In response to concerns from the aviation medical community, the Federal Aviation Administration (FAA) has sent out draft guidance for Aviation Medical Examiners (AMEs) on Obstructive Sleep Apnea (OSA) to key industry medical representatives to review within 14 days. Untreated OSA has always been and will continue to be a disqualifying medical condition.

Obstructive Sleep Apnea (OSA) inhibits restorative sleep. It has significant safety implications because it can cause excessive daytime sleepiness, cognitive impairment, cardiac dysrthythmias, sudden cardiac death, personality disturbances, and hypertension. OSA is nearly universal in obese people who have a Body Mass Index (BMI) over 40.

The revised guidance aims to improve safety and pilot health by reducing the burdens and disincentives that may have prevented some pilots from getting an OSA evaluation and treatment. Highlights include:

• Pilots will not be disqualified based on Body Mass Index (BMI) alone. AME’s will consider all of the OSA risk factors and make a recommendation regarding an OSA evaluation. AME’s will issue medical certificates to pilots regardless of BMI if they are otherwise qualified.
• Pilots with significant risk will be referred for an evaluation for possible OSA. OSA evaluations may be completed by any physician, not just sleep specialists, using standard criteria. Evaluations may not require a laboratory sleep study or even a home study if the certifying physician does not feel the pilot requires it.
• Reports from physicians may be given to the AME within 90 days of the FAA exam and forwarded to the FAA to satisfy the evaluation requirement.  The pilot continues to fly during this period.
• Pilots diagnosed with sleep apnea can bring documentation of effective treatment to the AME who will call the Regional Flight Surgeon or the Aeromedical Certification Division for assistance in order to continue flying on the previously issued medical certificate.
• The FAA will send the pilot a Special Issuance letter documenting the follow-up tests required and timing of the reports. Most follow-up reports will only require usage data from the Continuous Positive Airway Pressure (CPAP) machine and a brief statement from a physician.