Question on CPAP compliance any AMEs in the house?

C

CPAPappy Boyington

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So I want to make sure I have this right. In order to be in compliance you need to have 75% of the nights. With the nights that it is used averaging over 6 hours.

So in a years time (365 days) you could in essence miss about 91 days total. Is that correct?

Is it the average of the days used over 6 hours or do all those days need to be over 6 hours?

Compliance had never been an issue and in the past I have been 95+% compliant with only a few days here or there where for various reasons I just couldn't use the machine.

The reason I ask is I have been having some issues with discomfort in my ears (I can clear them) and I believe it is inflammation caused by the CPAP. When this happened before in conjunction with an ear infection my GP told me to take off the CPAP for a few days and see what happened. It helped but I don't think I was off long enough for it to really heal. I would like to take time off for a few weeks and see if it helps but I don't want to jeopardize my compliance. A bit of a catch 22.
 
I did find this:
https://www.faa.gov/about/office_or...me/guide/special_iss/all_classes/sleep_apnea/

Which says the following. I just wanted to make sure I am reading this right and that it is fresh info it seems to indicate an annual report is required. For example I didn't even think dental devices were allowed?
  • A current status report from the treating physician indicating that OSA treatment is still effective.
    • For CPAP/ BIPAP/ APAP:
      • A copy of the cumulative annual PAP device report which shows actual time used (rather than a report typically generated for insurance providers which only shows if use is greater or less than 4 hours). Target goal should show use for at least 75% of sleep periods and an average minimum of 6 hours use per sleep period.
      • For persons with an established diagnosis of OSA who do not have a recording CPAP, a one year exception will be allowed to provide a personal statement that they regularly use CPAP and before each shift when performing flight or safety duties.
    • For Dental Devices and/or for Positional Devices: No conditions known to be co-morbid with OSA (e.g., diabetes mellitus, hypertension treated with more than two medications, atrial fibrillation, etc). Once Dental Devices with recording / monitoring capability are available, reports must be submitted.
    • For Surgery: For successfully treated surgical patients, a statement attesting to the continued absence of OSA symptoms is required.
 
Interesting that this doc says to report a full year. I will have to look back at my letter - I thought the report was for the previous 90 days. As far as I can tell, that's the requirement for new SI applicants (in one of those PDFs). It's also possible that these docs contradict each other, too.

Do you already have an SI? If you do, see what the renewal letter calls for. My letter is stuck in my files right now.
 
I do have an SI I will take a look at what it says. I can always call my AME I suppose.
 
I'll look back...sometime.

I think FAA made some rule changes on the OSA SI since the last time I renewed. And I think these rules apply to the first time SI, NOT to the renewal.
 
"cumulative annual PAP device report", which the agency interprets as asking for a full year (they didn't tell anyone that) is what they want.
I write on the reports, "airman self grounded for vacation", and indicate the block of missed days, or "airman had otitis media" and block out the missed day block.

It's a pain. The current letters actually say 360 days, if your machine can't do that, print monthly/quarterly, etc. But if you want it to "go through" without waiting for FAA MD review, best get the whole year and satisfy the >75% showing >6 hours criterion. That will sail through in just 14 days. Otherwise you get a demand letter and then you have to argue.
 
Thanks for the heads up, doctor. Good catch.

I dug out my last letter and took a closer look. It DOES say "annual report". When I got it, I read it over, and everything sounded familiar, so I filed it away. I now see there is another page included this time that does mention an annual report. I hope I would have read that letter closer when I started to get my reports ready, but this thread made sure it happened. There is also a compliance certification form that's new.
 
Follow-up question for Dr. Chien:

Most of us that have this SI are familiar with the requirements of renewing it. In this case, I did get the letter, skimmed it, and missed that the requirement changed to a 1 year report.

Is there some way, other than paying more attention to that letter, for airmen to keep up with changes like this? This forum, and the AOPA medical forum, are great for that, but aren't really FAA sanctioned.
 
Matthew said:
Follow-up question for Dr. Chien:

Most of us that have this SI are familiar with the requirements of renewing it. In this case, I did get the letter, skimmed it, and missed that the requirement changed to a 1 year report.

Is there some way, other than paying more attention to that letter, for airmen to keep up with changes like this? This forum, and the AOPA medical forum, are great for that, but aren't really FAA sanctioned.
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Read the letter. Those are the Marching Orders. Is there a successful Lt. anywhere, who doesn't read the actual orders.....and we all "Read, write, and understand the English Language"....

