FAA Medical and pilots with Sleep Apnea

Hi everyone,

I've run into a problem with renewing my medical because of a
diagnosis of Sleep Apnea. It didn't cause me to fail my medical, but
I didn't pass either.

Since the AME had never run into a pilot with Sleep Apnea before, he
wound up calling Oklahoma and talking to the FAA. The FAA person had
the doctor "defer" the medical and send the paperwork to them.

I spoke with the doctor for quite a while and he feels sure that the
FAA will eventually approve the medical and I'll be flying again. But
he thinks that the FAA will be asking for paperwork on my diagnosis
and test results. And he suggests I get together as much information
as possible -- for when the FAA does ask for it. I'm working on that.

But in the meantime, I was wondering if anyone out there has been in
the same situation before? Has anyone out there run into a medical
problem because of Sleep Apnea? Or does anyone know of a pilot with
the problem???

I'd really like to speak to anyone with similar experience. I'd like
to talk about how their situation resolved and any
suggestions/recommendations they might have in dealing with the FAA.

Having the FAA consider Apnea a problem is actually kind of curious.
Sleep Apnea isn't something that sneaks up on you like a stroke or
heart attack. Apnea just keeps you from sleeping correctly and if
you've had a problem while sleeping, you know it when you get up. So,
Apnea isn't something that should affect you while flying -- at least
I hope no one is sleeping at the controls.

And if you had a problem with Apnea the night before, you get up
tired and feeling bad -- and I'd really hope that someone in that
situation wouldn't get behind the controls!!! So, I'm a little
puzzled why the FAA consider it a possible flight problem -- but I'll
play along and supply anything they request.

Thanks for listening guys. And if anyone has any information, please
send it to me at or post it to this list.



Chuck
PA28-180

("Chuck" wrote)
[snip]
Having the FAA consider Apnea a problem is actually kind of curious.
Sleep Apnea isn't something that sneaks up on you like a stroke or
heart attack. Apnea just keeps you from sleeping correctly and if
you've had a problem while sleeping, you know it when you get up. So,
Apnea isn't something that should affect you while flying -- at least
I hope no one is sleeping at the controls.

And if you had a problem with Apnea the night before, you get up
tired and feeling bad -- and I'd really hope that someone in that
situation wouldn't get behind the controls!!! So, I'm a little
puzzled why the FAA consider it a possible flight problem -- but I'll
play along and supply anything they request.


Sleep Apnea is generally NOT a 'couldn't sleep last night' problem. It is a
condition that wears you down over time - sometimes years. It wears you out
mentally AND physically (hypertension for one) ...and sometimes even
emotionally - it's all about the REM sleep!

Try a C-PAP machine for a while. For some, the results are remarkable and
immediate. For others, it's more like weight-loss...with a gradual
improvement over time.

http://www.cpapman.com/cpap.html#anchor692895
(Google C-PAP machines)

For me, I started having vivid dreams again ...almost better than taking
those 'fun house' melatonin pills. g


Montblack
Why am I posting this at 4am? Couldn't sleep!!

Chuck wrote:

I'd really like to speak to anyone with similar experience. I'd like
to talk about how their situation resolved and any
suggestions/recommendations they might have in dealing with the FAA.

Do you belong to AOPA (www.aopa.org) ? If not, join immediately, then call
their toll free number and ask to speak to a medical specialist (or perhaps
it is a telephone menu choice). AOPA has a staff of people devoted to
answering any medical question and can offer you some assistance. I
suspect sleep apnea is a very common issue for their staff to address.

--
Peter
























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I don't see any mention of AOPA. Call AOPA right away. You probably should have
done so before seeing your AME. DGB

Chuck wrote:
Hi everyone,

I've run into a problem with renewing my medical because of a
diagnosis of Sleep Apnea. It didn't cause me to fail my medical, but
I didn't pass either.

Since the AME had never run into a pilot with Sleep Apnea before, he
wound up calling Oklahoma and talking to the FAA. The FAA person had
the doctor "defer" the medical and send the paperwork to them.

