Sleep Apnea and 3rd Class medicals or BasicMed

Is there such thing as a false positive diagnosis from a sleep study?
I don't think so... During the study, they wire you up to collect so much data that getting a mis read would be difficult.

One important bit is to make sure the doc doing the reading of the data is board certified in sleep issues. Mine was, and he also took the time to show me all of the info and explain how he came to his diagnosis.

For background reading, look up AHI and Hypopnea.
 
You could try one of these- but maintain your CPAP until you are sure the device works. You will need a home sleep study for one night in which you wear the device, and if negative, (AHI<5.0) you can renew with the oral device and its record.
 

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I'm sorta thinking that once you're issued with the SI, 90 days worth of compliance history is no longer enough.... @Matthew had posted the information not that long ago... perhaps he can copy/paste.

I don't look at CPAP compliance as a cash grab. I had sea container loads of anecdotal data that indicated I likely had OSA before I was officially tested. And once I was used to the machine, the difference in quality of life was remarkable.

But if you wish this to be an equine anti-hydration problem, then I'm down with that.
I'm not sure what I did or didn't post earlier.

From my recollection, the renewal letter says an "annual report showing compliance". Keep your data from the last SI renewal on a regular basis and you're good. The first time you probably won't have a full year of records and the letter includes a personal statement of some sort that you sign saying that even though your records are incomplete, you are attesting that you are compliant.

I don't know what would happen if you went to a Tibetan monastery for 9 months, then wanted to renew your SI. You didn't comply, but you self grounded, too.
 
Is there such thing as a false positive diagnosis from a sleep study? It found you had "mild" OSA but is that a real thing, or is that like "mild" ADHD when you're really just bored at school? I don't know much about the results of sleep studies except your blood oxygenation has something to do with it and how often you stop breathing.

I asked the docs and the sleep study technicians. They both admitted (reluctantly) that they had never seen a negative result from the lab study, one dude had been working as a tech for 15 years. It is my own personal and non-medical opinion that the whole thing is a big goatrope designed to shovel cash at the sleep centers and DME providers. But cynicism is probably yet another symptom of OSA ;)

But I'm using it as continued motivation for weight loss, so silver lining, yadda yadda.
 
I asked the docs and the sleep study technicians. They both admitted (reluctantly) that they had never seen a negative result from the lab study, one dude had been working as a tech for 15 years. It is my own personal and non-medical opinion that the whole thing is a big goatrope designed to shovel cash at the sleep centers and DME providers. But cynicism is probably yet another symptom of OSA ;)

But I'm using it as continued motivation for weight loss, so silver lining, yadda yadda.

Well that might be a result from nobody ever coming in for the study without very bothersome symptoms. Not a random sample in other words but a preselected one.

As it happens, I got a "negative" sleep study myself. I have rare instances of waking up unable to breath at all. I have to sit bolt upright in bed and slap myself awake before my lungs will restart. Plus hubby said I snore so I went in for a study. They found zero OSA, I passed with flying colors. Naturally the event which concerned me didn't happen that particular night so they didn't catch it. But the physician (the certified sleep specialist, not my GP) told me he'd only seen one or two cases like mine ever, and he postulated that it was a kind of central thing, not central sleep apnea per se, but something related neurologically, where the wires get crossed when you're in REM and your body is paralyzed so you don't run around acting out your dreams. Your breathing muscles aren't supposed to be stopped, but he thinks that's what happens, fortunately very rarely, in my case and the couple others he had.

Anyway that's what he said, I have no idea if he is right or wrong, or just trying to put some kind of positive diagnosis on my study, but in my case there was no money to be made selling me a CPAP. Hey I wonder if that kind of thing is what's behind SIDS deaths?
 
I just wanted to second what others have said. If you really have an obstructive sleep disorder you've no business flying any airplane anywhere.

