It has long been appreciated that sleep apnea results in poor quality sleep, and that poor quality sleep is associated with daytime fatigue and decrements in performance. However, the relationship between sleep apnea and poor performance, including risk for accidents is not as well understood.

The purpose of this article is to review the basic epidemiology, pathophysiology, and treatment of sleep apnea, including major risk factors for apnea, such as body mass index (BMI), and to look at what is known about the impact of sleep apnea on performance in transportation related occupations.
Sleep Apnea in Obese Pilots
Ruskin KJ, Caldwell JA, Caldwell JL, Boudreau EA. Screening for sleep apnea in morbidly obese pilots. Aerosp Med Hum Perform. 2015; 86(9): 835 – 841