Sleep apnea compliance report

Discussion in 'Medical Topics' started by Mooneymayhem, Jan 27, 2023.

  1. Mooneymayhem

    Mooneymayhem Pre-Flight

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    I'm trying to submit a cpap compliance report to my AME to be sent to the FAA but all my sleep doctor and DME will give me are the insurance approved reports with <>4hours not <>6 hours. Is there a way I can generate a custom report?
    TIA
     
  2. Matthew

    Matthew Touchdown! Greaser!

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    Yes.

    There’s a s/w product called OSCAR that runs on PCs and Macs.

    Pull the SD card from your CPAP (make sure to write protect it!), plug it into your computer, import, set the report filter to 6hrs and previous 12 months, and print. Uninstall the SD card, remove it, re-set the write protection, and re-install in the CPAP.

    Give me a minute and I’ll find the link.


    Edit: Here it is:

    https://www.sleepfiles.com/OSCAR/

    You’ll just need to print the summary report.
     
  3. Mooneymayhem

    Mooneymayhem Pre-Flight

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    Got it. The FAA will accept OSCAR reports?
     
  4. Matthew

    Matthew Touchdown! Greaser!

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    Absolutely. I've been doing this for years.

    You can get very detailed info if you want to optimize your CPAP treatment. But for the FAA, there's a simple "summary report". It's pretty easy to get into the settings and change the "4 hrs compliance" to "6 hrs compliance". And when you print the report you'll need to tell it the date range. One option is "last 12 months" (or similar).

    It's good at importing data from many brands and models, but there's always a chance you'll have something that it doesn't recognize. Their tech support is normally handled through a forum: http://www.apneaboard.com/forums/

    They are normally good at getting tech support questions resolved very quickly.

    edit: There used to be a product called SleepyHead, and you'll sometimes see that name used interchangeably with OSCAR. There was some issue with SleepyHead and the developer, so a group re-released it under the name OSCAR. SleepyHead is no longer supported, it still works if you have a machine it recognizes, but OSCAR is the one that's being updated now.
     
  5. Mooneymayhem

    Mooneymayhem Pre-Flight

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    I've been using OSCAR to track my data (I'm only a few months into treatment) but until now, I wasn't aware it could generate reports that the FAA would accept. Thank you very much, I've been driving around town between my DME and sleep doctor trying to get them to help me with NO success!
     
  6. Matthew

    Matthew Touchdown! Greaser!

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    Yeah, I'm not sure why DMEs make it so hard to get a simple report. OSCAR is the way to go. The summary report will print a histogram of every night for the last 12 months, it's easy for FAA to eyeball it, since it shows the hours/night. All they have to do is look at all the bars that are taller than "6". This is in addition to the compliance percentage that's also printed. Expect 4(?) pages. On my Mac, I usually have to play with the formatting to get them to scale properly onto paper.
     
  7. Mooneymayhem

    Mooneymayhem Pre-Flight

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    I'll have to dig into this more. My report shows the raw data usage percentage, but no bars or graphs
     
  8. Matthew

    Matthew Touchdown! Greaser!

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    I'll check. I haven't used it for several months, there's probably something I missed.
     
  9. Matthew

    Matthew Touchdown! Greaser!

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    "Statistics" report is simply the numbers, "Overview" report shows the graphs. I turn in both.
     
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  10. AggieMike88

    AggieMike88 Touchdown! Greaser!

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    The original "I don't know it all" of aviation.
    I also use OSCAR for the reports.

    So far, the numbers summary has been sufficing for both primary doc and the AME.
     
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  11. Randomskylane

    Randomskylane Pre-takeoff checklist

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    I used Oscar as well. Sent the reports to the dr and never had a problem.
     
  12. Mooneymayhem

    Mooneymayhem Pre-Flight

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    Found it and scanned it all to my AME. Thanks again, you saved me a lot of grief
     
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  13. Brad W

    Brad W Pattern Altitude PoA Supporter

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    Not to hijack...but I'm getting ready to go in soon for a sleep study. Matthew said that most have this SD card data this program reads but some maybe not.
    I'm a little doubtful because I had a negative study years ago....but who knows
    Assuming my study comes back as positive, what should I look for or ask for in a machine?
    And what is this compliance report showing them? Using the machine over a certain percentage of the time?​
    I'm basic med right now but I want to get it right in case I want to go class 3 again in the future....
     
  14. Matthew

    Matthew Touchdown! Greaser!

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    I’m not sure you can find a CPAP that doesn’t use an SD unless you try, but I’m sure they are out there. A CPAP that auto adjusts is probably the most flexible - your prescription will be a pressure setting that your sleep study determines is best for your situation. Sometimes a range works better than a single setting and the machine can auto adjust within that range. FAA looks for compliance as >6 hrs for 75%(?) of the nights for the previous 12 months. You’ll also need an annual letter from your doc saying it’s working. This is for the SI, but N/A for Basic Med.
     
  15. TRC1969

    TRC1969 Pre-takeoff checklist

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    I have a Phillips Dream station and use the Dream mapper app on my phone/iPad. It shows the 4 hour compliance report but also has the 6 hour report.
     
