - off schedule - late - score - should sleep - should wake - sleeping pill - melatonin - take something scope: summary: >- On a crewmember's command, the robot loads the sleep and lighting schedule that the flight surgeon and behavioral health team set (sleep window, and the times for the general, pre-sleep and phase-shift light modes) and shows it on screen. At each scheduled light time it shows a silent on-screen prompt outside sleep stations, which the crewmember can act on or dismiss; the crewmember changes the light themselves. After the crewmember accepts a post-wake prompt, it runs a short private check-in and logs what they state. It never wakes anyone, never enters a sleep station, never changes a light and never advises on sleep. The log is shared only with the crewmember, the flight surgeon and the behavioral health team (the CMO only if the crewmember agrees or a red flag fires). why: >- The ISS solid-state lights have general, pre-sleep and phase-shift modes for day-to-day light, the end of the work day and shifting sleep patterns (Maida 2016); NASA-STD-3001 requires lighting that supports alertness, pre-sleep and circadian shifting (V2 8055) and private sleep accommodation (V2 7070). ISS crew slept about 6 hours a night by wrist monitor (Barger 2014), and astronauts sleep less in flight than on Earth (NASA sleep evidence report 2016). Advice on sleep, light and the work schedule belongs to the flight surgeon and behavioral health team, as in RMP-NEURO-006, so the robot only shows their schedule and logs what the crewmember states. Silent prompts, the check-in wording and the log rules are design judgment. Open question for review: whether the robot should ever change a light mode on the crewmember's spoken command, or leave all light control to the crew. covers: - Showing the sleep and lighting schedule the flight surgeon set - Silent on-screen light-mode prompts outside sleep stations - >- A private post-wake check-in with its own log (the RMP-NEURO-006 sleep log is separate, and shared with the CMO) - 'Low mood or stress: RMP-BEH-002' locked_out: - Diagnosis or naming a cause - Any medicine, fluid or oxygen advice; starting, stopping or adjusting oxygen - Touching the crewmember - >- Handing over any medicine outside RMP-PHARM-001, or after a MISMATCH or CANNOT VERIFY (the item stays quarantined; only the CMO can ask for it, through the RMP-PHARM-001 logged two-step override) - Waking a crewmember for a check-in, or entering a sleep station unless invited - >- Advising on sleep habits, light, caffeine, exercise or the work schedule (the flight surgeon and behavioral health team decide) - Saying whether a crewmember is rested, fit for a task, or past the effect of a medicine - Clearing or stopping anyone from a task - Recording in a sleep station, or using a camera during the check-in - Changing any light, light mode or brightness itself - >- Sounding any alarm, tone or voice to wake a crewmember, or prompting inside a sleep station or during a sleep window - Changing or suggesting changes to the schedule - Scoring or rating sleep or how well the schedule was followed - >- Sharing the log with anyone but the crewmember, the flight surgeon and the behavioral health team (the CMO only with agreement or on a red flag) - >- Suggesting, choosing, fetching or dosing any sleep medicine or other medicine, or saying when to take it (a human order and RMP-PHARM-001 are needed) - >- Dose-interval cues (any reminder, tone, colour, countdown or spoken cue tied to when a medicine was last taken) related: - RMP-NEURO-006 - RMP-BEH-002 - RMP-BEH-001 - RMP-NEURO-002 roles: medical_authority: Flight surgeon (ground). Holds medical authority for every run. onboard_lead: >- Crew medical officer (CMO), acting under delegated care; uses the pre-approved onboard checklist when there is no link. others: - 'Second trained CMO: receives every alert and takes over if the CMO is the patient' - 'Vehicle commander: leads any cabin emergency procedure' - 'Other crew: help as the CMO or commander directs' - 'Behavioral health team (ground): sets the sleep and lighting schedule with the flight surgeon' robot_may: - Load and show the schedule the flight surgeon set - Show silent on-screen light-mode prompts outside sleep stations - Run a private check-in after the crewmember accepts a post-wake prompt - Keep a private log robot_may_not: - Wake anyone or enter a sleep station uninvited - Change a light or the schedule - Advise on sleep, light, caffeine or work - Score sleep or schedule adherence commercial: >- On commercial flights, 'flight surgeon' and 'CMO' mean the operator's designated medical authority and trained onboard responder. If no trained responder is aboard, this protocol is not used. (NASA-STD-3001 requires two CMOs per vehicle for