OSA letter from the FAA

The FAA is such a mess. Clear as freaking mud.

I got a letter from the FAA saying they received a status report dated Feb. 7th regarding my history of sleep apnea and Hypertension. However they are still unable to establish my eligibility to hold a medical.

So I need to reply within 60 days. With...

Airman compliance with treatment form or equivalent
and
current CPAP download data

I did the renewal through my AME cost me $75. He sent me my cert in the mail.

Here is the kicker it then goes on to say if you or your AME have sent this don't resend it or it might screw stuff up.

WTH, so they somehow received the status report I provided the AME from my primary care physician but not the rest but if I do the easy thing and resend I could be screwed worse.

I have 60 days to fix it (less now since it is from the date of the letter a week ago) but don't know if I should do anything.

In any case I have a call out to the AME and hopefully they can straighten it out but seriously do they have to make it this complicated?
in addition to the data, there is, quite literally, a compliance form that you should have signed and dated during your medical exam that stated you're in compliance.
I also provided the 1 year of usage data
I alos provided a letter, from my sleep doc, agreeing that I was compliant, not sleepy, etc.
 
I am waiting on my annual certificate renewal as we speak. This was the off year so did not need a C3 exam, so I mailed in the four items required by the FAA. The CPAP report, the airman's attestation of compliance, the letter from my OSA Doctor stating full compliance and no daytime sleepiness, and a copy of my current C3 certificate. Sent that in on 30 August. Still waiting, but after the third call on non-consecutive days over 2 weeks, the person on the phone at the FAA said they would refer my file to their supervisor to see if they could get it expedited since it expires at the end of Oct, and I mailed it in over 60 days ago. Guess I will give them more lead time. Probably 90 days. ... Or BasicMed next year.....Sheeshhh!
 
I am waiting on my annual certificate renewal as we speak. This was the off year so did not need a C3 exam, so I mailed in the four items required by the FAA. The CPAP report, the airman's attestation of compliance, the letter from my OSA Doctor stating full compliance and no daytime sleepiness, and a copy of my current C3 certificate. Sent that in on 30 August. Still waiting, but after the third call on non-consecutive days over 2 weeks, the person on the phone at the FAA said they would refer my file to their supervisor to see if they could get it expedited since it expires at the end of Oct, and I mailed it in over 60 days ago. Guess I will give them more lead time. Probably 90 days. ... Sheeshhh!
This is why I do the renewal at my AME. I do pay for the privilege, but I don't have to wait on OKC backlogs. It seems like a poor system, where it really should only take 10 minutes (at an AME) or 60-90(?) days for the same thing through OKC.
 

This is all new to me and the only information provided to me was OSA spec sheet B and the FAA information brochure.

I have to personal physicians that believe I am at a low risk for sleep apnea but neither one is willing to write a letter if the FAA is involved.

Both physician referred me to a sleep specialist. I have come to understand that a sleep specialist will not write a favorable letter without a sleep study.

So this leaves wondering about which is the better option, the home sleep test or the Laboratory polysomnography?

Should I end up being diagnosed with OSA where can I find the FAA references on compliance and required documentation?
 
Should I end up being diagnosed with OSA where can I find the FAA references on compliance and required documentation?

Spec Sheet A has that info:

https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/OSA Spec Sheet A - Information request.pdf

>>>
If you are currently being treated, also include 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 indicating that OSA treatment is still effective.

For CPAP/ BIPAP/ APAP: A copy of the cumulative annual PAP device report. Target goal
should show use for at least 75% of sleep periods and an average minimum of 6 hours use per sleep period.
<<<

Once you get the SI, to renew it annually you need the PCP status letter, the CPAP report from the SD card, and your compliance statement. All this will be explained in the letter from FAA when they issue the SI.

Here are the renewal requirements:

https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/AASI.pdf
 
The trouble is, of course, if the AHI is between 5 and 15, it is indeterminate (Home study).

How much do home sleep studies cost? If the cost is low enough, it might be worthwhile for him to go that route, and then if the results are indeterminate, spring for the more expensive study.
 
IIRC, SNAP Diagnostics home sleep study is about $200 out of pocket. Not sure though as my insurance paid as my PCM doc directed it.


Sent from my iPad using Tapatalk
 
So if a home sleep study shows an AHI of 1 does that mean you have OSA and will have to use a CPAP? Also I just tend to hold my breath for various lengths of time while I’m awake. I don’t know why I do it...I just do. So if I do a home sleep study and I’m trying to fall and I hold my breath as I usually do is this going to reflect as an AHI situation? Maybe I’m overthinking all this but I don’t want to be diagnosed as having OSA if I don’t actually have it. It seems like everything I read or talk to that goes in for an assessment, leads to a sleep study, which leads to use of a CPAP.
 
So if a home sleep study shows an AHI of 1 does that mean you have OSA and will have to use a CPAP? Also I just tend to hold my breath for various lengths of time while I’m awake. I don’t know why I do it...I just do. So if I do a home sleep study and I’m trying to fall and I hold my breath as I usually do is this going to reflect as an AHI situation? Maybe I’m overthinking all this but I don’t want to be diagnosed as having OSA if I don’t actually have it. It seems like everything I read or talk to that goes in for an assessment, leads to a sleep study, which leads to use of a CPAP.