  16. Anthem

    Anthem Pre-takeoff checklist

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    almost all the CPAP machines will support and work EXCEPT some of the portable ones. Namely the RESMED airmini does not have an SD card, so as long as you have plenty of nights at time and only occasionally use the airmini - its fine. But if you use the airmini enough nights that it will put you below the threshold of compliance, you may want to consider something else.
     
  17. Larry in TN

    Larry in TN En-Route PoA Supporter

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    You don't have to combine the data into a single report. The Airmini uploads data to the cloud via a Bluetooth link to your phone. You get a compliance report from your DME. As long as the data from your multiple compliance reports add up to more than the minimum, there's no problem.
     
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  18. Chris Charanza

    Chris Charanza Pre-takeoff checklist

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    I just hope that the FAA is satisfied with 10 months or so of CPAP data for me. My SI didn't get to me until almost August and I started using my CPAP in May but I'll have to send them the info I've got at the beginning of March since my SI expires March 31st because it was issued retroactively to my exam date and then I'd be in sequence for when I have to have another exam in 2024 although I'm sure I will have gone Basic Med by then.
     
  19. Anthem

    Anthem Pre-takeoff checklist

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    Absolutely. Im just saying it looks nice and pretty when everything is on one report for the doc to see. Its unfortunate that all the others go to Oscar but the airmini is cloud only and cant be extracted to oscar. There might be a way to extract the cloud data and then reimport, but havent tried. I use my mini when I travel, but it isnt enough to lower the threshold to not passing.

    I think they'll accept 90 day data if its your initial first time. . . Then they want to see trailing 12 months.. .
     
  20. Chris Charanza

    Chris Charanza Pre-takeoff checklist

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    I initially sent them 30 days of data which got me the SI. Either way I guess they'll get what they get because I can't give them something that doesn't exist. I'm not really worried about it at this point...I just want to be sure they have the data before the SI expires.
     
  21. Anthem

    Anthem Pre-takeoff checklist

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    I’d they accepted the 30 day and you have unbroken usage because the si/medical cert expired within the timeframe that you don’t have a year for - I’m sure they should take what you have. Haha. /should/ bring the operative word here that saner heads will prevail.
     
  22. kell490

    kell490 Pre-takeoff checklist

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    My understanding is that if you were diagnosed in the same year that you applied for a medical, or reapplied then they want at least 2 weeks min. If you were diagnosed a few years before they want a years worth of data the problem is folks who tried it didn't like the CPAP never used it which is big percentage. Sleep doctors almost always diagnose sleep apnea even if you just snore don't stop breathing. They want to sell CPAP machines makes them rich.
     
  23. Chris Charanza

    Chris Charanza Pre-takeoff checklist

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    I gave them the initial status report with 30 days of data. I guess I'm just going to send them what I have, like I said-I can't give them what doesn't exist.
     
  24. kell490

    kell490 Pre-takeoff checklist

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    If you look at one of the AME's who regularly posts here this is what he says has to be in the letter from your sleep doctor. This is included with the cpap data. He might reply here in case not take a look.

    https://www.pilotsofamerica.com/com...ave-a-diagnosis-now-what.137720/#post-3246142

    Letter from your Sleep doc that has 4 components:
    Uses CPAP nightly
    No complaint of daytime sleepiness
    Appears refreshed
    ON exam, no stigmata of Rt Heart Failure
     
  25. Mooneymayhem

    Mooneymayhem Pre-Flight

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    My concern at this point is the AHI compliance requirements. The 6+ hours per night is no problem but my AHI is still hovering just under 5, occasionally rising above. Does the FAA look at both numbers equally or are they more concerned with the usage time?
     
  26. Matthew

    Matthew Touchdown! Greaser!

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    Can't answer that - but I thought that 5 was the lower limit for an OSA diagnosis. So at 5, that may not be considered properly "treated" and 3 or less is considered "normal". You're below 5 most of the time, though.

    The Apnea Board Forum (http://www.apneaboard.com/forums/) is full of pretty good technical advice on optimizing your CPAP settings. Log on, and simply ask. You'll be expected to download a report generator called OSCAR. Using that, you can print a detailed log of every single breath you took during the last night you used your CPAP. They can see every event, probably figure out what triggered it, and then suggest changes to your settings. I would be careful of making any pressure changes without a corresponding prescription from your doc, just in case FAA wonders why you are tampering with that, but there are other settings that can make a difference. With their help, I was able to get consistently below 1.5, and sometimes < 1.0. If you have a range of pressures on your scrip and your CPAP is an "auto" model, you can set the low and high limits within that range to tighten up your sweet spot and not have to rely on the CPAP hunting so much to find it. There are other ways to adjust pressure during exhales, and possibly some sensitivity settings.
     
  27. Mooneymayhem

    Mooneymayhem Pre-Flight

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    Thank you. I've been working with apneaboard.com and they've been able to help get my numbers down to where they're currently at. The Treatment Emergent Central apneas are the culprit right now, even though they're on a SLOW downward trend, they keep hanging around, keeping my AHI dangerously close and occasionally, over 5. I started treatment at the end of December, so I'm hoping it'll just take more time. I've heard so many different answers regarding the exact criteria the FAA wants to see, it would be nice to have a definite target to aim for.
     
