Atrial Flutter/sleep apnea


She doesn't snore.

My wife (an instrument rated pilot) suffered about of Atrial Flutter last year. She told her AME at her medical review and he deferred her medical. The FAA replied with a letter requiring quite a bit of testing (stress test, ECG, Echo and a sleep disorder test and more). Every test came back as normal and her cardiologist wrote a letter clearing her. Except for her sleep test. It was a home test and that was the one she was least worried about because she sleeps like a baby. She sleeps on her back and does not snore. But she received a score of 9.5. Her AME is on vacation for three more weeks and she is extremely upset. She is 67 yrs old and in great health, very fit becasue she works out often. She is 5 ft 9 and 145 pounds, which to me is perfect.

She was thinking of sending all the results in to the FAA but I suggested she wait and get some advice before sending it in.
Should she get a 2nd opinion?
Should she request an in-laboratory test?
Will the FAA balk at a score of 9.5?
her AHR was 9.5? how much did she desaturate (drop her oxygen level)? If she had Af then it’s important to rule out sleep apnea. If she‘s a good sleeper, then a lab test would probably be a worthwhile approach, if nothing more than for a 2nd opinion. If she indeed has SA, even mild, correcting the apnea may fix the Af. And FWIW the OSA SI is one of the easiest SI’s to get and keep as long as you‘re trying to take care of yourself and reporting on time. One of my pilots, same age as your wife, developed IAF. Good physical shape, no cardiac, no thyroid, normal BMI. Several conversions, meds, ablations, he was still going into AF and was struggling to keep his C3. I asked him again about sleep apnea (I’m not his PCP, and I had asked him about it when this all started) and it turned out no one else had mentioned it (besides me). Long story short, bad SA, after a couple years of CPAP and no AF, the took him off the SI for atrial fib and he just reports the sleep apnea annually. Good luck to you and your wife, hope it all works out well
I know it’s difficult to wait but too many cooks spoil the soup. Wait for her AME to return. let him run the show.
Agree with lbf. "What he said". however note there is a biological linkage between aFib and sleep apnea, whcih is why FAA's external consultant adivsed acceptance of AHI/RDIs <5 only. 5% of us with normal body habitus have sleep apnea in need of Tx.

"Sleeping like a baby" is subjective and those with full blow S.A. Report "slepeping like a baby". Me personally (an ATP) I'd get a jaw device and retest. To exclude Sleep apnea, FAA requires at least a type 2 test.