More than a year of lobbying work by general aviation’s advocacy groups on the FAA’s sleep apnea policy has brought considerable revisions to the agency’s original proposal, which would have forced costly sleep studies on pilots even if they had shown no symptoms of the disorder.
The new policy, which takes effect March 2, will not disqualify pilots from receiving a medical certificate based solely on body mass index (BMI). Pilots believed to be at risk for the condition will receive a regular medical certificate and be required to undergo a follow-up assessment. Those who are diagnosed with the condition must receive treatment to continue flying.
“The FAA’s new policy, as proposed, will not require a sleep study unless a pilot reports symptoms specifically associated with sleep apnea to their aviation medical examiner,” said Sean Elliott, vice president of advocacy and safety for the Experimental Aircraft Association. “We are still studying all the details of this proposed policy, but it is an improvement on the agency’s initial proposal more than a year ago that was quite overreaching, mandating additional tests based on Body Mass Index and other indicators even if no symptoms had been present. We found that very intrusive and draconian. EAA felt it was very important to get back to common-sense guidelines that can be primarily addressed between pilots and their local aviation medical examiners.”
The new policy “combines a focus on safety with a commonsense approach that lets pilots who haven’t been diagnosed with an illness keep flying,” added Mark Baker, president of the Aircraft Owners and Pilots Association (AOPA).
The issue of sleep apnea came to the forefront in 2013 when the federal air surgeon described a planned policy change in an FAA medical bulletin. Under the original FAA proposal, pilots with a body mass index (BMI) of 40 or greater would have been required to undergo testing for sleep apnea by a board certified sleep specialist. The FAA said it planned to expand the policy to include all pilots with a BMI of 30 or greater.
But GA’s alphabet groups strongly objected to requiring thousands of pilots to go through expensive and intrusive testing based exclusively on BMI. The groups turned to Congress for assistance, and the U.S. House of Representatives passed a bill that would have required the FAA to go through the rulemaking process before introducing any new policy on sleep disorders.
In December 2013, the FAA stepped back from its initial announcement and began working with pilots and GA advocacy groups to address concerns about sleep apnea.
Under the new policy, announced Jan. 23, the risk of obstructive sleep apnea will be determined through an integrated assessment of the pilot’s medical history and symptoms, as well as physical and clinical findings. Aviation medical examiners will be provided with guidance from the American Academy of Sleep Medicine to assist them in determining each pilot’s risk.
Pilots who are determined to be at significant risk will receive a regular medical certificate and undergo a sleep apnea evaluation. That evaluation can be performed by any physician, including the aviation medical examiner, and does not require a sleep study unless the physician believes one is needed.
Pilots will have 90 days to complete the evaluation and forward the results to the FAA’s Aerospace Medicine Certification Division, the Regional Flight Surgeon’s office, or the aviation medical examiner. Thirty day extensions will be available to pilots who need more time to complete the process.
If the evaluation does not lead to a diagnosis of obstructive sleep apnea, no further action will be required. Pilots who are diagnosed with sleep apnea will then have to send documentation of effective treatment to arrange for a special issuance medical certificate to replace the regular medical certificate issued previously.
The new policy also eliminates the initial plan by the FAA to eventually extend required sleep evaluation to those with a BMI of at least 30. That provision was among the most-opposed by EAA, as it was predictive medicine without evidence of safety benefit that would be extremely costly for pilots, even those without symptoms, association officials noted.
“We appreciate the FAA’s willingness to move forward toward a more realistic policy for addressing and treating this disorder within the aviation community,” Elliott said.
“It’s also important for pilots to be forthcoming with their personal AMEs if they do have sleep apnea symptoms, for their personal safety and that of their passengers,” he continued. “This is not simply because it’s required within the regulations. As EAA continues to push for medical certificate reform, we are telling regulators, the Administration, and Congress that pilots are responsible when self-certifying their fitness prior to every flight. Reporting and addressing disqualifying conditions by those who have them are essential to our overall goal of wider freedoms for pilot medical certification.”
So they say “Reporting and addressing disqualifying conditions by those who have them are essential to our overall goal of wider freedoms for pilot medical certification.”. Wonderful, we have to willingly allow the FAA to ground us for B.S. conditions out of hope that they will see how honest we are and eventually relax the draconian rules they hold over us. Do the people who make these quotes ever stop to think just how stupid they sound. Every trip to the AME is anouther round of “You Bet Your License” so who is really going to open up and disclose every problem they think they might be experiencing and give them the ammo to deny the medical and send you off to untold testing and possible treatment, a lot of which can be unpleasent, expensive and maybe even dangerous in itself.
If you are fit to drive to the airport, you are fit to fly the airplance when you get there period…
So the need for the Sleep Study will be based on part as to whether the pilot reports symptoms specifically associated with sleep apnea to their aviation medical examiner. OK so what pilot in their right mind would report such symptoms ??? If I was in such a situation I would say “No Problems” and leave it at that. What are they going to do, connect you to a Lie Detector before they start questioning you on your symptoms ? When you consider the consequences of saying yes to the symptoms, expensive testing, mandated use of sleep apnea equipment and loss of pilot privdlidges if not fully complient with testing and treatment is not something I would want to be subjected to.
By the way afterlooking at the guy pictured with his “solution” I would rather be grounded then to try to sllep like that. Maybe the equipment is helpful for some people but it looks like it would cause more loss of quality sleep then it delivers in return.
I don’t know if the soon-to-retire Dr. Fred Tilton was the instigator or merely the front guy for the BMI-based screening proposal, but his background was Air Force. I have no service history myself but a few of my pals used to fly F4s, F14s and so forth and briefed me on how competitive military flying is.
OTOH, I feel there is a big difference between the risks and responsibilities of “recreational GA” flying and everything else. That is to say, is it truly necessary to subject the 60 year old Cherokee driver to the same standards as an airline captain or F15 driver? Of course not.
The issue is one of common sense. I personally could be satisfied with LSA/Sport Pilot type rules (.e.g. stay out of the way of professional pilots) except for the fact I would have to write off my investment in my current E-AB and fork out a $100+K for a barely capable LSA toy. As a retiree I am simply unwilling to do that to play by the rules of some power-hungry FAA policy maker.
I am currently sitting on the sidelines, waiting to see what the Feds (FAA, DOT, GAO and so forth) are willing to sign off on. I know they are being lobbied hard by the AMA and and other financially-interested parties, but those guys are cutting their own throats. Once guys like me feel that flying is no longer viable from a financial and PITA viewpoint, those AME’s better switch over to administering pee-in-a-cup physicals to the many thousands of over-the-road truckers who need a medical certificate to support their families.
Just BTW, the new questionnaire, guidelines, protocol or whatever you want to call it will have to be published, probably in the new AME Guide. Everyone with a brain will download them, study and memorize the “correct” answers to let your AME off the hook on this ridiculous farce.
“Kinder, gentler”…a distant, fond memory. Now let’s play along with Washington in the new game ” How much intrusion can we get away with?”.
It feels like Bud and Cathy in an episode of Father knows Best.