Confused about sleep apnea screening

Discussion in 'Medical Topics' started by I don't snore, Nov 7, 2019.

  1. I'm obese. Part of the reason I stopped flying and let my medical lapse was the talk going around in 2012-ish about requiring a sleep study for a BMI over 40. I'm a very light sleeper and a CPAP is a deal-breaker for me. Anyway, it appears requirement never happened, and now it's just "screening" if obese. What does this screening consist of? My spouse attests that I don't have sleep apnea, but I'm worried about proving that to the FAA.
     
  2. unsafervguy

    unsafervguy Pattern Altitude

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    No offense, but the health problems of sleep apnea should be more important than getting a medical. The effects of sleep apnea can be fatal. If you have sleep apnea and are avoiding the doctor because younfear a cpap you could be putting yourself in real danger.
     
  3. Like I said, I'm a light sleeper. Can't sleep with the noise of a CPAP - My housemate’s used to keep my up in the next room. If that shortens my life, so be it. So will getting zero sleep because of the noise and something on my face.

    Not sure how you can have sleep apnea without snoring or waking up gasping for air, though.
     
  4. TCABM

    TCABM Cleared for Takeoff

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  5. schmookeeg

    schmookeeg Cleared for Takeoff

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    I can save you having to look up how to score the berlin questionnaire or administer the slap-chop screening. If you show up for a medical, it will go like this:

    1. Are you a fat dude? -> Cannot issue, go get sleep study.

    Let me save you another bit of suspense. The sleep study protocol is like this:

    1. Did this person arrive for a sleep study? -> this person has sleep apnea.

    Let me save you a third bit of suspense.

    1. Did you post online asking about sleep apnea? -> Apnea is worse than a dozen September 11s and will kill you instantly and every hour thereafter, even if you are a vampire who does not sleep. The CPAP device is literally the second coming of the jeesus without the need to move furniture, it will add two inches to your gentleman's region, give you the energy of Richard Simmons, and is something you needed yesterday.

    ==

    Enjoy your new CPAP or Basic Med fellow 'dude of gravity' :)
     
  6. So BMI is the sole criteria for referral? Obviously I missed something along the line. Thanks!
     
  7. schmookeeg

    schmookeeg Cleared for Takeoff

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    No. Being male is part of it. Being over a certain age is part of it. Neck circumference is part of it.

    Basically once you're in 'fat dude' territory, you're going to either tick 3 or 4 of the 8 boxes, even if you have zero symptoms.
     
  8. Morgan3820

    Morgan3820 Pattern Altitude

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    I’m in ‘fat dude’ territory. When it comes up, I just tell the AME that I am not tired and do not snore, and he moves onto the next topic. Never had a problem. I think the whole sleep apnea thing as it is related to flying is BS.
     
    idahoflier and flyingcheesehead like this.
  9. I'm not a dude. I'm 25 and losing weight. My neck is 13 inches (I have no idea if that's big or not).

    I guess what I'm asking is, how do I know if I should lose more weight before I renew so I can pass the screening?
     
  10. Matthew

    Matthew Touchdown! Greaser!

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    FAA documentation says they use this chart:

    https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/BMI chart and formula table.pdf

    then apply it to this checklist:

    https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/AASM Tables 2 and 3.pdf

    then use this flowchart:

    https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/FAA OSA Flow Chart.pdf


    Here's the source:
    https://www.faa.gov/about/office_or...ices/aam/ame/guide/dec_cons/disease_prot/osa/



    edit: looks like the target BMI for losing weight is <= 35.
     
    Last edited: Nov 8, 2019
  11. gkainz

    gkainz Final Approach

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    I've been on CPAP for many years (more than 20?) and CPAP machines have improved to the point that they are nearly silent (and downsized to the point that traveling with one is a non-issue). Don't let that keep you from proceeding down this path. Honestly, no - not everyone who goes in for a sleep study gets a positive sleep apnea diagnosis. My son had a sleep study as a senior in high school, as we observed his sleep patterns on a summer camping trip. However, the severity of OSA was categorized as minor and that was that.

    I snored a little, I stopped breathing (which freaked my wife out) and then would sometimes gasp for air, sometimes just start breathing again. For many years, I did not wake myself up. I self-diagnosed (ok, confirmed my wife's positive diagnosis) OSA when it exhibited in the dentist' chair when they tipped me nearly prone and pried by jaw down to my ankles to work on my wisdom teeth. I simply could not exhale through my nose... no matter how much tried to force it. I came upright fast, pushing hands and tools out of my way. I have a very understanding dentist now and he and the techs know if I wave my hands, clear the area because I'm sitting up. It's a lot like being water-boarded (thanks, SERE school). Dentist visits for me, even routine cleanings, are torture.

    But, as I explained to my GP who ordered my sleep study, before CPAP I felt like I was running a marathon all night long, only to cross the finish line to be hit by a bus as the alarm went off. I used to have nightmares about eating something and have it grow and grow and grow in my mouth and choke me.

    Since starting CPAP, I cannot imagine life without it. I had a couple of occasions of overnight power outages (resolved with a battery backup) and one business trip where I forgot to put my mask in the travel case. My local Respiratory Therapist found me a mask near me and I only spent one night of torture on that trip.
     
    Last edited: Nov 8, 2019
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  12. Jeffythequick

    Jeffythequick Pre-takeoff checklist

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    Amen, brother. I did the sleep study as shown above, and since then, my blood sugars have been more stable (T1D), and the days (I think 10 over the last 10 years) that I haven't used it have been disasters. Even 5 hours of sleep with the CPAP on is better than 10 hours without it, and here's why:
    To the OP, the light sleeper. If you have Sleep Apnea, you are, by definition, a light sleeper. The charts they showed me said that I stopped breathing 40-50 times per hour while sleeping, and that I'd nearly wake up each time, then go back to sleep.
    Day #1 with a CPAP - couldn't stand it. I felt like I was being buried alive.
    Day #5 with a CPAP - could tolerate it, and fell asleep with melatonin
    Day #30 with a CPAP - Didn't hear it, slept through the night
    Day #3650 with a CPAP - Now it's Pavlovian. When I put the mask on, my body says, "He's going to sleep, let's knock him out with natural melatonin." and I'm out in like 4 minutes.
    The morning after: I wake up, ride my bike for 8-13 miles, and am awake the whole day.

    Sending the information to the FAA: No worries. I used that open source CPAP reader and had my doctor pull his reports. I also wrote a letter explaining how I got the pretty charts, and got my SI.

    The diabetic stuff was in the letter too, so it was a harder SI than all y'all have.
     
  13. Maybe so, but I'm breastfeeding, which means there's another biological explanation for light sleep in my case. I was trying to be private about that detail, but I think that also explains why a sleep study within 90 days of an FAA request isn't possible (and why I'd likely fail one even without OSA). I'm not tired during the day, don't have any symptoms of OSA, but based on the reaction here, it looks like I'll be losing weight before trying to renew.