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Ovation: Testing Airline Pilots For Sleep Apnea.

11/21/2013

PilotsAt my last physical, my doctor and I had a long conversation about how much difficulty I have sleeping through the night.  I’ve always thought it was allergies that kept me from getting a good night’s sleep.  It seems that I always find myself tossing and turning, rolling from one side to the other trying to get comfortable and keep my sinuses open.  He asked a lot of questions like whether or not I snore and if I sleep on my back or on my side.  He suggested a test to rule out sleep apnea.

The test that he ordered for me didn’t require an overnight stay at a special facility.  I received a small device in the mail that I attached to a finger one night when I went to bed.  The next morning, I mailed it back to the testing facility in a pre-paid package and the results were sent directly to my doctor.  We learned that I had breathed normally throughout the night and there was no reason to believe that I suffered from sleep apnea.  And now this was documented in my chart.

Recently, the Federal Aviation Administration announced that it wants to start screening potentially obese pilots for obstructive sleep apnea because the condition may be making them too tired to safely fly an airplane.  A medical bulletin released by Federal Air Surgeon Dr. Fred Tilton says pilots with a body mass index of forty or higher will need to go for screening for the condition and the agency will eventually expand the testing to include all pilots.  Body mass index is a ratio of height over weight and people with a score of thirty or more are considered to be obese.  The same protocol will be eventually implemented for air traffic controllers as well.

Those afflicted by sleep apnea often wake up tired or unrefreshed and may experience sleepiness during the day.  They may be more likely to fall asleep at work, feel sleepy while driving, be forgetful, have headaches or act impatient and irritable.  Untreated sleep apnea may also raise risk for high blood pressure, heart problems and stroke.

While pilot fatigue has been a factor in several air safety incidents, opponents of the new policy reject the idea that most obese people have sleep apnea.  Pilots especially are more likely to work varying schedules that often make getting a sufficient night’s sleep more difficult because their sleep cycles are inconsistent.  Even pilots who routinely fly during the night might be more tired since most folks are accustomed to being awake during the day.

What do you think?  Should obese pilots be singled out for these tests?  Can mandatory “sleep hygiene” be enforced for all pilots?

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3 Comments
  1. As you note, it is not uncommon for overweight people to have a greater risk of sleep apnea. It is not uncommon for overweight people to have greater risks of diabetes, joint inflammation, depression, etc. Your question is it OK to single people out and require tests that you may not perform on others. The risk measurement and avoidance to me are between the patient and his/ her doctor. With that said, I think it is more appropriate that a series of tests including sleep apnea tests could be performed on all pilots, or at a very minimum, the ones who said on health screening form they are not getting enough sleep. Rested pilots are a must, so if the airline wants to require the tests on all, that is fine. I would add that if a test raises an issue, the pilot should agree to see a doctor.

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    • I absolutely agree. If a pilot is “cleared” by his or her doctor and deemed “fit to fly”, issues like sleep apnea should certainly be considered when making that decision.

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  2. Have you looked in a cockpit? How would an obese pilot even fit into the cockpit? To me, this just seems to be some silliness created by airlines to try to blame for mishaps on pilots. In Canada, there are very strict rules for pilots and their “rest time” which help to prohibit pilot fatigue. (BTW, I hope your recognize this is supposed to be sarcastic)

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