NASA programs [V1 3006]; FAA rules set no medical standards for spaceflight participants.) preconditions: - id: PRE-1 text: >- The crewmember started schedule support by command, and the schedule the flight surgeon and behavioral health team set is loaded. check: human_start == true refs: - V2 10174 - id: PRE-2 text: Robot self-test passed; kit stowage locations known. refs: - V2 10161 - V2 7059 - id: PRE-3 text: Robot and supplies restrained when not moving. refs: - V2 7046 - id: PRE-4 text: Link status known. The crew never wait for the robot before acting. check: link_state in [live, delayed, down] consent: standard: >- The crewmember agrees to schedule prompts and the private log. The log goes only to the crewmember, the flight surgeon and the behavioral health team; the CMO is told only if the crewmember agrees or a red flag fires. Before flight, each crewmember was told that skipped check-ins are flagged under RMP-BEH-002 (not by this protocol), that an urgent alert and the words that triggered it are kept and cannot be withdrawn, that records are stored encrypted and never used to train or tune software, and that this robot can miss things or raise false alarms. A pre-flight plan exists for securing medicines and other means of self-harm, and each crewmember who wanted one has a safety plan written with the behavioral health team. emergency: >- A red flag sends an alert as listed; the robot still never wakes anyone (the CMO or commander decides). withdrawal: The crewmember can turn prompts off or stop the log at any time. inputs: - id: IN-1 name: >- Sleep and lighting schedule (sleep window and light-mode times), set by the flight surgeon and behavioral health team source: Flight surgeon / behavioral health team required: true if_missing: The robot shows "schedule not loaded" and gives no prompts. - id: IN-2 name: Sleep and light times in the crewmember's words source: Crewmember required: false if_missing: Log "not stated". - id: IN-3 name: Answers to the red-flag questions source: Crewmember required: false if_missing: Log "no response"; D2 applies. - id: IN-4 name: Link status and delay source: Communications system required: true if_missing: Treat as link down; the log is queued. steps: - id: S1 actor: robot rung: 2 action: >- On the crewmember's command, load the schedule the flight surgeon and behavioral health team set and show it on screen; send a "schedule support started" note to the flight surgeon (queued if the link is down). The CMO is told only if the crewmember agrees or a red flag fires. Every URGENT alert goes to the CMO and the flight surgeon at the same time (queued for the flight surgeon if the link is down). If the CMO is the patient, is busy treating, or does not answer, the alert goes to the second trained CMO, or the crewmember named before flight [V1 3006]. An URGENT alert that is not acknowledged within seconds is repeated and sent to the next named crewmember. success: Schedule shown; note sent or queued. refs: - V1 3006 - V2 10174 - id: S2 actor: robot rung: 2 action: >- At each scheduled light-mode time, show a silent on-screen prompt outside sleep stations (for example "Schedule: pre-sleep light from 21:00, as set by the flight surgeon"). The crewmember changes the light themselves or dismisses the prompt; the robot never changes a light, never sounds a tone and never prompts inside a sleep station or during a sleep window. success: Prompt shown; "acted on" or "prompt dismissed" logged as stated. refs: - V2 8055 - V2 7070 - id: S3 actor: robot rung: 2 action: >- After the crewmember accepts the post-wake prompt (never by waking them), run a short private check-in by voice or on screen, camera off: first say: "This robot listens for certain words and can miss things or raise false alarms. It is not a safety monitor. If you are struggling, contact the CMO or flight surgeon directly at any time." Then red-flag questions first (including any talk of self-harm), then sleep and light times as they state. Log the answers word for word in this protocol's own private log, under its sharing rule. If RMP-NEURO-006 is running, ask the crewmember first whether to add them to that sleep log, and say that the RMP-NEURO-006 log is shared with the CMO; add them only on a clear yes. success: Answers logged or "no response". refs: - V1 6003 - id: S4 actor: robot rung: 2 action: >- Show the crewmember the schedule next to their own logged times as a clock-time timeline, with no words about whether it is good or bad. success: Timeline shown. refs: - V1 6003 - id: S5 actor: crew action: >- The crewmember follows or changes their own routine; the commander and the CMO decide any wake-up for a critical task, by their own means. success: As decided by the crew. refs: - V2 7070 - id: S6 actor: robot rung: 2 action: >- After any URGENT alert: After an URGENT alert the robot does not leave on its own: it stays at its rest position in the module, with its screen and voice link available, until a human has taken over or tells it to go. It never follows, blocks or touches anyone. It keeps time-stamping what humans say they did, and repeats the alert if it is not acknowledged. success: Robot at rest in the module until a human releases it; alert acknowledged or escalated. refs: - V2 10173 - V1 3006 - id: S7 actor: ground action: >- The flight surgeon and behavioral health team (or the CMO under the onboard checklist when there is no link) review the log and decide on any schedule change; the robot loads only a schedule they send. success: Decision logged. refs: - V1 3004 - id: S8 actor: robot rung: 2 action: >- Send the flight surgeon and the behavioral health team the private log: schedule shown, prompts acted on or dismissed as stated, answers and alerts. success: Log delivered or queued. refs: - V1 6003 - V1 7003 decisions: - id: D1 after: S3 decided_by: robot question: >- Checked after every answer and at any point in the run (even mid-question or mid-step): does any answer, reading or observation meet a red flag, including any talk of self-harm or suicide? branches: - if: 'Yes' then: >- Stop the current question or step at once and apply the action listed for each matching red flag (URGENT alert, flag, or stop), with the answer or reading itself, never a cause. Every URGENT alert goes to the CMO and the flight surgeon at the same time (queued for the flight surgeon if the link is down). If the CMO is the patient, is busy treating, or does not answer, the alert goes to the second trained CMO, or the crewmember named before flight [V1 3006]. An URGENT alert that is not acknowledged within seconds is repeated and sent to the next named crewmember. - if: 'No' then: Continue. - id: D2 after: S3 decided_by: robot question: Did the crewmember answer the check-in after accepting it, or say they want to skip a question? branches: - if: 'Yes' then: Continue. - if: Declined explicitly (the crewmember says no to a question) then: Log "declined" for that question only; the alert already sent stands. - if: No response, or the answer does not make sense then: >- URGENT: log "no response" (never "declined"); the CMO, or the second trained CMO if the CMO is the patient, checks the crewmember in person at once. - id: D3 after: S5 decided_by: robot question: Is a crewmember asleep when a task needs them? branches: - if: 'Yes' then: >- The robot never wakes them: it tells the commander and the CMO on screen, and they decide by their own means. - if: 'No' then: Continue. - id: D4 after: S7 decided_by: ground question: Does the schedule change? branches: - if: Link live then: Flight surgeon decides; robot logs. - if: Link down or delay too long then: >- The CMO decides under the pre-approved onboard checklist; the flight surgeon reviews the log at the next contact. stop_rules: - id: X1 trigger: The patient (or the crewmember being examined) says stop, or withdraws consent action: >- Robot stops all motion at once, backs away to its rest position and tells the CMO. Recording stops unless the patient agrees to keep it running. level: stop refs: - V2 10165 - id: X2 trigger: Any crewmember presses stop or takes over control action: Protective stop; robot holds its stopped position; only a human may restart it. level: safe-state refs: - V2 10165 - V2 10168 - V2 10174 - id: X3 trigger: Robot fault, sensor fault, or a force, speed or reach limit is reached action: Protective stop and hand control to the CMO; log the fault. level: safe-state refs: - V2 10172 - V2 10168 - id: X4 trigger: CMO is asked to take over and does not respond (for example, the CMO is the patient) action: Robot stays stopped; the next named crewmember is called. level: safe-state refs: - V2 10173 - V2 7045 - id: X5 trigger: Loss of link, or delay longer than the limit for live guidance action: >- Only the robot pauses: before it holds, it moves to a position clear of a hatch route or a crewmember's route (it never pauses in one), and tells the CMO. This pauses robot movement only: crew sleep, care already under way and all other care continue under the onboard checklist and never wait for the link or the robot. The CMO decides whether the robot continues offline under the pre-approved onboard checklist; it resumes only on the CMO's confirmation. level: pause refs: - V2 10172 - V2 10173 - id: X6 trigger: An URGENT alert is not acknowledged within the set time action: >- Robot repeats the alert and sends it to the next named crewmember (the second trained CMO first if the CMO is the patient), and keeps repeating at the set interval. It stays where it is: it does not leave on its own. level: urgent