Sleep Apnea and Basic Med?

[Brad W]

What are the ramifications if a Basic Med pilot was diagnosed with apnea?

I remember reading not so long ago here that apnea under control is not the big deal that I used think it was for the FAA.

Maybe 12-15 years ago I was tested and do not have apnea. I even went back to the sleep docs a few years later wanting to explore getting a machine anyway to try as a solution to snoring that was bothering the wife. No dice, they doubled down that I do not have apnea.

So the other day I go to my doc...well actually the NP in his office.... for a routine med refill...discussing my new diet that I'm trying (carnivore) and that I've been tired or more accurately I suppose "low energy". She said something about apnea and we discussed my diagnosis....said since it was >10 years ago things can change and mumbled something about ordering another sleep study. I'm not sure it's worth the trouble at this point and just let it go. thinking I might just not make the appointment...or maybe I will. Lack of energy wasn't the reason for my visit nor is it in any way what I would consider a big deal...it's not "severe"....It was all just sort of a flippant and short side track conversation and I'm not even sure if she entered it or if it was just for me to consider....

Anyway, just thinking about it this morning....wondering if they do call to set up a study for a referral, and if I do go, what would that mean for my Basic Med status?...and what would i need to do if negative diagnosis again? or what would I need to do if it's a positive diagnosis this time?
I'm not actively flying now (just time and life getting in the way) but hope to again some day and just want to march into this thing knowing what I would need to do.

 

[Checkout_my_Six]

If you think you may have it...do some research on automatic CPAP machines and get one and use it. You may find you feel better. You can get a good lightly used unit on FB market place for a few hundred. Well worth it IMHO.

I have friends who have done this and feel much better....and no doc is needed and they can honestly answer the questions about not being tired, because they aren't.

 

[Brad Z]

If you think you may have it...do some research on automatic CPAP machines and get one and use it. You may find you feel better. You can get a good lightly used unit on FB market place for a few hundred. Well worth it IMHO.

I have friends who have done this a feel much better....and no doc is needed and they can honestly answer the questions about not being tired, because they aren't.

Self diagnosing sleep apnea is not a great idea. Besides, how will you know what settings to use?

OSA is not a condition in 68.9 requiring a one-time special issuance, so no problem for BasicMed.

 

[OneCharlieTango]

Sleep apnea has no effect on BasicMed.

Google “requirements for BasicMed” and you’ll get this list from the FAA. Sleep apnea isn’t on it:

Medical Conditions Requiring One Special Issuance Before Operating under BasicMed

• A mental health disorder, limited to an established medical history or clinical diagnosis of—
  • A personality disorder that is severe enough to have repeatedly manifested itself by overt acts;
  • A psychosis, defined as a case in which an individual —
    • Has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or
    • May reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis;
  • A bipolar disorder; or
  • A substance dependence within the previous 2 years, as defined in §67.307(a)(4) of 14 Code of Federal Regulations
• A neurological disorder, limited to an established medical history or clinical diagnosis of any of the following:
  • Epilepsy;
  • Disturbance of consciousness without satisfactory medical explanation of the cause; or
  • A transient loss of control of nervous system functions without satisfactory medical explanation of the cause.
• A cardiovascular condition, limited to a one-time special issuance for each diagnosis of the following:
  • Myocardial infarction;
  • Coronary heart disease that has required treatment;
  • Cardiac valve replacement; or
  • Heart replacement.

 

[Brad W]

OSA is not a condition in 68.9 requiring a one-time special issuance, so no problem for BasicMed.

so basically if I go in for a test...and if they come back and say I do have it, then nothing to do, nothing to prove, nothing required, don't need to tell anyone?

 

[Jim_R]

so basically if I go in for a test...and if they come back and say I do have it, then nothing to do, nothing to prove, nothing required, don't need to tell anyone?

There's a form you have to fill out that (as I understand it) informs the doc doing your exam so they can ask the right follow-up questions. One part of the form has you fill out any visits to a health professional in the last 3 years and why you went.

Ref the PDF link at the bottom of the page here (and question 19): https://www.faa.gov/forms/index.cfm/go/document.information/documentID/1030366

So it might come up for discussion during your exam, but I think as long as your doc is satisfied that the situation doesn't impair your ability to fly, they let it go.

 

[OneCharlieTango]

so basically if I go in for a test...and if they come back and say I do have it, then nothing to do, nothing to prove, nothing required, don't need to tell anyone?

BasicMed-wise, that’s true. Personal health-wise, it’s not. If you have sleep apnea, you should treat it.

 

[somorris]

From my experience (not for myself) sleep apnea can cause a lot of issues with your heart and other things, depending on how severe it is. I agree with 1CT, get checked out.

 

[Palmpilot]

...don't need to tell anyone?

When you fill out the form to renew your BasicMed, question 18x asks about "other illness, disability, or surgery," and unlike the question about doctor visits, the section 18 questions are any time in your life, not just that past three years.

 

[Lindberg]

What are the ramifications if a Basic Med pilot was diagnosed with apnea?

I remember reading not so long ago here that apnea under control is not the big deal that I used think it was for the FAA.

Maybe 12-15 years ago I was tested and do not have apnea. I even went back to the sleep docs a few years later wanting to explore getting a machine anyway to try as a solution to snoring that was bothering the wife. No dice, they doubled down that I do not have apnea.