That said, I think the FAA's approach is, as usual too wide and full of unintended consequences. One of my friends got tagged for a sleep study because he is 1) male 2) over 50 and 3) has a wide neck. I am being utterly serious. I can tell you he doesn't have sleep apnea. Spend 5 minutes in his presence and you'll agree. I fit a couple fo those boxes myself, but I don't have a wide neck and I don't snore. I've never heard myself snore, therefore I don't.
 
I think the FAA's approach is, as usual too wide and full of unintended consequences.
I have some agreement with this.. the net catches folks really, really low on the scale, or like your buddy.

But as Dr. Bruce has pointed out on various issues, they have to have something to start with.

And all reading this thread need to keep in mind that the standards are not applied to pilots only, but also to ATC. Folks might remember 3-4 years ago when the news media was really talking about controllers falling asleep on the job.

https://www.nbcnews.com/health/heal...tudy-shows-they-re-dangerously-sleepy-n407256


The only additional advice I can give @schmookeeg is that the current rules/regs/policy are what defines the ability to play within the FAA's sandbox when it comes to an airman having OSA. He can follow his own drumbeat, if he wishes. Hopefully he won't get stuck as renewals for 3rd class or better happen because his drumbeat didn't fit within the FAA's sandbox rules/regs/policy.
 
OSA is a strange beast. I've snored all my life. I remember once going on a vacation with some friends of mine and we ended up sharing the same hotel room and I snored so bad they threw pillows at me to jostle me awake so I'd shut up.

I never realized how bad it was myself (I was sleeping just fine - I didn't care!) until I started having issues snoring myself awake as I was trying to drift off to sleep. I'd never had a problem with daytime drowsiness, never fell asleep during the day, and was never tired. It was just the falling asleep part that started bugging me.

I went in for a sleep study and IIRC my AHI was about 90. That was a wake up call (no pun intended)!!! I took to CPAP very well. Only had a few nights in the first month or so where I was subconsciously taking the mask off during the night. But once I got over that, it was a godsend. Except for a few nights where I pulled all-nighters boxing up for a move, I've used it every night since 2014.

Yeah, sleep studies are a pain, and can be expensive. I hated being hooked to all those wires, and then I had a hard time falling asleep during the first half of it where you go to sleep without the CPAP. I remember during the second half after they put the CPAP on me, I fell asleep almost immediately and I guess I was sleeping so well, when they woke me up a few hours later, I wanted to run out of the place with their CPAP machine!

Long story short... if you have sleep problems, bad snoring, insomnia, etc, do yourself a huge favor and get a sleep study done. It's just one night and could make a world of difference in your quality of sleep. It did for me!
 
The only additional advice I can give @schmookeeg is that the current rules/regs/policy are what defines the ability to play within the FAA's sandbox when it comes to an airman having OSA. He can follow his own drumbeat, if he wishes. Hopefully he won't get stuck as renewals for 3rd class or better happen because his drumbeat didn't fit within the FAA's sandbox rules/regs/policy.

I think you'll find, possibly on a re-read of my original post, that I am currently seated in the center of their sandbox, asking where the edges are -- so that I can sit closer to the edge and claw back some quality of life that I've surrendered to continue holding an FAA medical. :)

I haven't heard back from my AME about my question either. I wonder if it's even spelled out anywhere.
 
I think you'll find, possibly on a re-read of my original post, that I am currently seated in the center of their sandbox, asking where the edges are -- so that I can sit closer to the edge and claw back some quality of life that I've surrendered to continue holding an FAA medical. :)

I haven't heard back from my AME about my question either. I wonder if it's even spelled out anywhere.
Do you really need the 2nd class? The sad reality is, with any SI that has recurrent compliance requirements, you're going to be perpetually in the center of the FAA sandbox. They can tighten their requirements on you for no apparent reason, or even send you a letter of eligibility and then, years later, rescind it and put you back on the SI, again for no apparent reason (they did that to me).

For most people who could make do with a 3rd, BasicMed is the way to get out of the sandbox altogether (barring contracting one of the conditions that require a one-time SI - but even then, you wouldn't have to worry about recurring compliance and monitoring), though some people fly planes or in airspace where BasicMed is not an option. It's just a suggestion that might or might not work for you.
 
