Severely obese pilots will soon be required to undergo sleep apnea screening[1] , and if they are diagnosed with the condition, will be required to undergo treatment before receiving their medical certificate, according to a newly announced policy from the Federal Aviation Administration.


In the most recent Federal Air Surgeon's Medical Bulletin, Fred Tilton, M.D., the Federal Air Surgeon, explained that the new policy will require all pilots to undergo sleep apnea testing[2] by a board-certified sleep specialist if they have a body mass index of 40 or greater. (A person is considered obese if they have a BMI of 30 or greater[3] .) Air traffic controllers will also eventually be included in the new policy, pending some logistical details.


CNN pointed out that the new policy could affect as many as 125,000 commercial and private pilots[4] .


"OSA is almost universal in obese individuals who have a body mass index over 40 and a neck circumference of 17 inches or more, but up to 30% of individuals with a BMI less than 30 have OSA," Tilton wrote in the editorial[5] .


After everyone with a BMI of 40 or greater has been tested, then "we will gradually expand the testing pool by going to lower BMI measurements until we have identified and assured treatment for every airman with OSA," he added.


Tilton also explained in the editorial that obstructive sleep apnea -- a disorder characterized by pauses in breathing during sleep, leading to disrupted sleep -- can be a detriment to safety because it spurs a number of health conditions, such as hypertension and sudden cardiac death, and also promotes daytime sleepiness.


"Untreated OSA is a disqualifying condition for airmen and air traffic control specialists (ATCSs), and it is a concern for the other modes of the Department of Transportation. It has also been a hot issue at the National Transportation Safety Board for several years," he wrote.



ABC News reported that the move comes after a high-profile accident where two pilots fell asleep while flying between islands in Hawaii[6] , overshooting the airport. The captain was obese and had sleep apnea.



Also on HuffPost:




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  • Sleep Apnea Increases Risk Of Heart Attack


    The sleep disorder has a number of poor effects on the heart. "It's as if somebody's choking you, so your heart rate goes up, your blood pressure goes up," Charles Czeisler, M.D., the Baldino Professor of Sleep Medicine at Harvard Medical School told <em>Health</em> magazine. "Over time, even your daytime blood pressure is higher." Sleep apnea may be responsible for a third of all cases of <a href="http://www.huffingtonpost.com/2012/03/14/sleep-health_n_1310353.html">high blood pressure</a> in Americans, he told the magazine. A 2007 study showed just how serious these cardiovascular effects of sleep apnea are. The research found that people with sleep apnea were <a href="http://www.sciencedaily.com/releases/2007/05/070520183533.htm">30 percent more likely to have a heart attack</a> or die of any cause over a four to five year period.




  • Sleep Apnea May Increase Depression Risk


    The under diagnosed sleep condition takes a <a href="http://www.huffingtonpost.com/2012/03/30/sleep-apnea-depression-risk_n_1391707.html">serious toll on the mood</a>, according to March research from the CDC. In fact, men with sleep apnea were more than twice as likely and women more than five times as likely to feel hopeless, lose interest in their regular activites and display other signs of clinical depression, Health.com reported. Snoring did not seem to be associated with depression. Luckily, the very same <a href="http://www.huffingtonpost.com/2012/06/15/sleep-apnea-treatment-depression-cpap_n_1597703.html">treatment for sleep apnea may also ease depression</a>, according to Cleveland Clinic research.




  • Sleep Apnea May Be A Risk Factor For Diabetes


    There is a growing body of research supporting a link between the presence of sleep apnea and <a href="http://www.huffingtonpost.com/2012/05/24/sleep-apnea-diabetes-type-2-_n_1539933.html">metabolic disorders like diabetes</a>, HuffPost reported in May. Both moderate and severe obstructive sleep apnea were found to be predictors of the disease. A previous study found that people with sleep apnea had more than <a href="http://news.yale.edu/2007/05/24/sleep-apnea-increases-risk-heart-attack-and-diabetes">double the risk of developing diabetes</a>.




  • Sleep Apnea May Increase Cancer Risk


    Not only do people with sleep apnea have a <a href="http://well.blogs.nytimes.com/2012/05/20/sleep-apnea-tied-to-increased-cancer-risk/">higher risk of developing cancer</a>, but they also have a higher risk of dying from the disease, the <em>New York Times</em> reported. Two studies in May examined this link. One found people with sleep apnea had a 65 percent higher change of developing any kind of cancer. The second found that disordered breathing contributed to a five-times higher rate of dying from the disease.




  • Sleep Apnea May Sap Your Libido


    Excessive sleepiness is certainly enough to kill the mood, but research suggests that sleep apnea in particular has an effect on sexual function in both men and women. It may <a href="http://well.blogs.nytimes.com/2011/10/10/really-the-claim-sleep-apnea-causes-sexual-problems/">drive down sex hormones</a> like testosterone in a way that can extinguish the flame for women and cause erectile dysfunction in men, according to the <em>New York Times</em>. And while the typical treatment -- a CPAP machine -- is not exactly an aphrodisiac, Dr. Michael J. Breus writes, it can help not only with sleep apnea, but <a href="http://www.huffingtonpost.com/dr-michael-j-breus/sleep-apnea_b_1661687.html">with the sexual side effects as well</a>.




  • Sleep Apnea May Increase Stroke Risk


    Researchers have long studied the link between the sleep disorder and the risk of stroke, but a small recent study found that 51 of 56 stroke patients evaluated -- or <a href="http://www.huffingtonpost.com/dr-michael-j-breus/sleep-apnea_b_1342311.html">91 percent of patients</a> -- had sleep apnea, Dr. Michael J. Breus wrote for HuffPost. More research is still needed to determine just what role disrupted breathing plays in this elevated risk.




  • Sleep Apnea Increases Accident Risk


    It's not rocket science -- excessive sleepiness during the day leads to sleepier drivers who are at a higher risk of crashing. But a 2008 study found that people with sleep apnea have double the risk of being in a car accident and are <a href="http://www.sciencedaily.com/releases/2008/02/080218214401.htm">three to five times more likely to be in a serious crash</a>. The study was the first to examine the severity of car crashes among people with sleep apnea, and found that even mild disordered breathing was linked to increased risk.




  • Sleep Apnea Is Linked To Pregnancy Complications


    Granted, Perry doesn't have to worry about this particular concern. While sleep apnea is often perceived as a problem predominately for men, <a href="http://www.huffingtonpost.com/2012/08/16/sleep-apnea-in-women-may-_n_1779127.html">women are not immune</a>. And, in fact, sleep apnea presents unique complications for women. A recent study found that women with sleep apnea were more likely to develop high blood pressure during their pregnancies, to require a C-section birth and their babies were more <a href="http://www.huffingtonpost.com/2012/09/21/sleep-apnea-in-pregnancy-_n_1903534.html">likely to be admitted to the neonatal intensive care unit</a>.




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