NTSB recommends pilot screening for Sleep Apnea

[diggertwo]

http://www.pilotbug.com/?p=595

The NTSB has issued several recommendations in response to the February 13th, 2008 incident involving two go! airline pilots falling asleep and overshooting the airport at Hilo, Hawaii. Among them is to change the medical certificate application to specifically ask if the airman has sleep apnea and to identify high risk individuals.

According to the safety recommendation, studies have concluded that the go! airlines flight, operated by Mesa Airlines, wan not an isolated incident. Information contained in the National Aeronautics and Space Administration’s (NASA) Aviation Safety Reporting System (ASRS) reveled that from 1995 to 2007 there were 17 reported instances of at least one pilot falling asleep and in five of those, both pilots did. In addition, NASA found that 80% of pilots from 26 regional airlines had “nodded off” at one time or another, according to those responding to a 1999 survey.

Concerning the NTSB is the disconnect between the general population prevalence of sleep apnea and the pilot group. It is estimated that 7% of adults suffers from some form of sleep apnea, while only 0.5% of pilots holding a 1st Class medical have indicated to the FAA. One of the contributing factors to the go! airline’s captain falling asleep was his undiagnosed sleep apnea, causing increased daytime fatigue.

Several of the recommendation to the FAA are to:

1. Change the Application for Airman Medical Certificate to ask specific questions regarding sleep apnea.

2. Develop and utilize a program to identify those who may be susceptible to sleep apnea to be evaluated and treated before granting an unrestricted medical certificate.

3. Conduct research on fatigue of short-haul operations.

4. Require short-haul operators to modify operations based on recommendations provided by the research identified by the above recommendation #3.

 

[wms]

Go listen to the log-sawing competition in the crew room and you can tell who has sleep apnea!

 

[SEVEN]

Any pilot who is more than 15-20 lbs. overweight probably has some form of sleep apnea. I'm guessing that's probably over 50% of all pilots operating in the 121 world. Oh no, better yank the medicals of all those airmen for more testing. Let's just shut down the entire airline industry for 12-18 months while were at it. Gimme a break!

 

[Poahi]

Go listen to the log-sawing competition in the crew room and you can tell who has sleep apnea!

Good point, and the report doesn't explain why the FO fell asleep.

 

[gringo]

Go listen to the log-sawing competition in the crew room and you can tell who has sleep apnea!

Not necessarily true. I thought I had sleep apnea, as I do snore at night. I went and had a sleep study, and found out that my snoring is more of a component of my recent 25 pound weight gain. But it was not apnea, which is determined by a) number of times one wakes up per hour and b) blood/oxygen levels while sleeping.

The only way to find out is to have a sleep study done.

Bottom line is, all sleep apnea sufferers snore, but not all snorers have sleep apnea.

 

[Grinder10]

I'm sure the FAA will file this right next to the rest of the NTSB's recommendations.

 

[crj567]

Yeah-

NTSB recs seem to get a bit far fetched sometimes. I wouldn't bet on anything happening. Probably 80% of pilots would fail the test if they came off a brutal 4 or 5 day trip.

 

[PA44Jockey]

You will see changes with respect to airmen medical certificates due to Sleep Apnea. It's a continuing problem that is undiagnosed in a large majority of pilots, only because they aren't tested for it. Chances are, if you meet certain height and weight criteria in the not so distant future you will be required to be tested. The AME's are even starting to recommend sleep studies now and due to the heightened popularity of pilot fatigue, they aren't letting as many cases by.

 

[Dumb Pilot]

The only way to find out is to have a sleep study done.

This is done regularly outside of the US. We need a little more requirements here in the US to obtain a medical than just fogging a mirror

 

[deadstick]

So as long as you get 5 hours of good sleep during your 8 hours of rest, they don't have to change the duty limit regs.

 

[buscap]

I think this is all a bunch of crap!!

Who are they to say if I

ZZZZZZ
ZZZZZZZZZZZZZZZZZZZ


ZZZZZZZZ

ZZZZZZZZZZZZZZZZZ


ZZZZZZ
ZZZZZZZZZZZZZZZ

snort

 

[Beaver79]

Not necessarily true. I thought I had sleep apnea, as I do snore at night. I went and had a sleep study, and found out that my snoring is more of a component of my recent 25 pound weight gain. But it was not apnea, which is determined by a) number of times one wakes up per hour and b) blood/oxygen levels while sleeping.

The only way to find out is to have a sleep study done.

