Guest Blog: NTSB Responds on Sleep Apnea
In an AVweb Insider blog a month ago, we observed how the FAA got rapid and intense pushback on its proposal to require sleep apnea diagnosis for pilots with BMIs of 40 or higher. In this guest blog, the NTSB's Mark Rosekind explains that the agency has given this topic more than a passing glance.
The National Transportation Safety Board mission is focused on enhancing safety and the agency’s interest in obstructive sleep apnea (OSA) is to address a known and established safety risk. For example, on February 13, 2008, a go! airline flight in Hawaii overflew its destination airport by 18 minutes and 26 miles when both pilots fell asleep. Based on its investigation, the NTSB identified excessive daytime sleepiness due to fatigue resulting from the captain’s undiagnosed sleep apnea as contributing to this incident.
Among the recommendations issued, the NTSB included three to address the safety risks specifically associated with sleep apnea and are directed to all pilots required to obtain an FAA medical certificate in every aviation class. They are to:
Modify the application for airman medical certificate to elicit specific information about any previous diagnosis of obstructive sleep apnea and about the presence of specific risk factors for that disorder (A-09-61).
Implement a program to identify pilots at high risk for obstructive sleep apnea and require that those pilots provide evidence through the medical certification process of having been appropriately evaluated and, if treatment is needed, effectively treated for that disorder before being granted unrestricted medical certification (A-09-62).
And third, develop and disseminate guidance for pilots, employers, and physicians regarding the identification and treatment of individuals at high risk of obstructive sleep apnea, emphasizing that pilots who have obstructive sleep apnea that is effectively treated are routinely approved for continued medical certification (A-09-63).
The full Safety Recommendation with extensive background information can be found here. These NTSB recommendations were issued to ensure the safety of the traveling public because sleep apnea leads to excessive daytime fatigue, increases the risk of accidents, impairs cognitive skills, elevates the likelihood of critical errors and falling asleep, and because many individuals who have the disorder do not know they have it. With treatment, sleep can be improved, OSA symptoms reduced, and adverse effects reversed, leading to a return to normal duty for most civilian pilots.
Clearly, the NTSB has more than “opined” on the subject of OSA, its adverse effect on sleep, and the significant safety risks associated with human fatigue in transportation operations. For more than 40 years, the NTSB has identified fatigue as a problem. OSA is a common fatigue-inducing disorder that affects many pilots and it often remains undiagnosed, creating a hidden safety risk that can be managed effectively if identified.
Mark Rosekind has been a member of the NTSB since 2010 and is recognized as one of the world's foremost human fatigue experts. Prior to his joining the board, he was a consultant in human fatigue management.