So the other day I go to my doc...well actually the NP in his office.... for a routine med refill...discussing my new diet that I'm trying (carnivore) and that I've been tired or more accurately I suppose "low energy". She said something about apnea and we discussed my diagnosis....said since it was >10 years ago things can change and mumbled something about ordering another sleep study. I'm not sure it's worth the trouble at this point and just let it go. thinking I might just not make the appointment...or maybe I will. Lack of energy wasn't the reason for my visit nor is it in any way what I would consider a big deal...it's not "severe"....It was all just sort of a flippant and short side track conversation and I'm not even sure if she entered it or if it was just for me to consider....

Anyway, just thinking about it this morning....wondering if they do call to set up a study for a referral, and if I do go, what would that mean for my Basic Med status?...and what would i need to do if negative diagnosis again? or what would I need to do if it's a positive diagnosis this time?
I'm not actively flying now (just time and life getting in the way) but hope to again some day and just want to march into this thing knowing what I would need to do.

Why jump directly to sleep apnea? There are a thousand things that can cause sluggishness (one being a lack of carbs in your diet). Do you have other symptoms? Do you wake rested? Have you tried wearing a recording pO2 meter or a fitness tracker with that function?

 

[Brad Z]

so basically if I go in for a test...and if they come back and say I do have it, then nothing to do, nothing to prove, nothing required, don't need to tell anyone?

You need to disclose it on your next comprehensive medical exam checklist, but in the meantime you're making an assessment of whether you can safely fly an aircraft. If you're unsure, consult with your treating physician. The onus is on you, not the FAA, to determine if you're safe to fly with your medical condition.

 

[jbarrass]

The beauty of Basic Med and drivers licence options is medical concerns are between you and your doctors. You can do what's good for your health without feat of a bureaucrat in a windowless office in OKC overriding your medical treatment or threatening your flying just because they can.

OSA is a great example. We all know people who should get checked out for various things and treated but don't because FAA. Get tested, If negative, great, if needed, treat it. You'll be much healthier. This is why basic med is so good for health and safety.

 

[Brad W]

got it... thanks!!

and Lindberg, I have no idea why she jumped to that. Sorta struck me as almost odd....but then I suppose it is rather common, I thought it was more odd though that when I immediately answered that I have been tested and was negative, then she doubled down pushing follow-up questions. Yeah, diet change 2-1/2 months ago would seem like the obvious first line of questioning!
....and no it would certainly not be a lack of carbs, but there are apparently some short term issues that come up with some people in the first few months of transition while all the garbage stored in the body gets burned off. Electrolyte deficiencies is another seemingly more obvious conclusion to jump to.... I have no idea.

 

[OneCharlieTango]

got it... thanks!!

and Lindberg, I have no idea why she jumped to that. Sorta struck me as almost odd....but then I suppose it is rather common, I thought it was more odd though that when I immediately answered that I have been tested and was negative, then she doubled down pushing follow-up questions. Yeah, diet change 2-1/2 months ago would seem like the obvious first line of questioning!
....and no it would certainly not be a lack of carbs, but there are apparently some short term issues that come up with some people in the first few months of transition while all the garbage stored in the body gets burned off. Electrolyte deficiencies is another seemingly more obvious conclusion to jump to.... I have no idea.

Not knowing you, there’s no way I can mean this offensively, but the fact of everyone wanting to talk to you about sleep apnea implies things about your height and weight, maybe? If someone of a certain size and shape complains of daytime sleepiness, it’s sleep apnea until proven otherwise.

There is no “garbage stored in the body” that gets “burned off,” unless you mean fat.

As to “electrolyte deficiencies,” that isn’t even a thing, much less the thing causing your fatigue.

Have you had your thyroid checked?

 

[Brad W]

valid assumption/question
5-9 and currently 158.5# ( I was about 173# in late September when I stumbled across this diet idea when researching something else). About to start adjusting to maintain weight.

Her question was do you snore? I said yes. She had no follow-up questions about how bad it is, have I looked at breathing rates, O2 saturation ( I have a garmin fenix and a bed that both monitor all sorts of sleep data so I do have some awareness of when I snore and how much)
Maybe I do have apnea...but I've got lots of data, some of it even "professional", that says that I do not. I suspect that I might have a minor case of it that occurs only when sleeping on my back...but I have no proof of it. Even went back to the sleep doctor a long time after my study trying to convince them of it. They did not buy it. I even went back to the pulmonoligist a couple months ago to verify no damage from my most recent GERD aspiration episode...he's a sleep doctor....and apnea wasn't even a question from him!

The garbage I mean is the thought that oxalates and other "anti-nutrients" can be stored in body fat...so when a body is burning off excess fat that these can in some folks to have various symptoms, including fatigue.

I'm by no means an expert on the topic, but these last few months I've been doing a fair bit of reading, listening to lots of podcasts interviews and discussions between several doctors discussing the topic. I'm realizing that docs don't generally learn much in school about nutrition and metabolic health, anthropology...our physiological ability to digest certain things, etc. A lot of it is looking very plausible to me!

oh, and electrolyte deficiency....potassium, magnesium, sodium, iodine, etc.... Yeah, if you don't take it in, where do you get it?

 

[MrOSA]

I was diagnosed with OSA in my 30s and while I could stand to lose a few pounds, I’m not the picture you have in your head for what someone with Sleep Apnea looks like. But I have been a life long snorer - like since middle school.

It really hurt getting diagnosed, but let me tell you - life is so much better now. SO MUCH. And it has no impact on Basic Med, and if I wanted to go back to a traditional medical I don’t think it would honestly be that big of a deal if handled carefully.

If you said “I’m tired all the time” and “I snore so loud it is disruptive to my wife”, I would say you absolutely need a sleep study. There’s nothing to lose.