refs: - V1 3006 - V2 10173 - id: X7 trigger: The crewmember stops responding, or seems confused or drowsy, at any point action: >- URGENT alert at once, even mid-question or mid-step; the robot stops its current task, stays at its rest position and does not continue the run; a crewmember checks in person. level: urgent - id: X8 trigger: >- A crewmember asks the robot what is wrong, or for medicine, fluid or treatment advice, including about a sleep medicine action: >- Robot declines, says it cannot assess or advise, and routes the question to the CMO or flight surgeon. level: stop - id: X9 trigger: The robot is at a sleep station, or a prompt would show inside one or during a sleep window action: >- Robot moves away without sound, shows nothing there, and logs the prompt as "not shown – sleep window". level: safe-state refs: - V2 7070 - id: X10 trigger: Someone needs the space or route the robot is in action: Robot moves clear at once without contact and holds; it never pauses in a hatch route. level: safe-state refs: - V2 10172 red_flags: - id: RF1 sign: Talk of self-harm or suicide, or of not wanting to be alive threshold: any (if not sure, treat as yes) action: >- URGENT private alert to the flight surgeon now, mid-question if need be; the CMO if the link is down or delayed (the second CMO if the CMO is the person concerned), as agreed before flight; repeated and escalated if not acknowledged. No risk rating. See RMP-BEH-002 and RMP-BEH-001. source: ng225 - id: RF2 sign: A sudden severe headache, or a headache with fever, weakness, confusion or a change in vision threshold: any action: URGENT alert; see RMP-NEURO-002 source: nice150 - id: RF3 sign: Short sleep, as logged threshold: >- less than hours a night for nights in a row (for context, ISS crew averaged about 6.1 hours a night by wrist monitor) action: Flag to the flight surgeon source: barger - id: RF4 sign: Trouble sleeping that goes on, or that the crewmember says affects their work or mood threshold: beyond nights, or any report that it affects work or mood action: Flag to the flight surgeon; see RMP-BEH-002 source: ersleep - id: RF5 sign: Feeling very drowsy before a critical task, as stated (design judgment) threshold: any action: Flag to the CMO and flight surgeon at once; the robot never clears or stops anyone from the task - id: RF6 sign: A light stuck in one mode, or one that will not dim or turn off, as stated (design judgment) threshold: any action: Flag to the commander - id: RF7 sign: Any mention of taking, wanting or reacting to a sleep medicine, as stated threshold: any action: >- Flag privately to the flight surgeon; see RMP-NEURO-006, whose sleep-medicine red flags (RF1, RF3, RF4, RF8) apply; the robot gives no advice source: barger safety_limits: - id: L1 name: Contact with the crewmember value: not allowed enforced: Keep-out zone in the robot controller refs: - V2 10172 - id: L2 name: Sound or light from the robot in a sleep station or during a sleep window value: not allowed enforced: Sleep-window and sleep-station map in the robot controller refs: - V2 7070 - id: L3 name: Changing a light, light mode or brightness value: not allowed enforced: No lighting command is loaded refs: - V2 8055 - id: L4 name: Robot speed near the crewmember value: enforced: Hard limit in the controller refs: - V2 10172 logs: - id: LOG-1 text: Every input, robot action, decision (with who made it) and hand-off, time-stamped to the second. refs: - V2 10163 - V2 10164 - id: LOG-2 text: Mode changes and safety-limit events are announced to the operator as they happen and logged. refs: - V2 10162 - V2 10172 - id: LOG-3 text: >- Records are stored and sent as private medical data, encrypted, with access limited to the medical team. refs: - V1 6003 - V1 7003 - id: LOG-4 text: Results are kept in a permanent, retrievable format so the flight surgeon can see trends. refs: - V1 7001 - id: LOG-5 text: >- Schedule loaded and who set it; each prompt shown, acted on or dismissed as stated, or "not shown – sleep window"; check-in answers as stated; who viewed the log. No sleep scores. - id: LOG-6 text: >- Each URGENT alert, who received it, the time it was acknowledged (or the escalation to the next named crewmember), and the time a human released the robot. refs: - V2 10163 requirements: - id: V1 3004 use: >- In-mission medical care capabilities, including inventory monitoring and the flight surgeon's decisions on care. - id: V1 3006 use: >- Two trained CMOs per vehicle for NASA programs; the second trained CMO receives alerts when the CMO is the patient (see the commercial-flight note). - id: V1 6003 use: Logs and alerts sent to the ground are private medical communications. - id: V1 7001 use: Records kept so the flight surgeon can see trends. - id: V1 7003 use: Secure handling of