I spoke with the doctor for quite a while and he feels sure that the
FAA will eventually approve the medical and I'll be flying again. But
he thinks that the FAA will be asking for paperwork on my diagnosis
and test results. And he suggests I get together as much information
as possible -- for when the FAA does ask for it. I'm working on that.

But in the meantime, I was wondering if anyone out there has been in
the same situation before? Has anyone out there run into a medical
problem because of Sleep Apnea? Or does anyone know of a pilot with
the problem???

I'd really like to speak to anyone with similar experience. I'd like
to talk about how their situation resolved and any
suggestions/recommendations they might have in dealing with the FAA.

Having the FAA consider Apnea a problem is actually kind of curious.
Sleep Apnea isn't something that sneaks up on you like a stroke or
heart attack. Apnea just keeps you from sleeping correctly and if
you've had a problem while sleeping, you know it when you get up. So,
Apnea isn't something that should affect you while flying -- at least
I hope no one is sleeping at the controls.

And if you had a problem with Apnea the night before, you get up
tired and feeling bad -- and I'd really hope that someone in that
situation wouldn't get behind the controls!!! So, I'm a little
puzzled why the FAA consider it a possible flight problem -- but I'll
play along and supply anything they request.

Thanks for listening guys. And if anyone has any information, please
send it to me at or post it to this list.

On 9/27/2005 23:48, Chuck wrote:

Hi everyone,

I've run into a problem with renewing my medical because of a
diagnosis of Sleep Apnea. It didn't cause me to fail my medical, but
I didn't pass either.

Since the AME had never run into a pilot with Sleep Apnea before, he
wound up calling Oklahoma and talking to the FAA. The FAA person had
the doctor "defer" the medical and send the paperwork to them.

I spoke with the doctor for quite a while and he feels sure that the
FAA will eventually approve the medical and I'll be flying again. But
he thinks that the FAA will be asking for paperwork on my diagnosis
and test results. And he suggests I get together as much information
as possible -- for when the FAA does ask for it. I'm working on that.

But in the meantime, I was wondering if anyone out there has been in
the same situation before? Has anyone out there run into a medical
problem because of Sleep Apnea? Or does anyone know of a pilot with
the problem???

I am a pilot and I have Obstructive Sleep Apnea.


I'd really like to speak to anyone with similar experience. I'd like
to talk about how their situation resolved and any
suggestions/recommendations they might have in dealing with the FAA.

When I went to the AME, he asked about my treatment regime. I explained
that I use the CPAP machine nightly, and get adequate sleep each night.

That was the end of it.

I seem to remember there was some test that would verify that I was
really fully awake, but I can't remember now if he even did that. I
think he didn't...


Having the FAA consider Apnea a problem is actually kind of curious.
Sleep Apnea isn't something that sneaks up on you like a stroke or
heart attack. Apnea just keeps you from sleeping correctly and if
you've had a problem while sleeping, you know it when you get up. So,
Apnea isn't something that should affect you while flying -- at least
I hope no one is sleeping at the controls.

Are you being treated for Apena now? Perhaps your case is not that severe.

Before I began treatment, I had a hard time keeping awake during the
day. In meetings especially, it was tortuous to stay awake. I've read
about cases where people with the condition can suddenly pass out, even
while operating heavy machinery or driving a car, etc.

I definitely would not want to see anyone with untreated apnea in any
situation that could be hazardous if they should suddenly fall asleep.

After beginning to use the CPAP machine, the difference was like night
and day. As mentioned by another poster, the condition builds up and
wears you down. With adequate treatment, you can function like a normal
person again.




And if you had a problem with Apnea the night before, you get up
tired and feeling bad -- and I'd really hope that someone in that
situation wouldn't get behind the controls!!! So, I'm a little
puzzled why the FAA consider it a possible flight problem -- but I'll
play along and supply anything they request.

Most people that have apnea don't even realize it, or don't realize
how sever it actually is. It's not something that can affect you
one night but not another.

Of course, there are a lot of things that can happen that would cause
me to take pause before climbing into an airplane as PIC. Not being able
to get enough (CPAP assisted) sleep the night before would certainly be
one of those.


Thanks for listening guys. And if anyone has any information, please
send it to me at or post it to this list.



