Two pilots for Go! Airlines slumbered during a flight in Hawaii, were suspended for careless and reckless operation of an aircraft by the Federal Aviation Administration (FAA), and subsequently fired by their employer. The captain was later found as suffering from severe undiagnosed apnea.

Meanwhile, the National Transportation Safety Board has cited pilot fatigue as a factor in several recent crashes, including the February 2009 Colgan crash near Buffalo, NY, that killed 50 people.

Of the 18 million Americans who have sleep apnea, many are commercial drivers and pilots who are treated successfully with oral mouth devices, C-PAP (continuous positive airway pressure) masks, or othodontics. Dr. David Shirazi at The TMJ and Sleep Therapy Centre of Conejo Valley, says that treatment is simple and often covered by health insurance.

Apnea occurs when a person's air passages become blocked, forcing a wake-up gasp for breath. The waking occurs so briefly that many sufferers don't even realize it.

It is reported that bus drivers, truck drivers and railroad workers suffering from excessive 'daytime drowsiness' are a major cause of fatal accidents. Federal regulations in the near future will mandate truck and bus drivers to be tested for sleep disorders to decrease crash rates and fatalities. The Federal Motor Carrier Safety Administration (FMCSA) has taken positive action with regard to commercial drivers and has established a panel to determine the prevalence of obstructive sleep apnea on commercial truck drivers, and the FAA is following in its footsteps.

Airlines, pilot unions and federal officials have until September 1, 2009 to develop new rules to limit fatigue among pilots, the FAA recently announced in a move to address one of the industry's most contentious safety issues.

Dr. Shirazi provides some warning signs that might indicate that you have sleep apnea:

Excessive daytime sleepiness

Frequent episodes of obstructed breathing during sleep. (You may be unaware of this symptom, realizing it only after a bed partner has brought it to your attention.)

Loud snoring

Clenched jaw

Morning headaches

Un-refreshing sleep

Dry mouth upon awakening

High blood pressure

Overweight/obesity

Irritability

Change in personality

Depression

Difficulty concentrating

Excessive perspiration during sleep

Heartburn

Reduced libido

Chest retraction during sleep in young children (chest pulls in)

Insomnia

Frequent nocturnal urination

Restless sleep

Nocturnal snorting, gasping, choking (may wake self up)

Rapid weight gain

Confusion upon awakening

"Sleep apnea and its risks should not be taken lightly," says Dr. Shirazi. "We certainly want our commercial drivers and pilots to be free of sleep apnea for safety and health reasons."

Aviation regulators don't currently screen commercial pilots for sleep disorders. While efforts to reduce fatigue in aviation have focused on pilots' schedules, federal accident investigators say pilots also need to be screened for apnea.

The FAA requires pilots to get medical exams but there is no specific screens for sleep disorders.

While on the subject, what if your car (or aircraft for that matter) could keep an eye on you while you drive/fly, nudging you when you start yawning?

That's the aim of a new in-car yawn-detection system being developed by an international team in the US and India.

Aurobinda Mishra of Vanderbilt University, in Nashville, TN, and colleagues Mihir Mohanty of ITER, in Orissa and Aurobinda Routray of IIT, West Bengal, India, have developed a computer program that can tell when you are yawning and could prevent road traffic accidents.

The US National Highway Traffic Safety Administration estimates that at least 100,000 road crashes are caused by driver fatigue each year.

The new program is based around an in-car camera hooked up to image-processing software that captures a sequence of images of the driver's face. It then analyses changes in the face and accurately identifies yawning as distinct from other facial movements such as smiling, talking, and singing. The yawn frequency is then correlated with fatigue behavior and could then be hooked up to a warning system to alert drivers to the need to take a break.

The researchers say the algorithm is effective at yawn detection regardless of image intensity and contrast, small head movements, viewing angle, spectacle wearing, and skin color.

The researchers point out that for traffic safety, it is essential to recognize and understand the physical and mental stress leading to fatigue in drivers. Considerable research has been carried out to investigate and characterize biological signals, such as brain waves and heart activity.

However, it would be costly and inconvenient for drivers to have to connect to an ECG machine every time they took a trip. A system that watches the driver and analyses their facial expressions would be so much simpler and less invasive.