I'll have to look up the details: AHI ≥ 5 with symptoms like snoring and excessive daytime sleepiness is OSA. AHI≥15 with no other symptoms is OSA. In any case <5 is "normal".

My explanation of an apnea: Exhale normally, close your throat and try to inhale. Wait for ten seconds, open your throat. That gasp simulates an apnea. 5 or more per hour and you have OSA.
 
I'll have to look up the details: AHI ≥ 5 with symptoms like snoring and excessive daytime sleepiness is OSA. AHI≥15 with no other symptoms is OSA. In any case <5 is "normal".

My explanation of an apnea: Exhale normally, close your throat and try to inhale. Wait for ten seconds, open your throat. That gasp simulates an apnea. 5 or more per hour and you have OSA.

What's really odd is that I confirmed my OSA while being tipped back in the dentist's chair. Ok, that's not weird. What may be weird is my apneas (there) happened on trying to exhale. I couldn't. Could inhale but not exhale. Freaky when awake! They don't recline me any more.
 
Also I just tend to hold my breath for various lengths of time while I’m awake. I don’t know why I do it...I just do. So if I do a home sleep study and I’m trying to fall and I hold my breath as I usually do is this going to reflect as an AHI situation?

I should have added a few things:

An apnea has a definition of (paraphrasing) breathing stops for at least 10 seconds. There are some other criteria, but that's the simple version for this post. For your question, the simple answer is yes, it will register as an apnea.

For sleep apnea, breathing can stop for one of two reasons: physical obstruction (obstructive sleep apnea, OSA) when the tissue in the back of your throat interferes; and your brain and central nervous system don't tell your body to breathe (central sleep apnea, CSA). OSA is treated with CPAP and its variations. OSA us also a relatively simple Special Issuance. CSA requires some specialized equipment similar to CPAP but different and I am not sure FAA will give you a Special Issuance because it's a brain thing.

A hyponea is a period of shallow breathing that lasts for a certain amount of time. Shallow enough and long enough that it affects the CO2 and O2 levels in your system. (Apneas + Hypopneas)/sleep hours = AHI.

OSA is common, CSA is not. A few episodes per hour is normal, but when you get 4-5 per hour you get into the gray area between a diagnosis and not.
 
What's really odd is that I confirmed my OSA while being tipped back in the dentist's chair. Ok, that's not weird. What may be weird is my apneas (there) happened on trying to exhale. I couldn't. Could inhale but not exhale. Freaky when awake! They don't recline me any more.

I had that happen once. Normally not a problem, but when I got a filling I was in a different chair and my neck was bent a little differently. I couldn't inhale.
 
Today I am going for an OSA assessment...well the doctors office is calling it a “sleep consultation.” I was sent a rather extensive questionnaire ahead of time to complete and bring with me today. Last night I was doing some research and came up with a question. I found that my health care provider uses the Type I in-lab study and/or a Type III HST (Apnealink or Embletta equipment). The paperwork I received from the AME states it must be a Type II HST. I thought I read somewhere that if a Type II is not available that the FAA will accept a Type III but I can’t seem to find where I read that. Does anybody have experience with this or have a reference?

Thanks
 
7 years ago I did the in-lab study and the FAA was happy with that. Definitely helped that the sleep doctor administering the test was familiar with what the FAA wanted to see in the status letter.
 
So if a home sleep study shows an AHI of 1 does that mean you have OSA and will have to use a CPAP? Also I just tend to hold my breath for various lengths of time while I’m awake. I don’t know why I do it...I just do. So if I do a home sleep study and I’m trying to fall and I hold my breath as I usually do is this going to reflect as an AHI situation? Maybe I’m overthinking all this but I don’t want to be diagnosed as having OSA if I don’t actually have it. It seems like everything I read or talk to that goes in for an assessment, leads to a sleep study, which leads to use of a CPAP.
An AHI of 1 means you haven't got anything.
An AHI of 16....that's a problem-->CPAP.

Show that article that I think I sent you (it might not be you) and hand that to your PCP-doc. He can do this but he has to do it right.
 
What's really odd is that I confirmed my OSA while being tipped back in the dentist's chair. Ok, that's not weird. What may be weird is my apneas (there) happened on trying to exhale. I couldn't. Could inhale but not exhale. Freaky when awake! They don't recline me any more.
My dentist knows I can't be tipped back either. Not OSA, but a miserable sinus drip.
 
An AHI of 1 means you haven't got anything.
An AHI of 16....that's a problem-->CPAP.

Show that article that I think I sent you (it might not be you) and hand that to your PCP-doc. He can do this but he has to do it right.

This week I saw a Pulmonologist/sleep Doctor for the OSA assessment. He concluded that I am at a low risk for sleep apnea and feels that a sleep study is not necessary at this time.

He is going to write a letter that I can submit to the FAA but he asked me what things the FAA want to see in his letter? I’m just wondering if anybody knows what the FAA wants to see in a letter stating that I am a low risk for sleep apnea?

Thanks
 
Show him this! A pulmonologist has the credentials to do so IAW the AASM definition paper of 2009.
 

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