The great thing about Basic Med is that there is no reason to hide OSA. With the class III I know there was the temptation to not report it or to pretend you didn't have it because your medical would be deferred until you got the SI. A couple years ago they changed the rules so you could get the medical first, then fly while the SI was being processed. With Basic Med, there isn't even that to worry about.

If you suspect OSA, get it checked.

I know this was out there for a bit but I have a question. I just visited an AME and declared that I am being treated for OSA (two years and honestly glad to have it, though would rather loose the weight). I wanted everything to be on the strait and narrow, nothing to come back around later. He asked me to provide Letter from PC of compliance, I also got the 90 day report from the machine company, and feeling that was not enough printed down the 2 year average report from Sleepyhead using the onboard APAP chip. He said he had to defer to FAA for the SI. Is that not the necessary way to handle it?

I should note this is my absolute first FAA medical I just started training. My only real concern is the amount of time it will take to get the SI and medical vs when SOLO time comes up. I've read about time to get SIs and it seems to run from 4 weeks to 4 months. Running joke seems to be when they they get to it. AME did state to me that he sees nothing that would prevent the SI being issued. Other then Federal paper pushers.
 
I know this was out there for a bit but I have a question. I just visited an AME and declared that I am being treated for OSA (two years and honestly glad to have it, though would rather loose the weight). I wanted everything to be on the strait and narrow, nothing to come back around later. He asked me to provide Letter from PC of compliance, I also got the 90 day report from the machine company, and feeling that was not enough printed down the 2 year average report from Sleepyhead using the onboard APAP chip. He said he had to defer to FAA for the SI. Is that not the necessary way to handle it?

I should note this is my absolute first FAA medical I just started training. My only real concern is the amount of time it will take to get the SI and medical vs when SOLO time comes up. I've read about time to get SIs and it seems to run from 4 weeks to 4 months. Running joke seems to be when they they get to it. AME did state to me that he sees nothing that would prevent the SI being issued. Other then Federal paper pushers.

Unfortunately, some AMEs take the easy way out and defer to FAA. Others make the in-house decision. I honestly don't know why or how this sort of thing happens - it seems like it should be a pretty standard decision, but I don't know why different AMEs come to different conclusions.
 
Unfortunately, some AMEs take the easy way out and defer to FAA. Others make the in-house decision. I honestly don't know why or how this sort of thing happens - it seems like it should be a pretty standard decision, but I don't know why different AMEs come to different conclusions.

Thanks, I'm getting the feeling that "different day, different way" is the way of the FAA. Just like in the Fire Services ... ah well. Nothing to do but wait I guess. On with the training either way. I've got 2 hours on the yoke and I'm hooked.
 
Thanks, I'm getting the feeling that "different day, different way" is the way of the FAA. Just like in the Fire Services ... ah well. Nothing to do but wait I guess. On with the training either way. I've got 2 hours on the yoke and I'm hooked.
Actually your "different day" meme really applies more to the individual AME verses the FAA medical as a whole.

There are some AME's who are willing and will take a few additional steps to avoid deferrals. The key to the airmen is doing some regional homework to find them.
 
Actually your "different day" meme really applies more to the individual AME verses the FAA medical as a whole.

There are some AME's who are willing and will take a few additional steps to avoid deferrals. The key to the airmen is doing some regional homework to find them.
And one of my biggest pet peeves - student pilots don't know what they don't know. And going to an AME that's referred by their CFI isn't always the best option. "Go to my guy, as long as you can fog the mirror you can pass. And he's cheap." I actually heard that. But so many of us have that one "catch" that's going to result in the AME having to do extra work, and that AME can either do it himself or defer and you won't know until it happens.

I'm not sure what the answer is, other than go to one of several on-line forums and ask ahead of time. But again, if you are a student, beginner, and new to all of this, you might not even know to do that much.
 
