Oh, for a good night's sleep

Gary Crump

• Director, AOPA Pilot Information Center Medical Certification Section
• 28 years assisting AOPA members
• Former Operating Room Technician, Professional Firefighter/Emergency Medical Technician
• Pilot since 1973

First of all, no one with a basic understanding of the physiology and pathology of sleep apnea can argue that inadequate sleep, especially when caused by a “neuro-mechanical” obstruction such as apnea, can and does present safety issues that the federal government should be concerned about in some transportation modalities. However, the recent commuter train derailment in New York state allegedly caused because the operator “dozed off” is a good example of how confusing the facts can muddy the waters about the sleep deprivation problem in commercial transportation. There is the tendency to associate “dozing off” with a presumption that the operator has sleep apnea. Falling asleep at the wheel is a problem, but the reason may not be related to sleep apnea.

That is the industry’s position in its opposition to the policy change that would require any pilot with a body mass index (BMI) of 40 or greater to undergo screening for sleep apnea. Although the National Transportation Safety Board (NTSB) cited 30-plus commercial transportation incidents in which sleep fatigue was cited as a “factor,” an overall review of the accident data in general (private) aviation does not associate underlying untreated sleep apnea as a “causal factor” or even a contributing factor to any of those accidents. 

AOPA’s response to the policy “enhancement” to require screening for any pilot with a suspect BMI is that there is not enough evidence to support casting such a wide net in hopes of finding a few small fish. We felt it was necessary to draw a line in the sand and say to the FAA that the amount of medical certification oversight needs to be scaled back, not increased, especially right now when federal resources are shrinking and the FAA already has a monumental mess of a backlog that has lasted just about all of 2013 and probably will get worse in 2014. The cost of administering the medical certification process for recreational flying has minimal benefit in dollars and cents, and we will continue to work to show that as congress wanders into the arena in 2014.

There is good news to report, however. Just before Christmas, the FAA, in response to the overwhelming negative sentiment about the policy change, decided to delay the implementation of the new policy and convene a government/industry working group to negotiate the best way to address the sleep apnea issue. This meeting will take place in early 2014.

There has been a lot of press about the FAA’s recent announcement about changes in the policy for pilot medical certification and sleep apnea. Although the FAA and industry’s positions (including AOPA’s) might appear to be clear cut, the media sometimes get some of the underlying nuances confused. I believe that may be the case with this issue as well.