In response to concerns from the aviation medical community, the Federal Aviation Administration (FAA) earlier this month sent draft guidance for Aviation Medical Examiners (AMEs) on obstructive sleep apnea (OSA) to industry medical representatives to review. Untreated OSA has always been and will continue to be a disqualifying medical condition, the agency reiterated.
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. AMEs will consider all of the OSA risk factors and make a recommendation regarding an OSA evaluation. AMEs 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 CPAP machine and a brief statement from a physician.
“While some details still need to be worked out, the draft guidelines developed by FAA represent a significant step in the right direction over the policy announced last year,” says Jim Coon, senior vice president of government affairs for the Aircraft Owners and Pilots Association (AOPA), on the association’s website.
While the AOPA is optimistic about the revised guidance, the National Sleep Foundation (NSF) sees cause for optimism as well, in its case in the US Senate. It appears unlikely that Senate Bill 1941, which would mandate rule-making on the aviation industry-OSA issue will move forward. The NSF led a lobbying effort with leaders in the sleep community, including doctors and business people, against S. 1941. Similar to the NSF’s stance on the Public Law #113-45, the NSF, others in the sleep community, and the FAA’s own Flight Surgeon, oppose rule-making for numerous reasons, including the lack of any timetable during which a rule must come forward.
In February, the House passed a bill, supported by the AOPA and the National Business Aviation Association, in support of rule-making [http://www.sleepreviewmag.com/2014/02/house-rulemaking-bill-pilots-osa/]; however, it appears now that a compromise of stakeholder-accepted guidance may win out.