Whether you fly professionally or for the love of aviation, maintaining good health is critical—not just for your own well-being but also for safety in the air. While airline and military pilots face highly structured health oversight, private and recreational pilots are often left to manage their health independently. Yet the same risks—from fatigue and dehydration to cardiovascular issues—apply across the board.
While preventing serious health problems is the best way to keep flying, well-managed medical conditions do not prevent certification from the FAA. Understanding the unique health risks you face as a pilot and what you can do to prevent them from affecting you will make you a safer pilot and keep you flying for years to come.
Keep the following 10 health concerns especially in mind.
Circadian Rhythm Disruption and Jet Lag
Even for general aviation pilots, early morning departures or cross-country flights can disrupt natural sleep patterns. Irregular sleep schedules when flying across time zones or preparing for training flights can impair alertness and reaction time.
Adjusting your sleep schedule a few days in advance, maximizing natural light exposure during the day, and avoiding screens before bed can all help reinforce circadian alignment [1]. While commercial pilots may use layovers to rest, private pilots should prioritize sleep and recovery, especially before long flights.
Deep Vein Thrombosis (DVT)
Though commonly associated with airline pilots, DVT can affect any pilot who remains seated for long periods. Long drives and any prolonged inactivity raise your risk of blood clots, too.
Simple leg movements in the cockpit, staying hydrated, and making it a point to walk around during layovers or breaks are essential. Compression socks aren’t just for passengers—they’re effective for anyone spending hours in a seated position [2]. Consider using them on longer flights, especially if you know you have circulation issues or have noticed leg swelling in the past.
Noise-Induced Hearing Loss
Hearing protection is vital regardless of aircraft type. Proximity to engines and lack of adequate noise insulation in many GA-type aircraft actually increases noise exposure compared to larger jets. Over time, constant exposure to engine and propeller noise can cause irreversible hearing loss.
Wearing passive or active noise-cancelling headsets while flying, using earplugs around noisy ramps, and getting your hearing checked regularly should be part of every pilot’s safety checklist. Private pilots flying right behind their piston engines should take this very seriously [3]. You’ll likely never regain hearing you’ve already lost, but you can limit further decline with proper diligence.
Radiation and Altitude Exposure
While radiation exposure is a greater concern for long-haul airline pilots who operate near polar routes, general aviation pilots flying at high altitudes still accumulate low but non-negligible doses of cosmic radiation. Pilots who frequently operate above 10,000 feet MSL—such as those in high-performance or pressurized aircraft—should be aware of the risks [4].
Though exposure levels typically remain below occupational limits, long-term awareness is key, especially for pilots logging hundreds of hours annually.
Diet, Exercise, and Weight Management
Staying active and eating well is a challenge for everyone. Pilots may snack on fast food between flights or skip meals entirely due to busy flight planning or hangar duties. Over time, this can lead to weight gain, sluggishness, and insulin resistance.
Planning balanced meals in advance and building a consistent exercise routine go a long way. In addition to building exercise into your day-to-day routine, think about how you’ll maintain your fitness during extended travel periods. Planning consistent, well-balanced meals during longer flying days is just as important for maintaining peak performance [5].
Mental Health and Emotional Well-Being
Pilots often face pressure to perform, whether it’s facing a flight review, keeping up proficiency, or even more down-to-earth problems entirely unrelated to flying. Anxiety, stress, or burnout can creep in—yet stigma around mental health persists in aviation.
All pilots need to understand that seeking help doesn’t necessarily ground you. Many mental health conditions, such as mild anxiety or situational depression, are considered certifiable under the FAA’s Special Issuance process when properly managed and documented [6]. This applies to all certificate levels, including private pilots.
Pilots should cultivate support systems, practice mindfulness, and seek help when needed, without fear of losing their medical.
Sleep Disorders and Fatigue
Fatigue can affect pilots of all experience levels. Whether it’s long hours at a flight school, back-to-back instructional sessions, or flying after a full workday, sleep deprivation affects safety.
