How Often Are Airline Pilots Tested for Sleep Disorders

The FAA or Federal Aviation Administration is the arm of the Federal Government with the responsibility of protecting the safety of passengers on airlines, plus the lives and property of those on the ground. Currently, the safety record for US carriers is impressive, and the FAA works hard with aviation and medical departments to maintain medical certification ideals to keep passengers happy and safe.

One of the main concerns of the FAA is sleep apnea and other sleep disorders that have caused fatigue. These are the guidelines the FAA has enacted currently.

What is the FAA’s guidance on OSA?

In 2013, the FAA enacted guidance suggestions that would have required treatment for sleep apnea for pilots with a body mass index of 40 or higher, and these pilots would have to be grounded until they completed treatments. Pilots were also required to obtain a Special Issuance medical certificate from the FAA. However, members of Congress and stakeholders in the aviation industry disagreed with this proclamation as being too lax and the FAA was required to revise their guidance.

A new guidance sent out in 2015 does not use the Body Mass Index alone to determine whether a pilot has obstructive sleep apnea. The screening process now uses a combined evaluation of symptoms, physical and clinical findings, plus medical history.  Aviation Medical Examiners may screen for sleep apnea at the same time they conduct a physical examination as long as they follow the American Academy of Sleep Medicine or AASM guidance. Those pilots who may have obstructive sleep apnea are issued a medical certificate stating they are at risk of sleep apnea. Shortly after receiving the certification, the FAA’s Federal Air Surgeon sends out a letter requesting a sleep apnea assessment be finalized within 90 days. 

What is Obstructive Sleep Apnea (OSA)?

Muscles in the back of your throat and the area of the larynx or voice box are open to allow normal breathing. However, if you have obstructive sleep apnea, these muscles close up, and the airway becomes small. At times the area becomes so tiny that breathing and normal oxygenation of the blood is impaired. Sometimes people begin to choke, and this causes you to wake from a healthy sleep. Usually, someone with OSA is unaware of waking up, but they are not getting restorative sleep and wake up feeling tired.

Those with obstructive sleep apnea are in danger of excessive daytime sleepiness, cardiac dysrhythmias, personality disturbances, myocardial infarction, sudden cardiac death, stroke, hypertension and cognitive impairments. No one wants to consider these impairments in a pilot of a vehicle that is flying 30,000 feet above the ground!