For Immediate Release
March 28, 2014
Contact: Alison Duquette or Les Dorr
Phone: (202) 267-3883
The Federal Aviation Administration (FAA) is responsible for protecting the safety of people who fly as well as the lives and property of people on the ground. While the United States has an impressive safety record, the FAA continually works with the aviation and medical communities to ensure that pilots are fit to fly.
What is Obstructive Sleep Apnea?
Obstructive Sleep Apnea (OSA) inhibits restorative sleep. It has significant safety implications because it can cause excessive daytime sleepiness, cognitive impairment, cardiac dysrthythmias, sudden cardiac death, personality disturbances, and hypertension. OSA is nearly universal in obese people who have a Body Mass Index (BMI) over 40.
Can a pilot who has OSA fly?
Pilots who have OSA and are being treated under the care of a physician and their Aviation Medical Examiner (AME) may fly. The most effective treatment involves the use of a continuous positive airway pressure (CPAP) or Automatic Positive Airway Pressure device that is worn at night. In fact, there are currently 4,917 FAA-certificated pilots who are being treated for sleep apnea and are flying with a special issuance medical certificate. Of those, 1,437 are pilots who hold a first class medical certificate, 1,008 hold a second class medical, and 2,472 hold a third class medical. Of the 4,917 pilots diagnosed with OSA, only 347 have a BMI of 40 or greater.
What are the FAA’s current rules on OSA?
Untreated OSA has always been and will continue to be a disqualifying medical condition. AMEs are advised by the FAA to be alert for OSA and other sleep-related disorders such as insomnia, restless leg disorder, and neuromuscular or connective tissue disorders, because they could be signs of problems that could interfere with restorative sleep. Currently, if a pilot is diagnosed with OSA, an AME must submit all pertinent medical information and a current status report, a sleep study with a polysomnogram, and use of medications and titration study results to the FAA. The FAA will then decide if a special issuance medial certificate is appropriate.
Is the FAA changing the rules on OSA?
The FAA is not changing its medical standards related to OSA. The agency is pursuing a revised screening approach to help AMEs find undiagnosed and untreated OSA.
On March 28, the FAA sent draft guidance for Aviation Medical Examiners (AMEs) on Obstructive Sleep Apnea (OSA) to key industry medical representatives to review within 14 days. The revised guidance aims to improve safety and pilot health by reducing the burdens and disincentives that may have prevented some pilots from getting an OSA evaluation and treatment. Highlights include:
- Pilots will not be disqualified based on Body Mass Index (BMI) alone. AME’s will consider all the OSA risk factors and make a recommendation regarding an OSA evaluation. AME’s will issue medical certificates to pilots regardless of BMI if they are otherwise qualified.
- Pilots with significant risk will be referred for an evaluation for possible OSA. OSA evaluations may be completed by any physician, not just sleep specialists, using standard criteria. Evaluations may not require a laboratory sleep study or even a home study if the certifying physician does not feel the pilot requires it.
- Reports from physicians may be given to the AME within 90 days of the FAA exam and forwarded to the FAA to satisfy the evaluation requirement. The pilot continues to fly during this period.
- Pilots diagnosed with sleep apnea can bring documentation of effective treatment to the AME who will call the Regional Flight Surgeon or the Aeromedical Certification Division for assistance in order to continue flying on the previously issued medical certificate.
- The FAA will send the pilot a Special Issuance letter documenting the follow-up tests required and timing of the reports. Most follow-up reports will only require usage data from the Continuous Positive Airway Pressure (CPAP) machine and a brief statement from a physician.
What is an FAA Medical Certificate?
The FAA sets medical certification standards for three classes of pilots: first class – commercial pilot in command, second class – other commercial pilots, and third class – recreational pilots. Pilots, with the exception of sport pilots, are required to have both an FAA Airman’s and Medical Certificate. The FAA’s regulations outline the standards for medical certification.
Have there been any accidents or incidents caused by OSA?
The National Transportation Safety Board (NTSB) determined that OSA was a contributing factor in the February13, 2008 Mesa Airlines flight 1002, operated as go!, incident which involved two pilots who fell asleep during the flight. The captain had undiagnosed OSA. The airplane traveled 26 miles past the destination airport before the flight crew resumed communications with air traffic control. All three crewmembers and 40 passengers onboard arrived safely. While not listed as the “cause,” the NTSB database reveals 34 accidents, 32 of which were fatal, involving people who had sleep apnea and 294 incidents involving some type of sleep disorder.
The Bottom Line
Safety is always the FAA’s top priority. The FAA will continue to work with aviation stakeholder groups and the medical community to provide clear guidance on medical policies on OSA.
For more information on medical certification, go to: http://www.faa.gov/licenses_certificates/medical_certification/