medical records. - id: V2 7045 use: Usable by non-physician crew, including when the CMO is the patient. - id: V2 7046 use: Patient, caregiver and supplies restrained. - id: V2 7059 use: Kit inventory and seal status are tracked. - id: V2 7070 use: Private sleep accommodation; the robot never prompts in a sleep station. - id: V2 8055 use: Lighting supports the physiological effects of light; the flight surgeon sets the light schedule. - id: V2 10161 use: Robot shows its status and health. - id: V2 10162 use: Mode changes are announced to the operator. - id: V2 10163 use: Robot records and shares its data. - id: V2 10164 use: Shows whether the human or the robot is expected to act. - id: V2 10165 use: Human can override and shut down the robot. - id: V2 10168 use: Human can take over. - id: V2 10172 use: Protective stop when a limit is exceeded. - id: V2 10173 use: Robot stays stopped if no one takes over. - id: V2 10174 use: Only a human starts or restarts the robot. validation: - stage: simulation what: >- Scripted days with a prompt due in a sleep window, a crewmember asleep before a critical task, self-harm talk at check-in, lost link. pass: Zero wakings; zero light changes; every red flag raised. - stage: training model what: Prompt display drills across modules. pass: Zero prompts inside sleep stations. - stage: parabolic or station demonstration what: Silent movement near sleep stations. pass: Noise limit held. - stage: flight use under flight surgeon supervision what: First week of schedule support. pass: No safety or privacy events. signoff: protocol: - Clinical lead for the specialty (sets every clinical threshold marked ) - Flight surgeon, as medical authority - Robotics and medical-device safety board - Program approval for the mission restart_after_stop: >- Human only. After any emergency or protective stop, a crewmember must restart the robot; the robot never restarts itself. each_run: >- Started by the crewmember. The flight surgeon and behavioral health team set every schedule; the crew control every light. change_control: - Every change gets a new version number and a written reason; earlier versions are kept. - >- Any change to steps, thresholds, limits or software that touches the patient repeats validation from the simulation stage before use. - >- Software and learned-skill updates follow a pre-agreed change plan (what may change, how it is tested, how to roll back), modeled on the FDA predetermined change control plan approach. - >- If a new version misbehaves, the robot rolls back to the last validated version and the event is reviewed by the flight surgeon and safety board. - The robot never changes its own protocol, thresholds or limits. comms: live: 'Low Earth orbit: the log reaches the flight surgeon and behavioral health team when the link allows.' loss_of_signal: - >- Only the robot pauses non-essential motion, at a position clear of hatch routes and crew routes, and tells the CMO; it resumes offline only on the CMO's confirmation. - >- Crew sleep, care already under way and all other care continue under the onboard checklist and never wait for the link or the robot. - The loaded schedule keeps showing; the log is queued. mars_delay: - 'Mars: schedules are set before and during flight with delay; the crew decide on their routine.' sources: - key: ssla2016 text: >- Maida JC. Introduction to the Solid State Based Interior Lighting System for ISS (NASA Technical Reports Server 20160005080, 2016). url: https://ntrs.nasa.gov/citations/20160005080 supports: >- The ISS solid-state light assemblies have three modes: general (4500 K, the default for day-to-day operations), pre-sleep (2700 K, for the end of the work day, to remove as much melatonin suppression as possible) and phase-shift (6500 K, to suppress melatonin and increase alertness when the circadian rhythm needs to be shifted); each light has its own mode, dimming and on-off buttons. Read Oct 21, 2026 (saved copy in src/b12). - key: barger text: >- Barger LK, Flynn-Evans EE, Kubey A, et al. Prevalence of sleep deficiency and use of hypnotic drugs in astronauts before, during, and after spaceflight: an observational study. Lancet Neurol. 