I used to have airmen who would put the cert in the wallet and be clueless a year letter (they'd have LOST the letter)...

That said, the agency does NOT communicate well. When I discovered it, I broadcast an email to the about 30 odd pilots on my list with Sleep Apnea SIs....but ya gotta read.
 
Yep, thanks Doc! I have a new machine, but haven't learned how far back it will go yet. As I said in another post, I wish after x years of demonstrated total compliance they would understand that I get it, I comply, and enough with the red tape. Getting that letter and report every year from office assistants that think they have a clue but don't is a waste of time and frustrating as hell.
 
My renewal is coming up next month... I need to check how how much data my machine keeps. Also need to find my letter. And when I find it, I think I'll take pictures of it and store them on both my keychain flash drive and my Dropbox.
 
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If you want to get the data yourself, go to http://sleepyhead.jedimark.net and use Sleepyhead.

It's free, and it works with Mac, Linux, and Windows.

It'll download the info off of your SD card, and let you know your numbers. For safety, put your SD card in the Lock mode (slide the little switch on it). Before you put it back in your CPAP, unlock it.

I have a 5 year old CPAP, and it keeps all of your time used info in its internal memory, and the other parameters on the card. I had the card unplugged for about 3 years (it was in the slot, but not all the way), and when I finally plugged the card in, it downloaded all of the data to the card that the CPAP had, which was time used. The finer details weren't in there, but as I keep using the CPAP, the details are put in there.
 
bbchien said:
Read the letter. Those are the Marching Orders. Is there a successful Lt. anywhere, who doesn't read the actual orders.....and we all "Read, write, and understand the English Language"....
Click to expand...

Fair enough.

A month before I see my AME either for my SI renewal or my renewal and class 3 exam, I do read that letter more closely for the requirements. This change snuck past me the first time I looked at it.
 
Really hope that reform goes through someday just to simplify all this. I don't argue the benefits of CPAP I have an SI myself and would use it regardless but it does seem like a one size fits all solution. Raise your hand if you have ever laid awake in bed just breathing into the machine to get your six hours in. (Raises hand). I am not a doctor but as I understand it many of the issues are cumulative so is missing one day or even a few here or there any worse than getting a bad nights sleep? For a guy flying one hour at time here or there is it really a safety of flight issue. Are you supposed to not fly on the one night you didn't use the machine? I bet at OSH there are a lot of guys who leave the machine home for the week.
 
DFH65 said:
I bet at OSH there are a lot of guys who leave the machine home for the week.
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I know that everyone is different, but I figure that OSH is the time when I need to have the CPAP. Too much fun into the late night, so a good nights sleep is a good thing.

For me, I'd make sure I have mine. The difference in days with it and without it are striking.
 
Jeffythequick said:
For me, I'd make sure I have mine. The difference in days with it and without it are striking.
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This points out the issue with a one size fits all treatment. In my case while I would say I sleep better with and it my wife is happy I don't snore as much. I didn't feel like I was excessively tired during the day before I started using it. I know there are a lot of people like yourself who say it is a huge difference for me I would say there is some difference but wouldn't call it a profound change and I know some people who say they noticed no difference.
 
DFH65 said:
This points out the issue with a one size fits all treatment. In my case while I would say I sleep better with and it my wife is happy I don't snore as much. I didn't feel like I was excessively tired during the day before I started using it. I know there are a lot of people like yourself who say it is a huge difference for me I would say there is some difference but wouldn't call it a profound change and I know some people who say they noticed no difference.
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I'm glad I changed my wording from "you need to" to "I need to".
:sleep: -> CPAP -> :smilewinkgrin:
I guess after 30 years of Usenet to message boards has finally paid off in proofreading my messages before hitting 'send'.
 
I'm just getting into this for later this fall, and this is what I'm running into now -- Looks like I have time to print 3 90-day reports (roughly 7 months from 90 days ago) pretty easily if I start today, but an annual report is going to take some creativity.

