Residual Sleepiness Risk in Aircrew Members with -Obstructive Sleep Apnea Syndrome

Area of Science:

• Aviation Medicine
• Sleep Medicine
• Cardiology

Background:

• Obstructive sleep apnea syndrome (OSAS) poses significant risks in aviation due to sleepiness and cardiovascular issues.
• Residual sleepiness post-treatment is common and inconsistently managed in aircrew.
• Standardized management and guidelines are needed for OSAS in aviation.

Purpose of the Study:

• To describe the management of residual sleepiness in aircrew with OSAS.
• To propose evidence-based guidelines for assessing fitness to fly in affected individuals.
• To evaluate the effectiveness of current assessment methods.

Main Methods:

• Retrospective study of 138 aircrew members with OSAS history (2011-2018).
• Focus on residual sleepiness assessment, including Maintenance of Wakefulness Tests (MWT).
• Analysis of Epworth Sleepiness Scale (ESS) and Apnea Hypopnea Index (AHI).

Main Results:

• Severe OSAS (AHI ≥ 36.2/h) was prevalent (65.4%).
• Only 59.4% underwent MWT, with 10.1% showing residual excessive sleepiness.
• Despite OSAS, 83.1% were deemed fit to fly after evaluation.

Conclusions:

• Objective sleepiness evaluation is crucial for aircrew with OSAS, as ESS alone is insufficient.
• Maintenance of Wakefulness Tests (MWT) are valuable for assessing fitness to fly.
• Standardized criteria for normal MWT results in aviation are important for consistent management.