Sleep Apnea and Airline Safety

Sleep apnea, which is a sleep disorder characterized by abnormal pauses in breathing (and often accompanied by loud snoring) is an ongoing health issue that affects people all over the world, and can lead to higher risks of hypertension, heart attack, stroke, and diabetes.

While there are a number of treatments available for this problem, whether it gets properly treated depends on whether someone suffering from sleep apnea is made aware of the potential problem, and encourage to seek medical help.

What does this have to do with the airlines?
If you have ever been a passenger who was awakened in the middle of a red eye flight by someone three rows back snoring like an unmuffled chainsaw, you've probably been affected by sleep apnea. While sleep apnea in the passenger cabin may be an inconvenience, a flight or cabin crew member suffering from sleep apnea may have that condition affect the quality of their work, and the safety of everyone on board.

Recent article on sleep apnea
A recent article by two Harvard School of Public Health professors discussed whether some groups are more at risk for sleep apnea. Some of those risk factors include poor air quality, a factor that many air crew may be exposed to in the workplace.

Share your sleep apnea experiences
Please review the sleep apnea article and leave your comments on how sleep apnea may have affected you as a passenger or crew member. While the article focused on health disparities faced by low income populations, the flying population may be another population with increased risks. Your inputs may shed light on this issue.

Full disclosure
While sleep apnea has been a long term concern of the FAA, my interest in the subject today is sparked by one of the two authors of the Huffington Post article on sleep apnea. Dr. Michelle A. Williams is not only the Chair of the Department of Epidemiology at the Harvard School of Public Health, she's also my wife.

This was also the very first blog article she has ever written, and it ended up on the home page of the Huffington Post earlier today. We've actually have been learning from each other's profession for several decades, but this is the first time I've ever mentioned her by name.

Resources
FAA brochure on sleep apnea

FAA controllers sleeping on the job may have many causes

On April 14, 2011, after several very public and very embarrassing incidents involving air traffic controllers falling asleep on the job, FAA Administrator Randy Babbitt accepted the resignation of Hank Krakowski, who was the manager of the FAA's air traffic control organization. Babbitt promised to perform a full review of how the air traffic control system was operated, and several political leaders, most notably President Obama, did their best to neutralize the traveling publics concerns by emphasizing their concern about the situation and their determination to ensure that the air traffic control system remains safe.

The recent public concern about sleeping controllers, which started last month after two aircraft had to abort landings because of a sleeping controller at Washington's National Airport, may bring to light some of the underlying reasons why controllers may be falling asleep. One of those reasons may be the FAA's policy for staffing air traffic control positions. One reason may have been the policy that allowed single controllers to staff control towers at major airports during late night shifts when there are few aircraft taking off or landing. The policy was recently changed, but the FAA's policy of rotating the shifts that a controller may work, for example working for several days in a row on a morning shift before rotating to either an earlier or a later shift, may play a role in controller fatigue.

Possible Roles of Fatigue and Obstructive Sleep Apnea
One possible issue, one that the FAA has long recognized, is the role that obstructive sleep apnea (OSA) in causing degraded pilot performance, including increased sleepiness. This problem isn't limited to pilots, but one that is often associated with obesity. Both the NTSB and the FAA have also been concerned about the role of fatigue in aviation safety, with the NTSB highlighting air traffic controller fatigue as one of its Most Wanted Transportation Safety Improvements.

Part of FAA's response to those related NTSB safety recommendations was a 2008 FAA symposium on fatigue where the FAA brought together a number of subject matter experts to discuss fatigue’s effects on flight crews, maintenance personnel, and air traffic controller, including the effect of rotating shifts on air traffic controller performance.

Dr. Todd Curtis of AirSafe.com discussed these and other issues on the BBC radio program Newshour on April, 14, 2011.

BBC Interview with Dr. Todd Curtis (4:30)
Audio: MP3 | YouTube

Additional Resources
2008 FAA fatigue symposium (index of proceedings)
Obstructive sleep apnea
FAA brochure on obstructive sleep apnea
FAA brochure on the effects of fatigue in aviation