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Sleep, Interrupted

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Citing the “significant safety implications” of obstructive sleep apnea (OSA), U.S. Federal Air Surgeon Fred Tilton has proposed screening the most obese pilots — those most likely to have the disorder — and requiring those diagnosed with OSA to undergo treatment before they receive medical certification.

Tilton outlined the plan in November 2013,1 noting that OSA is “almost universal” among people with a body mass index (BMI) of 40 or higher — a category that BMI calculators sometimes label “morbidly obese” (see “Measuring Obesity”) — and a neck circumference of 17 in (43 cm) or more. About 30 percent of those with a BMI below 30 — the threshold for obesity — also have OSA, he said.

Initially, Tilton said that policy details would be released shortly after announcement of the planned changes, but the announcement was greeted by protests from pilots’ organizations, which objected to the lack of opportunity for their feedback on the proposa…

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