US to screen obese pilots, controllers for sleep apnea

WASHINGTON - Overweight US pilots and air traffic controllers will soon need to be screened for sleep apnea, a condition that can cause daytime sleepiness and potentially jeopardize passenger safety, according to a new federal policy.

The Federal Aviation Administration's chief medical officer told physicians in a recent memo that they will shortly be required to calculate the body mass index (BMI) of pilots and controllers and send those with a BMI of 40 or more to be evaluated by a sleep specialist.

Obstructive sleep apnea (OSA) is a potentially serious disorder in which a person's breathing repeatedly stops and starts during sleep. It commonly affects people who are overweight.

The FAA said the condition has "significant safety implications," from excessive daytime sleepiness to personality disturbances, cognitive impairment and sudden cardiac death.

"Untreated obstructive sleep apnea is a disqualifying condition for airmen and air traffic control specialists," Dr. Fred Tilton, the Federal Air Surgeon, said in the memo to aviation medical examiners.

While the condition has been frequently discussed at flying safety meetings, and has been a "hot issue" at the National Transportation Safety Board for several years, the new policy will require airmen and controllers who are diagnosed with OSA to be treated before they can be medically certificated, Tilton said.

The condition is "almost universal" in individuals with a body mass index over 40 and a neck circumference of 17 inches or more, Tilton said, though it also affects up to 30 per cent of people with a BMI of less than 30.

A body mass index of 40 equates roughly to a 5'10" individual weighing 280 pounds, according to the National Institutes of Health. A BMI of 30 or greater is considered obese.

Tilton said that examiners should also be on alert for other sleep-related disorders, from insomnia to restless leg syndrome.

After the first round of tests, the agency will gradually expand its programme to examine individuals with lower BMIs, Tilton said. The FAA has not announced a starting date for its new policy. The plan would be rolled out first to pilots and then to controllers.

"Remember," Tilton wrote, "you, as aviation medical examiners, are our front line, and your daily interaction with pilots and controllers has an enormous impact on the safety of the national airspace."