Sleep anxiety/Insomnia--need guidance on how to maneuver with FAA

[Anonymous]

Thanks for the help in advance.

I've been flying for 6 years and been totally healthy( thank God.). I have a current third class medical which expires in 2021 and am currently flying under that.

Recently, somewhat out of the blue, I developed sleep anxiety/insomnia. I went to the doctor and was prescribed Xanax for which I've been taking it on and off( mostly on) for the past month. It helps me sleep and all but my ultimate goal is to get off the stuff as soon as practical. I'm seeking out more natural aids but so far have not found anything that's very helpful. The dr also suggested I seek therapy for this which I have done. Here is the question, my supply of pills is running out and I need to know what I can legally do according to the FAA to continue to receive treatment, which may require me to refill this prescription, without harming my ability to have my medical renewed. I recognize that basicmed makes things a bit easier for us all but I'm very worried that if I seek out treatment that my dr may recommend, or even going to see the doctor to get his help, I may be crushing my ability to have my medical renewed when it comes due( especially because this same dr recommending treatment is my personal dr.) So basically I need to know if I should just try and plow through this myself( which is currently extrodinarly hard) or if I'm free to seek treatment( whatever the next steps may be.). I recognize that a diagnosis of anxiety or something like that may be a death blow to the medical and that has me very worried. I love flying and I don't want to give it up or, in the process of struggling through this short term issue, totally screw my ability to enjoy a lifetime of flying.

Any thoughts? I have read that Dr. Bruce seems to be helpful in these grey areas and I may reach out to him if needed.

 

[SkyDog58]

. I have read that Dr. Bruce seems to be helpful in these grey areas and I may reach out to him if needed.

Then why in the hell don’t you just contact him rather than asking the rest of us who are for the most part not qualified to answer your questions.

 

[A Different Anon]

I don't know much on the FAA side of this and my case might be different than yours but I've struggled with falling asleep my whole life. I've fortunately been able to handle it on my own without any diagnosis or prescription to complicate my medical and as long as I have it under control I won't be seeing anyone largely for that reason.

So first piece of advice- melatonin. It's a natural sleep hormone, you can get it just about anywhere that sells vitamins and supplements. It's cheap, no prescription, and(at least for me) there aren't any side-effects or downsides to it. 3-6mg about an hour before planning to go to bed can help a lot.

Alchohol- yeah it helps you fall asleep but you won't be well rested. Nothing wrong with ONE drink before bed now and then but drinking to get sleep doesn't really work. Avoid it.

Next don't try to force yourself to go to sleep. If you're wide awake and you know you won't fall sleep then don't even try. Read a book, do the dishes, do about anything else. Wait until you start to feel tired. If you try to force it you won't fall asleep, you'll lay there in bed and get more and more frustrated which will keep you awake and make the situation worse. In my case I know there's little point in trying to go to bed before around midnight so I don't bother unless I'm feeling tired. And to fall asleep I also know I often need everything just so- no irregular noises(hum of a fan is fine, TV/radio is not), 2 pillows for ideal sleeping configuration, comfortable temperature, dark room. I know I don't control when I fall asleep, I only can set up conditions that will be conducive to me falling asleep... and they usually work but not on a schedule.

Becoming self employed was also huge as I set my own hours. I don't work early in the morning to give me plenty of time to sleep in so I wake up rested and ready for the day. I DO still have to force myself to get up. I have a reasonably consistent +/- 2hr sleep schedule but if I don't force myself up in the morning latest I'll be sleeping until noon pretty quickly so I have to keep on top of that.

Whatever I've got going on it just seems like my body wants to naturally fall into a 3am-11am sleep schedule and that would fine except I have to interact with the rest of society that wants to start a workday at 8am or even earlier.

 

[Mtns2Skies]

So first piece of advice- melatonin. It's a natural sleep hormone, you can get it just about anywhere that sells vitamins and supplements. It's cheap, no prescription, and(at least for me) there aren't any side-effects or downsides to it. 3-6mg about an hour before planning to go to bed can help a lot.

+1 on Metatonin. I'm just naturally always awake. Don't need caffeine in the mornings, but gosh I have a hard time slowing my brain down enough to sleep. Melatonin is great, completely safe (it's actually an anti-oxidant) and cheap to boot.

 

[Capt. Geoffrey Thorpe]

and am currently flying under that.

was prescribed Xanax for which I've been taking it on and off( mostly on) for the past month.

So, you have already blown off 61.53... Xanax is in the "do not issue, do not fly" list.
https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/pharm/dni_dnf/

While denial is the official FAA approved treatment for this sort of thing, it would make more sense to me to quit flying anything that requires a medical for now and get things sorted out. Once life is in order, then you can reboot and pursue the Basic Med option.


https://www.faa.gov/licenses_certificates/airmen_certification/basic_med/media/basicmed_faq.pdf

 

[lbfjrmd]

xanax is a hard down. Your ame can prescribe/rec approved sleep aids.

 

[bbchien]

Every airman always starts out with, "I am totally healthy" and then the onion peel begins. There are a lot of "it depends" in here.

The way that alcohol really got started in aviation was the 8 hour layover. Captain knows he has only 5.7 hours of sleep ahead of him, from the time the bus leaves the curb to the motel, they eat and get to bed to getting up and waiting for the bus for the "show". So he takes a cordial form the First class galley, opens it when he steps off the curb to the van, and downs it. "8 hours bottle to throttle".

Then he gets tolerant. He takes two. Then it stops working because what is happening overnight is min-withdrawal, which is super dream-sleep disrupting (sleep, no rest).

The real question is going to be if the insomnia is simply age related or depression related. NB: the agency is looking hard for alcohol, sleep disorder, and depression. Be prepared to defend all of these.

Or you could be developing sleep apnea.

Sometimes you will need both a sleep eval and a psych eval to climb out of this one. It depends. FAA's view: Prove you don't have these other thing. Primary insomnia, if diagnosed by a sleep physician, end up in the neuropsychologist's office to both show that if you had depression, you're not depressed, and also to show that you get enough truly restful sleep to function a an aviator's level.