What can you do ... the AME I went to is an older fellow recommended actually by my PCP as his son went to him. Down to earth and laid back, his cost was at par with what I've been told to expect. Downside, not technologically incline and at this stage in his career(retired) no interest in learning.

As was said ... the new guys like me just don't know what we don't know. I did as much research as I could but the FAA site is ... well its full of information that is not always the easiest to interpret. One thing I will say is that I am absolutely convinced that he is doing what he believes is the right thing. He could have just differed the decision, then let the FAA tell me they wanted more info. He asked me to gather a few things so he could recommend that it be granted with SI. So perhaps not as much as some would have liked, I'd still say having his recommendation when the papers hit the table of what might be a clerk should help.
 
Not sure why he said he 'had' to defer to them. My ME issued mine on the spot. No problems at all.

I think i should have clarified, sorry for the delay in response btw. I did do some more research and in very small print (government and legal favorites) I found what pertains to me. I should have stated this was my first time getting a medical. Because of this the FAA does require the first issuance to be defered to the flight surgeon. I guess being honest sometimes doesn't pay.
 
I think i should have clarified, sorry for the delay in response btw. I did do some more research and in very small print (government and legal favorites) I found what pertains to me. I should have stated this was my first time getting a medical. Because of this the FAA does require the first issuance to be defered to the flight surgeon. I guess being honest sometimes doesn't pay.
But trying to conceal something in your history can come back to haunt you some day if you bend metal or get a pilot deviation and they launch a full investigation. This way, you will be able to rest easy that, at least, all your certificates won't be in jeopardy.
 
Oh I 100% agree. That and I do honestly believe the regs are there for good reasons. Regretfully many it seems are put in place because something happened and the solution put in place is to prevent another tragic accident. Waiting on an "Good To Go" is frustrating ... that's all.
 
Well that might be a result from nobody ever coming in for the study without very bothersome symptoms. Not a random sample in other words but a preselected one.

As it happens, I got a "negative" sleep study myself. I have rare instances of waking up unable to breath at all. I have to sit bolt upright in bed and slap myself awake before my lungs will restart. Plus hubby said I snore so I went in for a study. They found zero OSA, I passed with flying colors. Naturally the event which concerned me didn't happen that particular night so they didn't catch it. But the physician (the certified sleep specialist, not my GP) told me he'd only seen one or two cases like mine ever, and he postulated that it was a kind of central thing, not central sleep apnea per se, but something related neurologically, where the wires get crossed when you're in REM and your body is paralyzed so you don't run around acting out your dreams. Your breathing muscles aren't supposed to be stopped, but he thinks that's what happens, fortunately very rarely, in my case and the couple others he had.

Anyway that's what he said, I have no idea if he is right or wrong, or just trying to put some kind of positive diagnosis on my study, but in my case there was no money to be made selling me a CPAP. Hey I wonder if that kind of thing is what's behind SIDS deaths?
Nah that’s just a “goatrope”....
 
Nah that’s just a “goatrope”....

:lol::lol::lol: I had to look up goatrope. "A confusing, disorganized situation, a convoluted issue that is contested by many parties." Haha! In other words, he had no idea, and he just made up something to say. I can buy that. :lol::lol:
 
Just for anyone still monitoring or later looks this up. I just called my FAA Regional Flight Surgeon (couldn't get through to home office ... "we are experiencing higher then normal call volume and can't help you right now. Please call back later".) They said they had just scanned my information in today. So three weeks to receive and scan in. She said to call back next week.

All in all very polite, professional, but friendly enough so I'll absolutely give them that.
 
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Not sure why he said he 'had' to defer to them. My ME issued mine on the spot. No problems at all.
Some AMEs just don’t know or understand.

I was diagnosed with OSA this year. When I went recently for my medical, at first my AME told me he had to defer it. I told him I thought he could issue on the spot for OSA, so he took the time right there to call the OKC hotline and they confirmed that yes, he could indeed issue.

