Another Sleep Apnea Question

A

Anonymous

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I've searched the forums on this, but seems most of the questions have to do with OSA at time of receiving medical or as a student - so I apologize if this is beating a dead horse.

I hold a current 3rd class medical, issued in 2013, which doesn't expire until next year. A few months ago, I was diagnosed with and began successful treatment for OSA. Is this something that needs to be reported immediately or do I just wait to report on the next visit to the AME? Or, is this something the under PBOR2, I just wait out altogether and is not necessary to report at all?
 
Under the current rules, this is a disqualifying condition (aka requires a Special Issuance), and you're grounded for 45 days (or is it 60?) while you build up a history of being on your CPAP machine. Once that elapses, print off the compliance report and go visit the AME with that plus any other required documentation. The AME will then assist in getting you the SI medical.

And for the machine you go, make sure it can download a whole year's worth of information to an SD card so you can use the Sleepyhead reporting software. If your machine won't do that, see about an exchange for one that will do that. Talk to @Matthew for details on why and what machine. He recently went through this field of landmines and has some good information to share.
 
I haven't flown since January and my machine is one that reports to an SD card (and online). I think that info in itself would be easy enough to gather.
 
I'm not an AME.

Pretty sure you can still fly until your next medical. FAA is being proactive in screening for it, so you should report it when you see your AME - and under the current medical requirements, you have to. Get the reports together, as much data as you have available - show compliance rates of >75% nights at >6hrs, show a report from your doctor saying you are in compliance and that you are not showing symptoms of excess daytime sleepiness. Get it all together before you see your AME. You should be able to get issued in the office, but you will get some followup info from FAA either weeks or months later. My understanding is that for a first-time SI, a 90-day report or as much as you have will be good enough. To renew the SI, you will need a longer period report.

The deal with reporting compliance: for insurance purposes, almost all machines are capable of reporting 90-day compliance reports of >4hrs/night. FAA explicitly says (starting this year) these are not good enough, that you need "annual" reports that show >6hrs/night. The word "annual" has been interpreted to mean a full-year's worth of data, and not just one report per year. To get the report that FAA requires, you will have to use either a CPAP manufacturer proprietary package to generate the paperwork or a 3rd party software (Sleepyhead is the current favorite). Those reporting utilities will allow you to select the >6 hrs that FAA wants instead of default >4 that insurers want. These report generators require the use of a machine that has SD card capability.

I'm still not an AME.
 
Matthew said:
I'm not an AME.

Pretty sure you can still fly until your next medical. FAA is being proactive in screening for it, so you should report it when you see your AME - and under the current medical requirements, you have to. Get the reports together, as much data as you have available - show compliance rates of >75% nights at >6hrs, show a report from your doctor saying you are in compliance and that you are not showing symptoms of excess daytime sleepiness. Get it all together before you see your AME. You should be able to get issued in the office, but you will get some followup info from FAA either weeks or months later. My understanding is that for a first-time SI, a 90-day report or as much as you have will be good enough. To renew the SI, you will need a longer period report.

The deal with reporting compliance: for insurance purposes, almost all machines are capable of reporting 90-day compliance reports of >4hrs/night. FAA explicitly says (starting this year) these are not good enough, that you need "annual" reports that show >6hrs/night. The word "annual" has been interpreted to mean a full-year's worth of data, and not just one report per year. To get the report that FAA requires, you will have to use either a CPAP manufacturer proprietary package to generate the paperwork or a 3rd party software (Sleepyhead is the current favorite). Those reporting utilities will allow you to select the >6 hrs that FAA wants instead of default >4 that insurers want. These report generators require the use of a machine that has SD card capability.

I'm still not an AME.
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Neither am I, but spot on. I have been flying on a SI for sleep apnea for 8 years. Current rules still apply. Make the effort to comply now. We don't know when the new PBOR2 will actually take effect.

I actually submitted all the initial paperwork to the FAA for my SI since I was in between visits to the 2 yr AME visit. Got the SI, and took it into the AME at my next visit and all worked out. But, I am told it may of happened quicker working through the AME. It did take about 90 days to hear from the FAA medical on the initial.
 
So, is the general idea to go ahead and get my compliance reports/papers in order and ready to submit to the AME when I go in for the renewal of my medical next year?

On another note, what if the FAA just so happens to put PBOR2 into effect before July of next year (when my medical expires)? Still need to submit compliance/see AME?
 
