FAA Wants Pilots to Undergo Mandatory Sleep Apnea Evaluation

Is flying a plane easy? Is it like driving a car? Once you learn to fly, it must be a lot like driving a car, right?

Wrong. I have been learning to fly over the course of the last several months and I can tell you there are several differences; not the least of which is that cars do not operate at 3,000, 5000, or 30,000 feet above the ground. Piloting a plane has given me a better appreciation for safety and how things that may not affect you on the ground may have a big impact on you in the air. It is drilled into pilots that safety is a number one concern; both in terms of whether you leave the ground and when you are in the air.

In 2008, when two pilots aboard a Bombardier regional jet in Hawaii overflew their destination by 26 miles and communication could not be established with the tower for 18-minutes, the Federal Aviation Administration (FAA) wanted to know why.  After the plane landed safely, it was determined the pilots were both sleep-deprived and had nodded off during flight. The captain was diagnosed with severe sleep apnea.

Sleep apnea or a disturbed sleep results when the airways are obstructed during sleep. As a result, a person may be tired during the day and may exhibit confused thinking. They are also at a higher risk for sudden cardiac death.

Obesity is a leading risk factor for sleep apnea.  When the FAA investigated it uncovered five other incidents involving pilots who suffered from sleep apnea who fell asleep during a flight. The FAA concluded sleep apnea is “significantly underdiagnosed.”

Now the FAA plans to act. The federal agency has announced plans requiring a special screening of pilots who are overweight or obese as well as those individuals who may suffer from sleep apnea. Air-traffic controllers will be identified as well and will be required to undergo treatment before being allowed to return to the controls or the tower.

The Wall Street Journal reports there are about 600,000 certified pilots in the U.S. and of that amount, around one-half are commercial pilots. In 2011 the FAA expressed concern about 125,000 pilots who were obese; approximately 20% of the total pilots and 25% of commercial pilots. These individuals will be targeted during regularly scheduled medical exams by a board-certified sleep specialist.

First they will undergo a body mass index or BMI which is one measure of obesity. Pilots and air traffic controllers with a BMI over 40 will undergo an assessment to determine if they suffer from sleep apnea. Just as a point of reference a BMI of 40 would apply to a five-foot 11-inch man who weighs 287 pounds, reports CNN quoting the National Institutes of Health. A BMI of 30 or above is considered obese.

In response, the Aircraft Owners and Pilots Association (AOPA) questioned if any airline crashes of commercial or private plane had ever been linked to sleep apnea. AOPA has been looking at sleep deprivation, fatigue and sleep apnea for several years. Although I think everyone would agree that pilots should recognize fatigue as a risk factor and should not be flying if they are unduly fatigued; the same could be said for commercial truck drivers, train engineers and commercial bus drivers. Also, one might argue that a physician with a BMI over 40 and sleep apnea should be barred from the operating room and possibly from practice altogether.

The FAA is behind other federal agencies in identifying the problem. The National Transportation Safety Board requires big-rig drivers be tested for sleep apnea. Treatment can include a C-Pap machine that keeps airways opened during sleep.

Implementation, at least for now, seems onerous if a private pilot simply has a BMI over 40, the FAA is considering him or her as being required to undergo a sleep study or face suspension. Perhaps the FAA should consider differentiating between commercial and private pilots; and requiring private pilots with a BMI in excess of 40, without additional symptoms, to undergo more frequent medical certification. Without additional symptomology, with the exception of commercial carrier pilots, is there any wisdom in compelling ALL pilots to undergo expensive sleep analysis at a cost of between $600 and $5,070.

According to the NTSB about nine percent of tractor-trailer accidents are related to a fatigued driver. There are no accident statistics collected by the FAA relating airline accidents due to fatigue from sleep apnea.