Chuck
PA28-180



--
Mark Hansen, PP-ASEL, Instrument Airplane
Sacramento, CA

What worries the FAA is narcolepsy caused by sleep apnea. I have a
friend who is an absolute danger because he refuses to acknowledge his
narcolepsy, and I imagine that's not uncommon. I have two colleagues,
like me, overweight and past 50, who can only function with CPAP.
While they're not in danger of falling asleep while driving like my
other friend, they wouldnt have the energy to get through the day
otherwise.

For myself, it started when I let my regular doc talk me into a sleep
study. That produced a diagnosis of sleep apnea that I resisted.
(I'm not narcoleptic.) Nevertheless, I had to ground myself. (Per the
AOPA Website.)

To satisfy the FAA, I had to re-take not only the overnight sleep
study with all the wires, but the all-day test the following day (I
forget what it's called, maybe maintenance of wakefullness.) where
they monitor you continuously and then every couple of hours turn off
the lights and have you lie down and see if you go to sleep. (Thre's
an infrared TV camera in addition to the EEG.) Then I had to buy a
CPAP machine and use it.

What the FAA wanted was good results from the maintenance of
wakefullnes test and a letter from my regular doc that said the sleep
apnea was under control because I used the CPAP machine.

Sleep testing cost about $6000, of which my insurance paid a lot. The
CPAP machine cost less than a grand. On my second medical, I got the
doc to sign me off with a "no change," though he was reluctant and
said OK City might come back asking for more data. (They didn't.)
That suggests that you need to check around for an AME who's
comfortable with doing what mine did.

I was skeptical of the CPAP business, but after 4 years, I've found
that it does get me through the night without waking up at 4 am with
the heebie-jeebies about whatever I have hanging over my head that
day, and I actually go to sleep a little faster.

For the curious, a CPAP machine looks like a mini vacuum cleaner. Its
hose connects to either a mask that covers your nose or to what I
have, which is a snorkel-like contraption that ends in a couple of
buds that stick into your nostrils. (Not a cannula, they actually
close the nostrils.) Either way, it means the air pressure at your
nose is higher than the air pressure at your mouth, forcing you to
keep your mouth closed while you sleep and to breathe through your
nose. The result is no more snoring and none of the sudden
interruptions of breathig air that occur when your tongue or glottis
gets in the way of the air you'd be breathing through your mouth. And
those interruptions are the apneas that interupt your REM sleep, which
is what you need enough of in order to avoid narcolepsy.

For the really curious, yes you take the damned thing off for sex.

Alternative surgical approaches that don't involve CPAP include cuting
off your uvula and breaking your jaw and resetting it further forward.
I understand that some people actually opt for them. Go figure.

Don

("Don Tuite" wrote)
For the really curious, yes you take the damned thing off for sex.


....or, you can keep it on and play Dennis Hopper in Blue Velvet (1986).

(That means she gets to be Isabella Rossellini ...or, she can wear it and
*you* can be Isabella Rossellini. Either way works on "movie night" g)


Montblack
"I like to watch"

I had an extreme case of obstructive apnea. The sleep study showed that
I stopped breathing up to 50 times an hour for up to 45 seconds at a
time. On weekends, I'd sometimes "sleep" for 12 hours - and wake up
exhausted. I used the CPAP for about a year and probably lost as much
sleep to it as I had with the apnea. My doctor got offended when I
suggested he try it for a night.

So, at the delicate age of 46, I had my tonsils removed (by a different
doctor) along with a couple of hands full of other tissue including my
uvula. They did not have to do anything with my jaw.

The surgery was done on an out patient basis and that night, though I
had a whopper of a sore throat, I felt air going freely through my
airways for the first time in years. I did go into the hospital the next
day when swelling caused a problem, but a couple of cortisone shots and
I was AOK.

Now the soap box. Sleep apnea is an insidious condition because you
probably don't know you have it. If you're single, there presumably
isn't anyone there to notice that you convulse periodically as you semi
wake up to get some air.

So, don't worry about the FAA or losing your medical, get it treated!
'nuf said.