It definitely helps to do the research in advance and arrive informed for your appointment.

On a side note: how long does it typically take for OKC to issue the actual SI letter?
 
Some AMEs just don’t know or understand.

I was diagnosed with OSA this year. When I went recently for my medical, at first my AME told me he had to defer it. I told him I thought he could issue on the spot for OSA, so he took the time right there to call the OKC hotline and they confirmed that yes, he could indeed issue.

It definitely helps to do the research in advance and arrive informed for your appointment.

On a side note: how long does it typically take for OKC to issue the actual SI letter?

@Fearless Tower I got my medical on May 8, 2017, and the SI letter I got from the FAA with another medical in it was dated June 6. So a month for me. The date stamp on the envelope was the 9th. So I assume I got it in the mail probably around the 11th or so.
 
Some AMEs just don’t know or understand.

I was diagnosed with OSA this year. When I went recently for my medical, at first my AME told me he had to defer it. I told him I thought he could issue on the spot for OSA, so he took the time right there to call the OKC hotline and they confirmed that yes, he could indeed issue.

It definitely helps to do the research in advance and arrive informed for your appointment.

On a side note: how long does it typically take for OKC to issue the actual SI letter?

I'll post timeframe once I get my'n. So far it took three weeks from date mailed out to today and the operator I spoke to said they had just scanned the documents in today.
 
All in all very polite, professional, but friendly enough so I'll absolutely give them that.
Yup... the few times I called OKC for some aeromedical assistance, the lady I spoke with was very friendly and helpful.
 
I'll post timeframe once I get my'n. So far it took three weeks from date mailed out to today and the operator I spoke to said they had just scanned the documents in today.
Not too out of the ordinary from the timelines Dr. Bruce has reported.

I think I remember him saying initial SI approval was averaging 12 weeks.
 
Quick Update, Got a letter Today (Saturday 7/21/18) requesting more information ... sixty day timeline stinks but can't fight that. So at the very least review was made well within 30 days of initial sent information. (Sent 6/28, Scanned in 7/16, Request for more info received 7/21)
 
(and if you had sent in all of the right information in the first place......)
 
(and if you had sent in all of the right information in the first place......)

Pretty much. Ah well you don't know what you don't know. Hopefully more people will see this thread before they see an AME and get that info in. I'm personally impressed by the response turn around.
 
Quick Update, Got a letter Today (Saturday 7/21/18) requesting more information ... sixty day timeline stinks but can't fight that. So at the very least review was made well within 30 days of initial sent information. (Sent 6/28, Scanned in 7/16, Request for more info received 7/21)
Interesting. I had my exam and the paperwork should have been submitted mid-June. My medical shows up as valid in the online database, but I haven’t heard a peep out of OKC.
 
Hmm... maybe call them and ask them to fax you a temporary?
But I have a physical medical certificate. It was issued by the AME right there in the office.

As I understand it, I’m waiting on the SI letter from OKC that tells me what I have to do to remain in compliance.
 
But I have a physical medical certificate. It was issued by the AME right there in the office.

As I understand it, I’m waiting on the SI letter from OKC that tells me what I have to do to remain in compliance.

Based on the letter my application is currently being handled by Medical Field office. Not at OKC. Likelihood that is the difference.
 
But I have a physical medical certificate. It was issued by the AME right there in the office.

As I understand it, I’m waiting on the SI letter from OKC that tells me what I have to do to remain in compliance.
Ahh, okay. As long as you have the cert, you're good (at least for now).
 
As promised, update. Received the 3rd class medical certificate today in the mail, with the special issuance and as expected a long list of conditions that must be met at one year intervals. The list really isn't that long, its just long winded stating that issuance will be re granted as long as I send in the CPAP logs ON OR AROUND the date indicated on a yearly interval. Nice that I can submit that information directly to the field office rather then OKC though.

So total turn around:
Started the process in or around June 30 2018, Special Issuance and 3rd Class Medical received August 10 2018.
 
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