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Old 03-15-2015, 04:20 PM   #1
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Default Sleep Apnea-new FAA Guidelines - be prepared!

As a sleep physician (not an AME) who deals with pilots at all stages of the Special Issuance process. Let me explain the new Guidelines as best as I can. It is explained as well in detail at ZEE APPNEA ? Sleep Apnea Risk

The bottom line is that what is being written on the AOPA website is a little misleading.
It is very important to be aware of the implications of the new guidelines as it pertains to your next AME exam. The AME's now for the first time , is required to screen for sleep apnea (OSA) risk. Prior to these guidelines, this uncomfortable topic could be avoided by just ignoring it. Now it cannot!
My guess is a lot more Airman will be identified as high risk for OSA.

If you present to the AME and it is determined that you are at High risk of having OSA, you will be given Spec Sheet B, which will give you 90 days to get assessed and if required treated for OSA. But what needs to be made very clear is that once you do the sleep study, you cannot exercise your privileges of your medical certificate until you are deemed to be in compliance with treatment. The FAA now knows that you are in the process of being evaluated. Once your are in compliance with treatment, your medical certificate is valid.

I would strongly advise that prior to your next AME exam, predetermine if possible if you are at risk for OSA. Review Spec Sheet B carefully.
The new guidelines are definitely more lenient on those Airmen who have been evaluated prior to the AME exam. In these cases the Airman has 90 days + 30 days to get in compliance . See Spec sheet A. In this situation the Airman will be issued a medical certificate and will have 120 days to provide all information to the FAA.
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Old 03-15-2015, 05:18 PM   #2
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Originally Posted by sleepdoclv View Post
As a sleep physician (not an AME) who deals with pilots at all stages of the Special Issuance process. Let me explain the new Guidelines as best as I can. It is explained as well in detail at ZEE APPNEA ? Sleep Apnea Risk

The bottom line is that what is being written on the AOPA website is a little misleading.
It is very important to be aware of the implications of the new guidelines as it pertains to your next AME exam. The AME's now for the first time , is required to screen for sleep apnea (OSA) risk. Prior to these guidelines, this uncomfortable topic could be avoided by just ignoring it. Now it cannot!
My guess is a lot more Airman will be identified as high risk for OSA.

If you present to the AME and it is determined that you are at High risk of having OSA, you will be given Spec Sheet B, which will give you 90 days to get assessed and if required treated for OSA. But what needs to be made very clear is that once you do the sleep study, you cannot exercise your privileges of your medical certificate until you are deemed to be in compliance with treatment. The FAA now knows that you are in the process of being evaluated. Once your are in compliance with treatment, your medical certificate is valid.

I would strongly advise that prior to your next AME exam, predetermine if possible if you are at risk for OSA. Review Spec Sheet B carefully.
The new guidelines are definitely more lenient on those Airmen who have been evaluated prior to the AME exam. In these cases the Airman has 90 days + 30 days to get in compliance . See Spec sheet A. In this situation the Airman will be issued a medical certificate and will have 120 days to provide all information to the FAA.
This isn't really correct. Why doesn't anyone who has a bmi of 35 or greater take a look at the FAA information and get the facts they need:
http://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/faa%20osa%20reference%20materials.pdf
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Old 03-15-2015, 05:24 PM   #3
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So now instead of BMI over 40 pretty much anyone with BMI 35+ is going to have to do an OSA assesment? Following the flow charts I don't see a way around it. What a bunch of crap.
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Old 03-15-2015, 05:33 PM   #4
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BMI is pretty crazy......as a healthy guy who is still higher on the charts than what they say is healthy, the BMI is out of control. Though dude, seriously over 30? Join a gym and stop eating the airport food though I love the Cuban at the Food Network place at Fort Lauderdale.
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Old 03-15-2015, 05:38 PM   #5
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So now instead of BMI over 40 pretty much anyone with BMI 35+ is going to have to do an OSA assesment? Following the flow charts I don't see a way around it. What a bunch of crap.
Quick story: bmi > 35 (or other risk factors, but bmi > 35 is what will gather up 95%) will get you an assessment. If you need an assessment you will get spec sheet B. Read it and follow the instructions.

An assessment can be done by the AME (but the FAA doesn't recommend that), your PCP (personal care physician), or a board certified sleep specialist. The assessment will determine if you need a sleep study or not. Just because you are high risk and get spec sheet B doesn't mean you automatically get a sleep study. You only get a sleep study if the assessment finds you need one.

Only time will tell how well the FAA accepts assessments that determine one doesn't need a sleep study.

I have already heard about several AMEs who all are interpreting the guidance differently (and incorrectly), so it would be wise to be knowledgeable yourself by reading the AME guide linked above.
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Old 03-15-2015, 05:41 PM   #6
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So now instead of BMI over 40 pretty much anyone with BMI 35+ is going to have to do an OSA assesment? Following the flow charts I don't see a way around it. What a bunch of crap.
First, to the OP and doctor thanks for visiting this site with info.

Second, a BMI of >35 you're classified as OBESE.

What other incentives do you need to cut back?
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Old 03-15-2015, 05:41 PM   #7
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Originally Posted by WARich View Post
BMI is pretty crazy......as a healthy guy who is still higher on the charts than what they say is healthy, the BMI is out of control. Though dude, seriously over 30? Join a gym and stop eating the airport food.
So gym yes airport food no? Thanks for the hot tip dude. Maybe better just change my genetics not to be an endomorph.
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Old 03-15-2015, 05:42 PM   #8
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Quote:
Originally Posted by Raptor View Post
Quick story: bmi > 35 (or other risk factors, but bmi > 35 is what will gather up 95%) will get you an assessment. If you need an assessment you will get spec sheet B. Read it and follow the instructions.

An assessment can be done by the AME (but the FAA doesn't recommend that), your PCP (personal care physician), or a board certified sleep specialist. The assessment will determine if you need a sleep study or not. Just because you are high risk and get spec sheet B doesn't mean you automatically get a sleep study. You only get a sleep study if the assessment finds you need one.

Only time will tell how well the FAA accepts assessments that determine one doesn't need a sleep study.

I have already heard about several AMEs who all are interpreting the guidance differently (and incorrectly), so it would be wise to be knowledgeable yourself by reading the AME guide linked above.
Can we safely say that we need to make sure we roll with our local friendly AME? My last one, wow, stress........though my normal one, sweet, very airline friendly.
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Old 03-15-2015, 05:45 PM   #9
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So gym yes airport food no? Thanks for the hot tip dude. Maybe better just change my genetics not to be an endomorph.
Get in contact with a good Naturopathic Doc. Seriously. The natural way is the best way. I know a great one in the Seattle area but that's it. Not trying to dismiss issues, but there are always ways to get around it. Seriously, I'm a natural guy and have found that there are many natural ways to fix issues in our bodies.
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Old 03-15-2015, 05:48 PM   #10
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Get in contact with a good Naturopathic Doc. Seriously. The natural way is the best way. I know a great one in the Seattle area but that's it.
I wasn't trying to be a jerk but I hover at around 32-33 and am not obese. I am energetic and active and don't have any issues. It is just frustrating knowing I will now have this hanging over my head forever. I am getting older and the weight wants to creep up.
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