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

Plane crash kills two tourists in Kenya

22 August 2012; Mombassa Air Safari; Masai Mara Game Reserve, Kenya, Let 410; 5Y-UVP: The aircraft was on an unscheduled domestic flight, and crashed shortly after takeoff. Both crew members and two of the 11 passengers were killed.

While this airliner accident resulted in fatalities, it is not counted as a fatal event as defined by AirSafe.com

This airline had a previous Let 410 crash in 1998 that killed both pilots. That accident flight had no passengers on board.

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The AirSafe.com Ebook project is still in its early stages, and will continue to accept contributions until the end of next month. To read more about the project, please visit books.airsafe.com.

Photo: AFP

Recent positive TSA survey may be misleading

Earlier this month, the polling organization Gallup released the results of a random survey of US adults from July 2012 that concluded Americans' views of TSA were more positive than negative. Specifically, 54% of those surveyed thought that the organization was doing a good or excellent job.

Would these results be a surprise to most travelers?
The TSA certainly welcomed this result, featuring a link to the Gallup survey on their home page. While this was certainly good news to TSA management, it may come as a surprise to passengers who have to experience the TSA's procedures on a regular basis.

Most surveyed were not frequent flyers
The positive results could have been a result of who was polled. According to Gallup, only about 12% of those surveyed had flown on a commercial airline flight five or more times in the previous year, and 48% had not flown on a commercial airliner at all in the previous year.

Could the questions have been different?
While there is no reason to doubt the results, one has to wonder what the response would have been to a different set of questions. For example, the survey asked for opinions about the TSA as a whole, and not about the behavior, quality, or performance of the TSA security officers who screen passengers.

Not clear who paid for the poll
Another unknown is who sponsored the survey. Gallup did not state if the survey was paid for by an outside organization or by Gallup. If it were funded by an organization that would benefit from a positive perception of TSA, that would not make the poll invalid, but it could explain why the poll results were released to the public.

Poll results may be out of context
Perhaps the biggest reasons to question the usefulness of the results is that the results were not put in a context of how those perceptions may have changed over time, or more importantly how those results compare with those of comparable organizations.

Since the TSA was established in the wake of 9/11, the public's perception of the organization has gone up and down. The positive results that were reported in the recent Gallup poll would be much more useful to the public if they could be compared with earlier results from similar poll questions. While it is possible that Gallup or the organization that paid for this recent poll may have this kind of comparative data, none were offered in Gallup's report.

Police viewed much more positively than TSA
TSA is not a law enforcement agency, and TSA screeners do not have the power to arrest anyone or use deadly force, it may be quite fair to compare the public's view of police and the TSA. This is especially true because of the steps that TSA has taken to have uniforms that look very much like police uniforms.

In October 2005, Gallup conducted a national poll that revealed that confidence in local police had dropped to a 10-year low, with 53% of those surveyed having either "a great deal" or "quite a lot" of confidence in the ability of police to protect them from violent crime. In 2011, this figure was 56%.

Police viewed more positively than TSA
While the two polls did not ask the same questions, it may be quite fair to use the TSA and police polls to compare the public's perception of the ability of the police and the TSA to accomplish their core missions. One could conclude that while the public's perception of the TSA in 2012 is good, police had a better public perception in 2011 and in every year from 1996 to 2005.

What to do if you get seriously ill on a trip

What would you do if you started to feel really ill either just before or during a trip? Not just a slight head cold kind of sick, but sick with unusual pains or symptoms that you've never felt before? Unless you are are examined by a properly trained medical professional, you may not have any idea how minor or serious your situation may be.

If this happens on your last flight before you return home, your decision is probably an easy and sensible one—get on the flight and get checked out by a doctor when you land.

If you are away from home, or if it happens right before you fly, getting examined by a physician is still a good idea, but if doing so forces a change in travel plans, other considerations may cause you to think about doing something riskier, like going ahead with your trip and hoping for the best:

• If you are on a bargain air fare with a cancellation penalty, you may decide the the loss of money (including the cost of any new ticket) is worth the risk to your health.
• If changing the schedule means you may miss out on an important event like a wedding or a trip on a luxury cruise.
• If taking time to deal with your potential health issue significantly affects the travel plans of others.
• You convince yourself that the medical advice you get (either from the web or from an actual medical expert) doesn't apply to you.

Like many medical judgment calls, there may be no way to tell ahead of time if what you have is a minor annoyance or an immediate threat to your life. Given the potential financial or personal impact that canceling the trip may have, it may make sense to take some basic precautions before you travel that will either: (1) help make your decision making easier, (2) reduces or eliminates any financial impact of any significant change to your scheduled trip, or (3) allows you to get properly treated should you get seriously ill away from home:

• Choose an airline fare that allows you to make changes or even cancel the ticket with little or no penalty.
• Buy trip insurance that will reimburse you if you make a change that leads to fees or penalties.
• Make sure that you can get adequate medical attention at your destination, or at any location where you may be changing planes en route
• Purchase emergency medical evacuation insurance if you are traveling overseas, especially to places where sophisticated medical care is unavailable.
• Purchase supplemental medical insurance if you medical plan doesn't cover expenses at your destination (most US medical plans have limited or no coverage for medical treatment overseas).

This is the kind of advice the kind of advice that will be included in the upcoming AirSafe.com ebook series which will be provided to the public at no cost, and will provide air travelers with a valuable resource that will help them avoid or manage many of the common problems they face when they fly. To find out more about the project and how you can support it, please check out the video below or visit books.airsafe.com.

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Check out the Ebook Project Video

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