NOTE: I did see that Dr Chien addressed the multiple 30/60/90 day reports as an option. But that only helps if you already started a year prior to your AME visit.

edit: Yes, I should have read that letter more closely, and that's my fault. Even so, by the time that letter arrived, I'm not sure I would have been able to get enough data reported anyway without missing some time since that letter came around 3 months after I saw my AME.

edit - edit: Turns out my copy of the report I turned in to my AME included a total lifetime counter. I can generate another report with the new total and that should give me enough info to show compliance for the year.
 
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When I read about some of the verification requirements FAA Medical puts non-commercial pilots through, I get the feeling that OCD ought to be disqualifying for government service.
 
Palmpilot said:
When I read about some of the verification requirements FAA Medical puts non-commercial pilots through, I get the feeling that OCD ought to be disqualifying for government service.
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Really. And we are the ones TRYING to follow the rules...
 
Threads like this and what we need to do to comply remind me of this book

cheese.jpg
 
I have that book somewhere. Maybe need to dust it off. :)
 
Matthew said:
Really. And we are the ones TRYING to follow the rules...
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Matthew, think thus: You are a federal Medical Officer. A guy who you agreed to SI certify, (contributory: medically) crashed. What do you think that does to your "record"?

So, one of the keys to making this work is to "stay on top" of the inherent un-ease which each may have.....this results in the current situation.

Attachemnt: Please note this is about Hazard, not risk. Understand the difference.
 

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bbchien said:
Matthew, think thus: You are a federal Medical Officer. A guy who you agreed to SI certify, (contributory: medically) crashed. What do you think that does to your "record"?...
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That explains a lot. Thanks.
 
bbchien said:
Matthew, think thus: You are a federal Medical Officer. A guy who you agreed to SI certify, (contributory: medically) crashed. What do you think that does to your "record"?

So, one of the keys to making this work is to "stay on top" of the inherent un-ease which each may have.....this results in the current situation.

Attachemnt: Please note this is about Hazard, not risk. Understand the difference.
Click to expand...

I do understand, were I to switch places with my AME I'd be even more conservative than he is. A guy like me walks in with the paperwork I have, and he's putting a reputation and record on the line trusting me.
 
My SI expires July 31. My Letter required "annual cumulative report". My equipment provider couldn't provide an annual report, per se. They generated four consecutive quarterly reports covering the year. I sent in the four reports, doctor's letter and my signed compliance affidavit on June 3. I had my new certificate in less than three weeks. I'm now good thru July 31, 2017 when I'm due for AME visit.


This space intentionally left blank for future sarcasm.
 
That plus calling three times expressing interest as the good Dr has instructed me to do the last two years

Sent from my SM-N920V using Tapatalk
 
If you have a CPAP, get a SOclean machine.
Before I got mine I was not cleaning the cpap mask and tube often enough.
I was getting low level respiratory "Crud"...
The SoClean machine is really easy to use and all of the "Crud" is just gone.

Its the best thing I've ever gotten for my Cpap (7 years )

Paul
 
anonymous said:
If you have a CPAP, get a SOclean machine.
Before I got mine I was not cleaning the cpap mask and tube often enough.
I was getting low level respiratory "Crud"...
The SoClean machine is really easy to use and all of the "Crud" is just gone.

Its the best thing I've ever gotten for my Cpap (7 years )

Paul
Click to expand...

I dont use the humidifier. Everything softens up and comes out in the shower if its a low humidity night. But being on the third coast that only happens a few times during the winter.

No humidifier? No gunk. No cleaning. Replace tubing quarterly. Replace filters on condition.
 
What are the 121 guys doing to ensure they meet the compliance requirements? Are they hauling the machine around in their flight bags and hoping they get enough time in the hotel room?
 
Fearless Tower said:
What are the 121 guys doing to ensure they meet the compliance requirements? Are they hauling the machine around in their flight bags and hoping they get enough time in the hotel room?
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Not a 121 guy, but I definitely take my machine with me on out of town overnights...
 
AggieMike88 said:
Not a 121 guy, but I definitely take my machine with me on out of town overnights...
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I'm mostly curious about the time requirement. Some of those guys are doing 'high speeds' where they fly a late night leg to an out station. Crash in the hotel for a few hours and then fly the first flight back to the hub in the morning. I don't think they even get 6 hours in the hotel on those trips.
 
@Matthew has been better at reviewing the recent regs... But my recollection is an average of 6hrs over the long time period. So if these "high speeds" are infrequent, then they might be okay. Just need to make sure the other nights are typically 7+ hours.
 
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