Sleep apnea for initial medical

Discussion in 'Medical Topics' started by NotSoSleepy, Oct 18, 2017.

  1. NotSoSleepy

    NotSoSleepy Guest

    I have mild sleep apnea (OSA) which is treated with a dental device and practically removed any paean events. I goes down to an AHI of 1.0.

    Reading the FAA site it is confusing if an AME can issue a 3rd class medical without deferral.

    Can they?
     
  2. idahoflier

    idahoflier Pre-takeoff checklist

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    Unfortunately no they cannot OSA still requires a Special Issuance. If memory serves I don't believe an oral device is good enough for the FAA...
     
  3. idahoflier

    idahoflier Pre-takeoff checklist

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  4. Matthew

    Matthew Touchdown! Greaser!

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    https://www.faa.gov/about/office_or...ices/aam/ame/guide/dec_cons/disease_prot/osa/

    >>>
    If the applicant has had a prior sleep assessment (Group/Box 2 of OSA flow chart (PDF)), select Group 2 on the AME Action Tab:
    • If the airman is under treatment, provide the requirements of the AASI and advise the airman they must get the Authorization of Special Issuance;
    • Give the applicant Specification Sheet A (PDF) 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;
    • Notate in Box 60;
    • Issue, if otherwise qualified
    <<<

    I think you fall into this category.

    The way I read it -- as long as you are "otherwise qualified", you will be issued a medical.

    All your documentation and reports will be sent in (deferral) and you will be told you need to get the "Authorization of Special Issuance". You will get a letter from the Federal Air Surgeon requesting more information. Eventually, you'll get the "Authorization of Special Issuance" letter (the SI) in the mail, it will probably include a new medical with a new expiration date. It will explain how to renew it every year. Renewals can be done by mail or in the AME office.

    The first time is always a pain, but renewals are easy.

    It used to be that you had to wait for the deferral process before you could fly. The OSA procedure was changed a few years ago to allow you to fly while you wait.

    --

    I am not a AME and what I just explained may be completely wrong.
     
  5. gkainz

    gkainz Final Approach

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    I cannot find it right now, but last time I dug into this, CPAP was the only FAA accepted treatment for OSA. Dental Appliances, UPPP (uvulopalatopharyngoplasty), etc were not considered acceptable treatments.
    No idea if this is still current or not.
     
  6. Matthew

    Matthew Touchdown! Greaser!

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    https://www.faa.gov/about/office_or...me/guide/special_iss/all_classes/sleep_apnea/

    Dental devices seem like they are allowed, as long as you don't have other conditions. Note that this info is for renewal and not the initial SI.


    edit:

    For the initial SI, see Spec Sheet A:

    https://www.faa.gov/about/office_or...ices/aam/ame/guide/dec_cons/disease_prot/osa/

    Same thing, dental devices are allowed. I don't know what documentation FAA is going to require so you can prove you are using it.
     
    Last edited: Oct 18, 2017
    gkainz likes this.
  7. lbfjrmd

    lbfjrmd Pre-takeoff checklist

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    yes, can issue but most will defer is this is 1st medical. If an airman has a medical and develops OSA i will issue and advise he of she will be hearing from FAA on the specifics. this is big deal with FAA and their countenance of this disease is continuously evolving. for 2nd and 1st class ... i defer.
     
  8. bbchien

    bbchien Touchdown! Greaser!

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    I wait until I have the first month’s sleep doc report, the one month use report (which makes standards) and then issue. Why? Because at that point I know he will not get retroactively revoked....
     
  9. Matthew

    Matthew Touchdown! Greaser!

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    Don't be *that* guy.

    Went to my AME yesterday to renew my OSA SI, I still have 1 year left on my Class III.

    My AME looked over all my paperwork, printed out a fresh ticket, then told me about a guy that had been in earlier in the day. He's been on CPAP over 5 yrs, and hasn't reported it on MedExpress 2yrs ago or yesterday. AME caught on when the guy happened to mention something about it during his exam. I'm not sure of the full story, but it was off to deferral to OKC for him.
     
  10. Weebs

    Weebs Filing Flight Plan

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    Oral devices are allowed under an SI. As of a 2 years ago OKC required a yearly statement from your sleep physician and an annual sleep test showing effectiveness with the appliance. A take home test has been acceptable. Of course OKC could have changed their minds on that. Again...
     
  11. bbchien

    bbchien Touchdown! Greaser!

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    Oral device: The home sleep study is only needed if you don’t have a high quality current status letter.

    The guys who lose here are the ones who only want to go to the pcp and don’t want cpap or to see a sleep doc.

    If you saw some of the dentist and some of the pcp letters you know that they hadn’t read AASM 2009. EVER.

    Most commonly the unread doc betrays that he hasn’t the foggiest idea, what observations really matter......