I think it's been quite clearly established that you have violated the TOS on this forum by posting to promote your own business and line your pockets. You may claim an altruistic reason, but it just doesn't appear that way.

I posted that some information you had posted and provided on your website was wrong. I fail to see where you've provided information contrary to my assertion.

In my post #2 on this thread, I provided the reader the complete AME guide provided by the FAA and you discounted this information, yet you post the link to the overall Guide and ask people to drill down to get the information I've provided.

If one goes to the AME informed, there is no "roll the dice" as you propose. If you truthfully don't have reports of apnea symptoms, don't report that you snore, don't report less than restful sleep, and don't have a BMI over 35, you are most certainly in the clear. The STOP BANG sheet you provide does come from the FAA materials, but as everyone can see if you're male, over 50, you would almost certainly think you'd be selected. But you fail to mention that the triage process is much more complicated that the single self-serving form you present. A history is to be taken, clinical observations etc. The FAA specifically references tables to be consulted, and a lot more that you let on. That taken overall overrides the fear mongering you are trying to provoke.

Let's take your point that you think you can smooth the flow by having pilots go to your fly in program and do a sleep study prior to their AME visit. If they do that prior to an AME visit, they have to report it. They will have to provide your complete workup/report to the AME/FAA. Do you think any pilot is crazy enough to do that? For a simple cold, go to a nutritionist and they will find a food problem with you, an ENT will find you need sinus surgery, you'll find a sleep problem is causing the cold, etc. Pilots don't take treadmill stress tests unless they HAVE to. Pilots don't take sleep studies unless they HAVE to. Whether a pilot finds a problem prior to their physical or afterwards, the paperwork and the process is virtually the same. Why put yourself in career jeopardy with you before one has to?

You also conveniently fail to mention that being put in category 5 by one's AME is a process that COULD result in a sleep study, not a process that WILL result in a sleep study. There is a heck of a lot of stuff that goes into the determination of what is needed once a pilot is put in high risk/category 5. Being put in a high risk category by the AME flow chart is NOT a certain need for a sleep study--as much as you would like to convince potential clients otherwise. You fail to mention the Epworth Sleepiness Scale and the Berlin Questionnaire which often provide different results than the "Scary" STOP BANG assessment.

Let's take a look at the process--taken directly from the AME guide:

The AME while performing the triage function must conclude one of six possible

determinations. The AME is

the presence or absence of OSA.

Step 1 -

Applicant Previously Assessed:

Group 1:

Group 2:

Special Issuance. Reports to follow.

Applicant Not at Risk:

Group 3:

Applicant at Risk/Severity to be assessed:

Group 4:

Group 5:

Applicant Risk/Severity Extremely High:

Group 6:

required. Reports to follow.

Step 2 –

Step 3 –

Step 4 –

In assessing airmen for groups 4 and 5, the AME is expected to use their own clinical

judgment, using AASM information, when making the triage decision.

Some AMEs have voiced the desire to perform the OSA assessment.

accordance with the clinical practice guidelines established by the American Academy

of Sleep Medicine.*

*If a sleep study is conducted, it must be interpreted by a sleep medicine specialist.

************************************************** ************************
Group 5 is what MAY lead people to a sleep study. Let's see what the FAA directs for those in group 5:

OBSTRUCTIVE SLEEP APNEA SPECIFICATION SHEET B

ASSESSMENT REQUEST

Due to your risk for Obstructive Sleep Apnea (OSA), and to review your eligibility to

have a medical certificate, you must provide the following information to the Aerospace Medical Certification Division (AMCD) or your Regional Flight Surgeon’s Office for review within 90 days:

•

A current OSA assessment in accordance with the American Academy of Sleep

Medicine (AASM) by your AME, personal physician, or a sleep medicine

specialist.

•

If it is determined that a sleep study is necessary, it must be either a Type I

laboratory polysomnography or a Type II (7 channel) unattended home sleep test

(HST) that provides comparable data and standards to laboratory diagnostic

testing.

It must be interpreted by a sleep medicine specialist and must

include diagnosis and recommendation(s) for treatment, if any.

If your sleep study is

positive for a sleep-related disorder, you may not exercise the privileges of your medical certificate until you provide:

•

A signed Airman Compliance with Treatment form or equivalent;

•

The results and interpretive report of your most recent sleep study; and

•

A current status report from your treating physician addressing compliance,

tolerance of treatment, and resolution of OSA symptoms.

If you are

not diagnosed with a sleep-related disorder or the study was negative

for a sleep-related disorder

, you may continue to exercise the privileges of your

medical certificate, but the evaluation report along with the results of any study, if

conducted, must be sent to the FAA at the address below. All information provided will

be reviewed and is subject to further FAA action.

In order to expedite the processing of your application, please submit the

aforementioned information

in one mailing using your reference number (PI, MID, or

APP ID).

************************************************** ******

How does your personal physician determine if a sleep study is needed:

History of findings that suggest increased risk of OSA include:



Hypertension requiring more than 2 medications for control or refractory hypertension



Type 2 Diabetes



Atrial fibrillation or nocturnal dysrhythmias



Congestive heart failure



Stroke



Pulmonary hypertension



Motor vehicle accidents, especially those associated with sleepiness/drowsiness



Under consideration for bariatric surgery

Symptoms that suggest an increased risk of OSA include:



Snoring



Daytime sleepiness



Witnessed apneas



Complaints of awakening with sensation of gasping or choking



Non-refreshing sleep



Frequent awakening (sleep fragmentation) or difficulty staying asleep (maintenance insomnia)



Morning headaches



Decreased concentration



Problems or difficulty with memory or memory loss



Irritability

Physical/clinical findings that suggest increased risk of OSA include:



High score on an OSA screening questionnaire (e.g., Berlin, Epworth)



Increased neck circumference (>17 inches in men, >16 inches in women)



A Modified Mallampati score of 3 or 4 (assessment of the oral cavity)



Retrognathia



Lateral peritonsilar narrowing



Macroglossia



Tonsillar hypertrophy



Elongated/enlarged uvula



High arched/narrow hard palate



Nasal abnormalities such as polyps, deviation and turbinate hypertrophy

 Obesity (AASM guidelines)

And he will use the information in the AASM tables 2 and 3.

All a lot more complicated that you would lead people to believe. If you have a BMI of 35 or above and don't have hardly any of the findings above, your PCP may determine you don't need a sleep study. If you have a BMI of 35 or above, and you snore or have other major indicators, then you'll get a sleep study. But, in any case, either through what you propose prior to or after the AME visit, the result and process will be the same. So why take a chance on seeing you prior to the AME....it would be foolish!