Anonymous said:
So, is the general idea to go ahead and get my compliance reports/papers in order and ready to submit to the AME when I go in for the renewal of my medical next year?

On another note, what if the FAA just so happens to put PBOR2 into effect before July of next year (when my medical expires)? Still need to submit compliance/see AME?
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Not an AME.... but in my opinion, anything you can do "officially" now, might make future things go smoother, since you're will be well within the PRNC (previously reported, no change) concept.
 
Under current rules there are two issues: One is to get the SI the first time. FAA is encouraging AMEs to look for people that fit the profile. If you already have it FAA is trying to make it relatively painless to get it reported, treated, and to issue that SI in the office.

The other is to renew the SI. This HAD been the same requirements as the original issue, but starting this year FAA changed the reporting requirements for the renewal.

I have no idea how the new PBOR will affect any of this.
 
I did not stop flying. I got my treatment plan in place and had 60 days of treatment history when I visited AME for new CLIII. I was issued my SI by FAA and nothing else said. I was deferred for another issue not my OSA treatment. Got my SI in 67 days from initial AME appt.

I just renewed my SI with interim reports. Sent directly to FAA in OKC. I sent in requested reports (1 year cumulative summary), treating doctor letter with Dr Bruce's recommended specific statements and my compliance affidavit and had my new medical certificate in less than three weeks.

Interim reports are requested 30-60 days prior to expiration. Mine expires July 31, 2016. I mailed First Class June 3. Got the new certificate around June 22. Now good to go through July 31, 2017. With new PBOR2 rules, I may not need another. If I do, it is no big deal as my family doctor can do testing I need and CPAP provider emails me reports when asked.
 
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My take is that unless you are a CFI and have proveable "reason to know " about 67.313, you fly to your next medical. But at any point if you have a usage report graph showing >30 days in which >75% of the bars are >6 hours tall, and a letter from your doc saying, "well rested, no daytime sleepiness, compliant, and no exam findings of right heart failure- package that with a copy of the sleep study and you will review an SI authorization.

I would not do this if you have less than a year left on your 3rd class...because then the authorization will be for less than a year.
Subsequent renewal need the doc's letter and all 360 days' report from the CPAP machine.
 
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A discussion last night at our flying club meeting on potential impact to insurance if some portion of our members no longer have or need 3rd class medicals. Thoughts and speculation?
Edit - oops, wrong freq. disregard. Switching to ground.
 
bbchien said:
My take is that unless you are a CFI and have proveable "reason to know " about 57.313, you fly to your next medical. But at any point if you have a usage report graph showing >30 days in which >75% of the bars are >6 hours tall, and a letter from your doc saying, "well rested, no daytime sleepiness, compliant, and no exam findings of right heart failure- package that with a copy of the sleep study and you will review an SI authorization.

I would not do this if you have less than a year left on your 3rd class...because then the authorization will be for less than a year.
Subsequent renewal need the doc's letter and all 360 days' report from the CPAP machine.
Click to expand...

Thanks for the great info. With regard to how the PBOR2 will potentially affect this - should I change my course of action? Or, will I still need to seen an SI?
 
I was wondering anyone's advise regarding OSA. I had it while AD military. I got out and received a Second Class Cert with the waiver for OSA. Job changes knocked me out of flying and I did not intend to fly in my next career. Meanwhile CPAP treatment wasn't really working well but I didn't have a current doc. I stopped using CPAP for about 7 months. Started treatment again a short time ago. Now I'm currently looking at ramping back up and trying to fly commercially. How is less than a year of compliance looked at if you already had the waiver? What issues will this present in getting a First Class Cert? Anyone had a similar case with less than the required compliance? Thanks!
 
New transition to ATP said:
I was wondering anyone's advise regarding OSA. I had it while AD military. I got out and received a Second Class Cert with the waiver for OSA. Job changes knocked me out of flying and I did not intend to fly in my next career. Meanwhile CPAP treatment wasn't really working well but I didn't have a current doc. I stopped using CPAP for about 7 months. Started treatment again a short time ago. Now I'm currently looking at ramping back up and trying to fly commercially. How is less than a year of compliance looked at if you already had the waiver? What issues will this present in getting a First Class Cert? Anyone had a similar case with less than the required compliance? Thanks!
Click to expand...
For the right answer, send this question to Dr. Bruce Chien
http://www.aeromedicaldoc.com/how-to-start.html
 
I'm already in touch with Dr. Chien. He has provided some good information and I'll likely use him for working through the paperwork drill. I was just checking who else might have been through this.
 
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