to the member who PM'd me, did you get my response? I no longer have your PM in my inbox, nor my replies. Not sure what happened. Darn computers.

For what it's worth, I just saw a new AME the other day with a reputation of being a little too by the book. None of this stuff even came up.

Sleep Apnea
 

This OSA stuff has been a non issue for me up until today when I decided to see a new AME. My exam went from 1:15 to 2:30 this guy seemed to be trying to find ways to deny or defer the medical. He acted as if he was a detective trying to catch me in a lie. He asked very unusual questions. Usually I get asked a couple questions about sleep and snoring and we move on but that was not the case for this guy. He said I had three or four out of the 10 criteria that is to be evaluated in regards to OSA screening. I'm not even sure what those 3 or 4 things are or what he was referencing to make that determination. He made it seem as if he was just going to give me educational materials about OSA and that I should consider getting a sleep study for my health. When I got home I skimmed over the paperwork and one of them was a something known as OSA Specification sheet B. Which states that I have 90 days to do a sleep assessment to determine if a sleep study is warranted or not. All night I have been looking at FAA stuff trying to figure out how he came to this conclusion. I really think he was on some kind of power trip. Most of my AME experiences have been 15 minutes tops and this guy took an hour and fifteen minutes to do this.

Anyways, I guess I don't have any recourse other than to comply at this point. I really don't think I have OSA but I'll need to get a sleep assessment from an AME, primary care physician, or a sleep specialist. I plan to go to my primary care physician to accomplish this. My question is that I don't really know what a sleep assessment is or what things my doctor will have to asses. Does the FAA require specific things to be assessed that must be submitted to the AME when I return? I guess I should be getting a letter from the FAA about this and I'm hoping that the letter will clarify things.

I'm really just writing this because I've come to expect that OSA is not really a big deal when the time comes to renew your medical. Today I found out that it is if you go see the wrong AME. So if anyone is planning on seeing a new AME that you don't know much about you might want to ask how they plan to evaluate OSA.

If anybody has any input I'd appreciate it.

Osa
 

Ask around and find a good sleep specialist. It is a slippery slope once the whole sleep study thing happens. It sure seems some physicians are in collusion with Med suppliers. I found one that said I had sleep apnea and another that said no I did not. The doctor that spent the most time with me said I did not have it. If the sleep specialist has a Maserati parked out back of his office then run the other way.

Make sure you get referrals from other pilots before selecting a 1C AME.

The assessment is designed to be more of a sit down with the doc to discuss your “symptoms” that triggered it. The study is the actual big deal where you sleep in a monitored facility with tons of wires and stuff hooked to you and try to sleep. If you have been with your PCM for a while, and you have a good relationship, your assessment will be more like a discussion of any changes to your sleep or daytime fatigue, etc, and then he will write a memo summarizing the discussion. Should take 30 minutes and not be a big deal if he finds no further reason to pursue an OSA sleep study. All the FAA wants is to ensure that people discuss OSA with their PCMs if they have enough indicators. I went through the process a few years back.

Do you guys with OSA have to do a wakefullness test every year for the FAA?

No, if you use a CPAP you just have to get a report from the machine reviewed by a Doc saying that you are within compliance (I think 75% usage). That happens on your annual.

I’ve been through the OSA thing and have a special issuance for it. It is a bit of a pain, but I deal with specific AMEs that know what they are doing and know the system.

Dr. Bruce Chien is in Peoria, IL. I did my original Special Issuance with him. Super squared away guy. He is a Senior AME, ATP, CFI, and was a P3 pilot in the Navy. Last I knew he had an office at the GA airport in Peoria, as well as a small office at PIA next to the rental car counter. I didn’t find him expensive, either.

Dr. Charles Mathers is at the University of Texas Medical Branch Aerospace Medicine Center. He is also a senior AME, and may have been a NASA flight surgeon (or maybe it was one of his partners, I can’t remember). He handled my upgrade from 2nd Class to 1st Class with an AASI. I will say that it’s the only flight physical I’ve ever had where I had to turn my head and cough, but the guy knows his stuff, and isn’t going to bust your medical unless you really don’t meet the requirements.

Both of these guys are solid professionals, and they aren’t there to treat and diagnose. They are there to determine if you meet the medical requirements set forth by the FAA. No more, no less.

OSA can become an issue based on a high BMI, and a few other things. Some AMEs don’t know that much about how to deal with OSA, and they don’t really care. I highly recommend you contact one of these doctors for advice. They are easy to find on Google, but if you need their info, PM me.

Generally, they will advise you as to the steps to take to minimize risk to your medical certificate as well as jump through the fewest hoops possible. If you don’t have OSA, great. If you do, once things are squared away with the FAA, you’ll see your treating physician each year before your flight physical to have them review your CPAP data, ask you if you have been sleepy, and check for right heart failure. This is typically a 15 minute visit with my sleep doctor, and half of the time is talking about flying. I leave his office with the required paperwork and just take it to my AME with the FAA special issuance paperwork.

Having the wrong AME working the problem can cause delays in getting your medical, or difficulties in keeping it.

If you have any questions, feel free to ask...

Call ALPA Aeromedical ASAP. They will walk you through the entire process with the least amount of hassle possible.