(Damian Dovarganes/AP)

Overweight pilots and air traffic controllers can expect fresh scrutiny from the Federal Aviation Administration.

That’s addressed in a bulletin from Federal Air Surgeon Fred Tilton, who says that all pilots and controllers with a body mass index of 40 or more, or a neck circumference of 17 inches or more, will have to be evaluated by doctors to retain their medical certification. The issue, Tilton says, is obstructive sleep apnea, which “is almost universal in obese individuals.”

Anyone who suffers from sleep apnea will undergo evaluation by a “board certified sleep specialist.” Tilton writes that apnea “has significant safety implications because it can cause excessive daytime sleepiness, cognitive impairment, cardiac dysrhythmias, sudden cardiac death, personality disturbances, and hypertension, to cite just a few.”