Obstructive sleep apnea affects around 20 million Americans and can lead to hypertension, heart attack, stroke, depression, muscle pain, fibromyalgia, morning headaches, and excessive daytime sleepiness.

Friday, September 24, 2010

"Landmark" New FAA Fatigue Rules Ignore Sleep Apnea

Earlier this month, the Federal Aviation Administration (FAA) announced that it was creating "landmark" new pilot fatigue rules that would "help protect 700 million air passengers each year," but the FAA rules continue to leave these passengers at risk by ignoring the danger of obstructive sleep apnea.

The new rules come from an extensive study of pilot fatigue that began after the crash of Colgan Air flight 3407 in February 2009. A number of safety forums were held and the recommendations of safety and fatigue specialists were consulted. However, although they addressed many key points relevant to pilot fatigue, they ignored the important issue of sleep apnea.

The potential significance of sleep apnea was highlighted by an incident one year before the Colgan Air crash. In February 2008, go! Flight 1002, a short-haul flight from Honolulu to Hilo, Hawaii, flew past its destination when the pilot and copilot both fell asleep for at least 18 minutes. In subsequent investigation, the pilot was found to have undiagnosed obstructive sleep apnea. As a result, the National Transportation Safety Board (NTSB) recommended that the FAA revise its medical examiner guidelines to better inform them of when pilot candidates need to be evaluated for this dangerous condition, due to the following rationale:

  • About 7% of the US population is estimated to have obstructive sleep apnea
  • Only about 0.5% of commercial airline pilots have been diagnosed with obstructive sleep apnea
  • 1% of Air Force pilots have been diagnosed with obstructive sleep apnea
  • Commercial airline pilots are more likely to be obese than Air Force pilots. Obesity is a major risk factor for obstructive sleep apnea, and studies indicate that 15 to 24% of commercial airline pilots are obese.
  • The FAA is the only US Federal agency overseeing passenger safety that does not collect or utilize subjective data relevant to obstructive sleep apnea (such as reports of snoring).

Despite the alarming consequences of pilots with sleep apnea and its potential prevalence, the FAA's new fatigue rules ignore this condition, and despite a pilot education program, the actual rules regarding sleep apnea remain unchanged. Once diagnosed, the FAA recommends treatment with CPAP, oral appliances, medication, or surgery, but the FAA does not screen its pilots, so many of them may have undiagnosed sleep apnea.

Tell the FAA that your safety matters and that it should include sleep apnea in its recommendations for passenger safety. To learn more about sleep apnea, please contact a local sleep dentist today.

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posted by Dr. Candelaria at 12:21 PM