NTSB calls for sleep apnea screening

August 13, 2009

The NTSB has recommended that the FAA change the application for an airman medical certificate to request information related to sleep apnea. The NTSB also made other recommendations directed at determining the impact of short-haul, multi-segment flights on pilot fatigue.

The Aug. 7 letter addresses pilot fatigue and recommends that the application “elicit specific information about any previous diagnosis of obstructive sleep apnea and about the presence of specific risk factors for that disorder.”

“While the FAA medical application form does not specifically mention sleep disorders in the medical history section, it does include a question about ‘other illness, disability, or surgery’; and sleep apnea would appropriately be reported there,” said Gary Crump, AOPA director of medical certification.

The FAA requires a report of the initial sleep study that diagnoses obstructive sleep apnea and a maintenance of wakefulness test after therapy is begun to confirm that there is no excessive daytime sleepiness. Pilots with a history of controlled sleep apnea are then followed annually by the FAA under a special-issuance authorization. The AOPA Pilot Information Center provides resources about sleep apnea, including treatment options acceptable to the FAA and follow-up requirements.

AOPA will stay in close contact with the FAA’s Federal Air Surgeon to discuss any potential changes to the medical application.

The NTSB recommendation stems from an incident in 2008, when a Bombardier CL-600-2B19 operated by Mesa Airlines flew past its destination airport, General Lyman Field in Hilo, Hawaii, after both the captain and first officer fell asleep. Upon waking, the crew resumed communications with ATC and returned to Lyman Field with no injury, damage, or further incident. The NTSB ruled that the flight crew’s recent work schedules, which included several consecutive days of early-morning start times, and the captain's undiagnosed obstructive sleep apnea (OSA) contributed to the incident.

In addition to asking about any previous diagnosis of obstructive sleep apnea, the NTSB would have the FAA identify pilots at high risk for the sleep disorder and require those pilots to provide evidence of having been evaluated and, if needed, effectively treated before granting them an unrestricted medical certification.

For information on fighting pilot fatigue, see the AOPA Air Safety Foundation Fighting Fatigue Safety Brief.