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flow to the different regions. Specifically, reduced blood flow and metabolic activity was observed in those same regions of the brain (hippocampus, amygdala, and frontal lobe) in individuals with chronic OSA. 19 Taken together, these findings suggest that OSA poses risks to aviator performance through increased fatigue, daytime sleepiness, and decreased cognitive function. The U.S. Army Aeromedical Activity hosts a database that archives aeromedical records, physicals, waivers, and suspensions known as the Aeromedical Electronic Resource Office (AERO; also

The medical status of military aviators and crewmembers is routinely assessed to ensure their medical fitness is maintained. Certain medical or neurobehavioral conditions have the potential to adversely affect cognitive functioning and so disqualify aviation personnel from full flight status. This necessitates an aeromedical evaluation if the service member wishes to obtain a waiver to pursue or regain flight status. In such cases, flight surgeons often refer the service member for a neuropsychological evaluation to help discern the appropriateness of a waiver

Carbon dioxide is a major product of metabolism in the body and is eliminated through respiration. Carbon dioxide in the blood directly affects blood pH and thereby respiratory drive. When respiration exceeds the amount necessary to eliminate carbon dioxide, the pH is raised and can induce symptoms such as light-headedness, headache, visual disturbances, paresthesias, and even loss of consciousness. These symptoms are very similar to hypoxia and when occurring in flight may cause an aviator to believe he or she is experiencing hypoxia due to another cause such