Help with OSA plan, student pilot

[Unregistered]

I am just starting out as a student pilot.

I was diagnosed with OSA about 7 years ago. I haven't been to the sleep doc in over 2 years).

I have a CPAP machine and have NOT been compliant with it, until May, when i decided to become a pilot.

Since then (mid may), I've been using it 28 out of 30 days every month for 6 hours, so I'm super compliant.

I have not done anything yet with the FAA (I've not scheduled my physical nor have I filled the medxpress form).

What's the best order of attack and how long do i need to have a record of compliance before going in for medical to get issued on the spot?

I know I need sleep doc to say "he's a good boy" and then GP to say "no right side heart issues" and then go to DME, but I don't know if I need a year's worth of compliant logs on the CPAP or if as long as I have enough to satisfy the sleep doc, i'll be fine.

 

[Matthew]

Basically - you have a diagnosis and you have a prescription: get yourself back under compliance, see your doc, get your status report, and try to make sure you have around 30-90 days of data to support it (the more, the better). You will need to check your machine - if it's 7 yrs old, there's a good chance it will not be able to print out a report. If that's the case, you'll be needing a new one that can do it and as many days of data that you can get. FAA has been wanting not only a status report from your doc that you are compliant, but the report from the machine to back it up.

 

[bflynn]

Your best plan is to make an appointment with an AME to meet and for a consult on what the requirements are. Or you can take a slight gamble and jump straight to the medical with the understanding that if you discover something additional, you'll have to be deferred until the FAA can look into it.

Under the new protocols, the AME should be able to issue you a medical when you take your medical, but you will be required to undergo a sleep assessment. If the sleep assessment is Ok, you get to keep your medical. If it shows OSA, you lose your medical until you submit certain information. If you have that information in advance, you can continue through without a stoppage.

http://www.faa.gov/about/office_org...ices/aam/ame/guide/dec_cons/disease_prot/osa/

http://www.faa.gov/about/office_org...ices/aam/ame/guide/media/OSA Spec Sheet B.pdf

 

[Matthew]

Your best plan is to make an appointment with an AME to meet and for a consult on what the requirements are. Or you can take a slight gamble and jump straight to the medical with the understanding that if you discover something additional, you'll have to be deferred until the FAA can look into it.

Under the new protocols, the AME should be able to issue you a medical when you take your medical, but you will be required to undergo a sleep assessment. If the sleep assessment is Ok, you get to keep your medical. If it shows OSA, you lose your medical until you submit certain information. If you have that information in advance, you can continue through without a stoppage.

http://www.faa.gov/about/office_org...ices/aam/ame/guide/dec_cons/disease_prot/osa/

http://www.faa.gov/about/office_org...ices/aam/ame/guide/media/OSA Spec Sheet B.pdf

I think he's actually in better shape than this. He won't need a sleep assessment, he already has a diagnosis of OSA. The sleep assesment is for an airman that is suspected of having OSA and needs a definitive answer.

He gets to skip that part, but does need a properly written status report and compliance data. Also, since this is a first time medical, he will probably need a copy of the original sleep study.

It really is a good idea to call the AME ahead of time and verify you have all the proper paperwork. You should be able to get the medical while you wait - the old process was that someone with OSA had to wait for the first medical to be issued by FAA, which could take 3-4 months. Now, the AME can issue a first time medical as long as the paperwork is good.

 

[bflynn]

Hmmm...yes, I think I got down the wrong path. Perhaps group #2 is the better one? This is why you don't take medical advice from some guy on the internet.

Regardless, the OP will need the results of his most recent sleep study and will probably have to redo it if it's not available - the protocol doesn't allow for an exception. (Everyone who poo-poos the cost of medicals, pay attention here). There has to be a CPAP compliance report and a statement from the treating physician.

 

[Matthew]

Hmmm...yes, I think I got down the wrong path. Perhaps group #2 is the better one? This is why you don't take medical advice from some guy on the internet.

Regardless, the OP will need the results of his most recent sleep study and will probably have to redo it if it's not available - the protocol doesn't allow for an exception. (Everyone who poo-poos the cost of medicals, pay attention here). There has to be a CPAP compliance report and a statement from the treating physician.

It does looks like Group #2:

http://www.faa.gov/about/office_org...e/guide/media/faa osa reference materials.pdf

For the OP:
See the flowchart on P 6. You should fall into Group 2.

>>>
If the applicant has had a prior OSA assessment (Group/Box 2 of OSA flow chart), select Group 2 on the AME Action Tab:


o If the airman is under treatment, provide the requirements of the AASI and advise the airman they must get the Authorization of Special Issuance;

o Give the applicant Specification Sheet A and advise that a letter will be sent from the Federal Air Surgeon requesting more information. The letter will state that the applicant has 90 days to provide the information to the FAA/AME;

o Notate in Box 60;

o Issue, if otherwise qualified
<<<

For Group 2 - it says you'll get Spec Sheet A (on page 9), which tell you what paperwork you need and that you have 90 days to get it turned in. The flowchart also says "ISSUE, if otherwise qualified".

Note: Because an OSA special issuance is on a one-year renewal basis, your medical from the AME will probably show an expiration date of one year, even if you are on a 5-year (younger than 40) or 2 year (40+). You'll be needed an annual status report for your medical to be extended each year. You will still only need the physical exam ever 2 or 5 years.

So the AME can give you your medical in office, and you have 90 days to put all your paperwork in order (what's required on p9) and get it sent in. If FAA doesn't get it within 90 days, you'll probably get a letter saying your medical is being revoked or cancelled or something like that.

 

[Kiddo's Driver]

What's the best order of attack and how long do i need to have a record of compliance before going in for medical to get issued on the spot?

I know I need sleep doc to say "he's a good boy" and then GP to say "no right side heart issues" and then go to DME, but I don't know if I need a year's worth of compliant logs on the CPAP or if as long as I have enough to satisfy the sleep doc, i'll be fine.

Pretty straight forward, but would advise emailing Dr Bruce.
http://www.aeromedicaldoc.com/
I was in your shoes a couple of years ago and it was relatively painless. I got my medical on the spot. Dr. Bruce is one of the few that can do this.

IIRC (please verify) this is the guidance I got:
Copy of the initial sleep study. You sign a release that lets your sleep clinic send the study to your AME.
CPAP compliance report from your CPAP machine, for >31 current (less than 90 days old) days, showing >75% of days with >6 hours/night of useage.
AHI <4.0.
Letter from your current sleep physician that EXPLICITLY states
(1) Appears well rested
(2) No excess tendancy to fall asleep (usually done with an Epworth questionnaire, mindlessly simple).
(3) Compliant with therapy.
(4) No Physical exam findings of right heart failure.

SI every year.

That said, I got the letter from my GP since I don't have a sleep physician. I generate the compliance reports and carry them to my GP. I use the open source sleepyhead software.
http://www.sleepfiles.com/SH2/

-Jim