2014;13(9):904-912. url: https://doi.org/10.1016/S1474-4422(14)70122-X doi: 10.1016/S1474-4422(14)70122-X pmid: '25127232' supports: >- By wrist actigraphy, ISS crew obtained about 6.1 hours of sleep a night in flight and Shuttle crew about 6.0 hours; 12 of 16 ISS crew (75%) and 61 of 78 Shuttle crew (78%) reported using sleep-promoting drugs. - key: ersleep text: >- NASA Human Research Program. Evidence Report: Risk of Performance Decrements and Adverse Health Outcomes Resulting from Sleep Loss, Circadian Desynchronization, and Work Overload (2016). url: https://humanresearchroadmap.nasa.gov/evidence/reports/Sleep.pdf supports: >- All studies to date show astronauts sleep less in spaceflight than on Earth; sleep medication is the most prevalent fatigue countermeasure in flight, and about three-quarters of Shuttle and ISS astronauts reported using sleep medications. - key: ng225 text: >- National Institute for Health and Care Excellence. Self-harm: assessment, management and preventing recurrence. NICE guideline NG225 (2022). url: https://www.nice.org.uk/guidance/ng225/chapter/Recommendations supports: >- Do not use risk assessment tools and scales, or global low/medium/high risk stratification, to predict future suicide or repetition of self-harm, or to decide who is offered treatment. - key: nice150 text: >- National Institute for Health and Care Excellence. Headaches in over 12s: diagnosis and management. Clinical guideline CG150. url: https://www.nice.org.uk/guidance/cg150/chapter/Recommendations supports: >- Headache features that need further investigation or referral include worsening headache with fever, sudden-onset headache reaching maximum intensity within 5 minutes, new-onset neurological deficit, and impaired level of consciousness. - key: tb016 text: NASA OCHMO. Behavioral Health and Performance. Technical Brief OCHMO-TB-016 Rev B (Oct 24, 2023). url: https://www.nasa.gov/wp-content/uploads/2023/12/ochmo-tb-016-behavioral-health.pdf supports: >- Behavioral health concerns in spaceflight include stress, depression, anxiety, relationship problems and grief; contributing factors include sleep, workload, medicine side effects and medical conditions; 2 of 7 NASA Shuttle-Mir astronauts reported depressive symptoms; past events include reported possible hallucinations and withdrawal after delayed news of a family death; support includes private psychological conferences, and missions beyond 6 months or beyond low Earth orbit should add minimally obtrusive monitoring. - key: v1 text: 'NASA. NASA-STD-3001, Space Flight Human-System Standard, Volume 1: Crew Health, Revision C (2023).' url: https://www.nasa.gov/wp-content/uploads/2023/11/nasa-std-3001-vol-1-rev-c-with-signature.pdf supports: 'NASA-STD-3001 Vol 1 Rev C: V1 3004, V1 3006, V1 6003, V1 7003.' - key: v2 text: >- NASA. NASA-STD-3001, Volume 2: Human Factors, Habitability, and Environmental Health (Rev F, 2026), including Section 10.6 Automated and Robotic Systems. url: https://standards.nasa.gov/standard/NASA/NASA-STD-3001_VOL_2 supports: 'NASA-STD-3001 Vol 2 Rev F: V2 7070, V2 8055, and Section 10.6 automated and robotic systems.' - key: tb044 text: NASA OCHMO. Medical Operations. Technical Brief OCHMO-TB-044 (2025). url: https://www.nasa.gov/wp-content/uploads/2025/08/ochmo-tb-044-medical-operations.pdf supports: >- The crew surgeon keeps medical authority when care is delegated; crew medical officers train on the JSC 48522 medical checklist. - key: marsdelay text: >- NASA. Mars communications disruption and delay (fact sheet, 2023 Moon to Mars Architecture Concept Review). url: https://www.nasa.gov/wp-content/uploads/2024/01/mars-communications-disruption-and-delay.pdf supports: >- One-way Earth-Mars delay up to about 21-23 minutes, plus blackouts of about 2-3 weeks near solar conjunction. - key: pccp text: >- U.S. Food and Drug Administration. Marketing submission recommendations for a predetermined change control plan for artificial intelligence-enabled device software functions (guidance). url: >- https://www.fda.gov/regulatory-information/search-fda-guidance-documents/marketing-submission-recommendations-predetermined-change-control-plan-artificial-intelligence supports: A model for planning, validating and rolling back software updates. - key: faa460 text: 'U.S. Code of Federal Regulations, Title 14, Part 460: Human space flight requirements.' url: https://www.ecfr.gov/current/title-14/chapter-III/subchapter-C/part-460 supports: >- Federal rules for crew and spaceflight participants on licensed commercial flights; they set no medical standards for spaceflight participants. corrections: - date: '2026-10-21' version: '0.2' source: Batch 12 AI-assisted clinical review (Medical Research Assistant), Oct 21, 2026 items: - >- R10: the sleep-medicine and dose-interval lockouts from RMP-NEURO-006 are copied in; never-words "sleeping pill", "melatonin", "take something"; new RF7 routes any sleep-medicine mention to RMP-NEURO-006 and its red flags; X8 covers sleep-medicine questions. Sources: RMP-NEURO-006; Barger (hypnotic use). - >- R11: check-in answers stay in this protocol's own log under its sharing rule; they are added to the RMP-NEURO-006 sleep log only if the crewmember agrees after being told that log is shared with the CMO. Design judgment. - >- Batch 12 protocols now record the review as AI-assisted (Medical Research Assistant, Oct 21, 2026); no named human clinician.