  28. Matthew

    Matthew Touchdown! Greaser!

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    I know, it would help a lot. The only numbers I'm sure about is the 6 hrs.

    I got the 5 AHI from various sources, here's one: https://www.hopkinsmedicine.org/health/conditions-and-diseases/obstructive-sleep-apnea

    5-14 is "mild", so I figure <5 is the target. I know there are times when mine is >=5, but there's normally something associated with it like allergies or sinus problems and it's just a temporary thing. I normally side-sleep, so I have my pressures optimized for that. If I do end up on my back, my numbers start to go up again.

    Since you're still relatively new to this, maybe it takes a little while for your system to adjust? I hope so.
     
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  29. Morgan3820

    Morgan3820 En-Route PoA Supporter

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    Thank goodness for BasicMed.
     
  30. Mooneymayhem

    Mooneymayhem Pre-Flight

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    I've got to get my 3rd class first...
     
  31. Morgan3820

    Morgan3820 En-Route PoA Supporter

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    True. But then, Thank goodness for Basic Med
     
  32. kell490

    kell490 Pre-takeoff checklist

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    I was reading this from the AOPA no mention of AHI. I would think if the sleep doctor doesn't mention it in the letter should be okay. I would review what they write before you send it to the FAA.
     
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  33. Mooneymayhem

    Mooneymayhem Pre-Flight

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    Good find. From what I gather, I would be in Group 2 and would need to complete Specification Sheet A which makes no mention of AHI. You're right, it seems dependant on what the treating physician deems "effective"
     
    Last edited: Feb 16, 2023
  34. bbchien

    bbchien Touchdown! Greaser!

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    mooneymayhem, practically, the medical officers need both the graphic where you can actually count the bars taller than 6 hours (you can create it with "OSCAR" freeware and an SD card reader, looks like the attached,a 30 day report). But an AHI above 5 rings alarm bells.

    I keeps telling my guys, lose the weigh, teh AHI will go down.
    Lose even more weight, and (commonly) get off of the CPAP.
     

    Attached Files:

  35. Mooneymayhem

    Mooneymayhem Pre-Flight

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    Thanks Dr. Chien, I upload my data to Oscar already. I just needed some clarification on the exact criteria. I've had 2 sleep studies done. The first was about 8 years ago when I was eating horribly and not exercising and it indicated an AHI of 3. Since then, I've lost 30 lbs, cleaned up my lifestyle, never drink and after my second sleep study back in November my AHI was 23 so losing weight is far from a silver bullet. I appreciate your input, though.
     
  36. Wrench978

    Wrench978 Pre-takeoff checklist

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    as someone who has to submit reports every year for both ATC and my pilot medical, I have never had the FAA care enough to ask for 6 vs 4 hours of usage or any other parameters. I ask my care provider to send me a year report and I forward it to FAA medical. done and done.
     
  37. kell490

    kell490 Pre-takeoff checklist

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    Your AHI was 3 per hour 8 years ago now after using CPAP for 8 years it's 23 without the cpap during the sleep study. I'm not surprised likely your body has gotten used to the CPAP. I have read people developed central sleep apnea from long term CPAP treatment. Central sleep apnea is when you stop breathing but not from an airway obstruction.
     
  38. Mooneymayhem

    Mooneymayhem Pre-Flight

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    For clarification, I wasn't prescribed cpap 8 years ago because my AHI was below the threshold and was considered mild. Fast forward 8 years, after telling my AME about it, he advised having it rechecked so we could rule it out for the FAA. I was confident my mild apnea was resolved due to the reasons I already gave, I was shocked to find out it had gotten worse, and was prescribed a cpap. Forever, we've heard from physicians that "losing weight will resolve sleep apnea" and while it may be accurate in some cases, it's simply not true for everyone. (By the way, a majority of my apneas were obstructive with only 2 centrals the entire study) I informed my AME about the results and here I am now, fighting with this machine and the resulting treatment emergent centrals.
     
  39. Matthew

    Matthew Touchdown! Greaser!

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    I was one of those who also "didn't fit the profile". Back in the day, I was running many miles a week, lean, and had a <=16" neck size (I think 17" triggers scrutiny.) But my AHI (obstructive) numbers were very high, worse in some positions than others, but certainly high enough to cause me to wake up gasping for air many times a night. Then I got the CPAP and went from that to around 1 event per hour and getting full night's sleep. I'm pretty much at the same weight I was when I started treatment, and only about 5 lb heavier than when I was running 40 miles a week. Sometimes it's just anatomy and not excess weight, but usually it's weight.
     
  40. kell490

    kell490 Pre-takeoff checklist

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    I agree the cause of sleep apnea is not always obesity. Good luck getting used to it took me a year had to start out with the thing very lose on my face and tighten it over a few weeks I could not fall asleep with that thing on my face unless I stayed up all night was exhausted.