JJF

Don Tuite wrote:
What worries the FAA is narcolepsy caused by sleep apnea. I have a
friend who is an absolute danger because he refuses to acknowledge his
narcolepsy, and I imagine that's not uncommon. I have two colleagues,
like me, overweight and past 50, who can only function with CPAP.
While they're not in danger of falling asleep while driving like my
other friend, they wouldnt have the energy to get through the day
otherwise.

For myself, it started when I let my regular doc talk me into a sleep
study. That produced a diagnosis of sleep apnea that I resisted.
(I'm not narcoleptic.) Nevertheless, I had to ground myself. (Per the
AOPA Website.)

To satisfy the FAA, I had to re-take not only the overnight sleep
study with all the wires, but the all-day test the following day (I
forget what it's called, maybe maintenance of wakefullness.) where
they monitor you continuously and then every couple of hours turn off
the lights and have you lie down and see if you go to sleep. (Thre's
an infrared TV camera in addition to the EEG.) Then I had to buy a
CPAP machine and use it.

What the FAA wanted was good results from the maintenance of
wakefullnes test and a letter from my regular doc that said the sleep
apnea was under control because I used the CPAP machine.

Sleep testing cost about $6000, of which my insurance paid a lot. The
CPAP machine cost less than a grand. On my second medical, I got the
doc to sign me off with a "no change," though he was reluctant and
said OK City might come back asking for more data. (They didn't.)
That suggests that you need to check around for an AME who's
comfortable with doing what mine did.

I was skeptical of the CPAP business, but after 4 years, I've found
that it does get me through the night without waking up at 4 am with
the heebie-jeebies about whatever I have hanging over my head that
day, and I actually go to sleep a little faster.

For the curious, a CPAP machine looks like a mini vacuum cleaner. Its
hose connects to either a mask that covers your nose or to what I
have, which is a snorkel-like contraption that ends in a couple of
buds that stick into your nostrils. (Not a cannula, they actually
close the nostrils.) Either way, it means the air pressure at your
nose is higher than the air pressure at your mouth, forcing you to
keep your mouth closed while you sleep and to breathe through your
nose. The result is no more snoring and none of the sudden
interruptions of breathig air that occur when your tongue or glottis
gets in the way of the air you'd be breathing through your mouth. And
those interruptions are the apneas that interupt your REM sleep, which
is what you need enough of in order to avoid narcolepsy.

For the really curious, yes you take the damned thing off for sex.

Alternative surgical approaches that don't involve CPAP include cuting
off your uvula and breaking your jaw and resetting it further forward.
I understand that some people actually opt for them. Go figure.

Don

("Foster" wrote)
[snip]
I used the CPAP for about a year and probably lost as much sleep to it as
I had with the apnea. My doctor got offended when I suggested he try it
for a night.


Ahh, another 'at war' with his mask.

The leaking mask under the eyes is one nightly problem (eyelash flutter).
After a while you learn to flick your head a little, like a hound on the
front porch when flies are bothering him, and it usually seals back up.
Otherwise, you can (lightly) smack/tap the side of the mask, like
'fine-tuning' our old 1963 TV set - that will sometimes cure air leaks too.

Other nights you take it off. It wins that round.


Montblack

On 9/28/2005 12:19, Montblack wrote:

("Foster" wrote)
[snip]
I used the CPAP for about a year and probably lost as much sleep to it as
I had with the apnea. My doctor got offended when I suggested he try it
for a night.


Ahh, another 'at war' with his mask.

The leaking mask under the eyes is one nightly problem (eyelash flutter).
After a while you learn to flick your head a little, like a hound on the
front porch when flies are bothering him, and it usually seals back up.
Otherwise, you can (lightly) smack/tap the side of the mask, like
'fine-tuning' our old 1963 TV set - that will sometimes cure air leaks too.

Other nights you take it off. It wins that round.


Montblack


Sheesh, I thought I was the only one ;-)

When I first got the set-up, the technician showing me how to use it
said:

You can make this work, or you can do without. The choice is yours.

.... I got the impression that it wasn't going to do me any good to
complain.



--
Mark Hansen, PP-ASEL, Instrument Airplane
Sacramento, CA