Bottom line is, all sleep apnea sufferers snore, but not all snorers have sleep apnea.

You speak the truth. I had the same issue. I didn't know I was snoring until the sleep study, but once I got the "TAP" device to wear at night, the sleepiness, snoring, and the insomnia went away. It was strange though - all of my numbers were below sleep apnea numbers so I was perplexed with the sleepiness. Turns out that snoring is enough. I actually had a doctor ask me "why are you here" at one of my consults. I think my response "aren't you the f**ing doctor?" really pleased him. Either way, if you aren't sure about what is normal and what isn't, ask your personal doctor - he or she can point you in the right direction. Irrespective of the flying issue, sleep apnea is no joke and can yield REALLY bad problems as you age. The biggest risk factors for sleep apnea are male, over 40, BMI of 30 or more, and a neck circumference of 17 or greater. Unfortunately these are only indicators - you could have none of these and still have sleep apnea.

 

[Seaknight1]

I was just diagnosed with sleep apnea. I snore really bad and my wife said that I stopped breathing while I was asleep. I went to my regular physician and asked about it. He asked me some qestions and with that he sent me off to do a sleep study. Heck I actually fell asleep in the waiting room at my first appointment! I did my sleep study and the doc said that I stopped breathing 55 times an hour during an 8 hrs study period. Everytime breathing stops the body unconciously awakens to start breathing again. So essentially I woke up 55 times an hour for 8 hours! The body will never go into a deep sleep. My snoring was a 9 out of 10 with 10 being the worst. I have my last sleep study this week to find the right airflow level for the cpap device and the doc will give me the thumbs up that it's under control and I can go to my FAA medicical examiner and get a special issuance. I really can't wait to actually feel awake and rested and not nod off all the time during the day.

 

[PA44Jockey]

When I was diagnosed with OSA before my surgery I would stop breathing on average of 25 times per hour for 20 seconds intervals. Now I am down to around 13 times per hour and about 14 seconds per episode.

 

[Seaknight1]

When I was diagnosed with OSA before my surgery I would stop breathing on average of 25 times per hour for 20 seconds intervals. Now I am down to around 13 times per hour and about 14 seconds per episode.

They're not pushing the surgury anymore since doesn't cure sleep apnea in most cases and most come back and get cpaps which does control the apnea.

 

[deadstick]

I have read all about this issue since the NTSB report, but what is the time line for all of this? About the surgery, one article indicated that the FAA really like that option because the other options aren't "sure things." Now it sounds like the surgery isn't a "sure thing" either.

 

[crj567]

I have read all about this issue since the NTSB report, but what is the time line for all of this? About the surgery, one article indicated that the FAA really like that option because the other options aren't "sure things." Now it sounds like the surgery isn't a "sure thing" either.

I wouldn't worry about it-the NTSB has also said that airliners wouldn't crash from structural failures if you stuck a big enough parachute on every plane.

-I wouldn't hold my breath.

 

[WMUSIGPI]

A better first step would be the end to "swing shift" or reserve duty period swapping during the month.... Going from CDO reserve to AM ready reserve on 10 hours notice is Bull********************e!

 

[joe_pilot]

A better first step would be the end to "swing shift" or reserve duty period swapping during the month.... Going from CDO reserve to AM ready reserve on 10 hours notice is Bull********************e!

I agree. This seems to be the most obvious change that needs to be made. I would be willing to bet that there is enough evidence about circadian rhythm interruption (without having to do another study) to shut this down.

CDOs can be fine, but only if you're prepared for them.

 

[Salukipilot4590]

Good thing I got fixed up after the furlough! Here's my story in shorthand:

Graduated from college in 2007 at about 250 pounds.
Went to work in Jan of 08 for...err...an airline
Had my tonsils flare up in sim training to the point where they were touching
Thought I had it all under control but was noticing that I couldnt sleep/was getting up a lot/drooled a lot on my sheets
I gained about 50 pounds during the next 8 months flying (Five guys is AWESOME!)
By the time I was furloughed I weighed 306 (At the time of my tonsillectomy) and hadnt slept at all from about May until September

Since I had the two balls of death removed and a lot of free time I decided to lose weight. From the middle of October until February I lost more than 70 pounds (Went from 306 to 224 ish...) by long distance bike riding, light dieting and weight lifting. August of 2008 I was completely miserable, couldn't sleep, had white gobs of crap coming out of my mouth (off my tonsils), my breath was worse than death and I looked like overall hell.

Thats just my story, now when I wake up I feel like that happy fellow to the left!