Sleep apnea, in particular, is underdiagnosed among recreational and older pilots. Fortunately, treatments such as CPAP therapy are highly effective and do not disqualify a pilot from holding a medical certificate if managed correctly [7].
Whether you have a sleep disorder or not, good sleep hygiene, like consistent bedtimes and minimizing caffeine late in the day, will help you get the most out of the sleep you can obtain. Make those practices a priority.
Cardiovascular Health and Blood Pressure
Heart health is just as crucial for weekend flyers as it is for airline captains. Long-term hypertension and high cholesterol can quietly develop in pilots of any age or certificate level.
The FAA permits medical certification for many cardiovascular conditions when they are adequately controlled. Regular checkups, routine lab work, and a heart-healthy lifestyle can help prevent surprises during your next AME visit [8].
Medications, Supplements, and FAA Compliance
Pilots are responsible for understanding the impact of any substance they ingest, including herbal supplements and common cold remedies. Many over-the-counter medications impair cognitive function and are prohibited within certain hours of flight.
Diphenhydramine (Benadryl) is especially mentioned in this category. Diphenhydramine and other similar sedating antihistamines are present in almost every medication labelled “PM” or “nighttime”. These medications stay in your system for quite some time and generally require 60 hours after each dose before you can legally fly.
Consult the FAA’s “Do Not Issue/Do Not Fly” list, reference our medication database, or speak with an AME before starting any new medication. The safest approach is to ask before you fly—never assume a medication is permitted just because it’s over the counter [9].
FAA Medical Certification. Stay Healthy; Stay Flying.
A persistent concern is that even minor health problems will prevent them from flying. In truth, the FAA medical system is built around individual assessment. Many conditions are not only treatable but certifiable, often through the Special Issuance process.
Whether it’s ADHD, hypertension, diabetes, or anxiety, the FAA allows pilots at all levels to continue flying when they demonstrate effective management and a low risk to flight safety [10]. Disclosing health concerns, rather than hiding them, is always the best course of action.
If you’re unsure about your eligibility, consult an AME you know and trust or another expert like Wingman Med. You’re not alone—and you’re not grounded by default.
Best Practices
No matter your certification level, pilot health isn’t a side concern—it’s a foundation for safe flight. By staying proactive about sleep, diet, mental health, and routine medical care, chances are that you can continue flying well into your golden years without disrupting your medical certification.
Most important: a medical diagnosis is not the end of your flying journey. In most cases, with the right support and management, you can maintain your medical certificate and continue flying. Do your best to stay healthy, but when medical issues do arise, see your doctor early and keep them from progressing into something worse.
References
[1] C. A. Czeisler et al., “Stabilized sleep/wake schedules and circadian phase affect performance,” Sleep, vol. 13, no. 6, pp. 418–429, 1990.
[2] G. Scurr et al., “Traveller’s thrombosis: airlines and deep vein thrombosis,” BMJ, vol. 325, no. 7369, pp. 386–387, Aug. 2002.
[3] NIOSH, “Occupational noise exposure: Revised criteria 1998,” U.S. Dept. of Health and Human Services.
[4] E. Friedberg et al., “Radiation exposure of aircrew,” Occupational Medicine, vol. 16, no. 2, pp. 285–295, 2001.
[5] A. M. Smith and L. P. Jones, “Impact of meal timing and composition on pilot health,” Aerospace Medicine and Human Performance, vol. 91, no. 3, pp. 205–211, Mar. 2020.
[6] FAA, “Pilot mental health: FAQs,” [Online]. Available: https://www.faa.gov.
[7] M. Stepanski et al., “Sleep apnea and cognitive function in aviation,” Chest, vol. 117, no. 5, pp. 1240–1247, May 2000.
[8] American Heart Association, “Exercise and cardiovascular health,” [Online]. Available: https://www.heart.org.
[9] FAA, “Medications database,” [Online]. Available: https://www.faa.gov.
[10] FAA Guide for Aviation Medical Examiners, “Special Issuance Certification,” [Online]. Available: https://www.faa.gov.