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.”