It's interesting for me to watch this - I already had an OSA diagnosis prior to training. Since I'm already in the system, this doesn't apply to me. But I do know the ramifications for others.
FAA already screens for a lot of diseases at our medicals. Unless you have high blood pressure, diabetes, poor eyesight, poor hearing, colorblindness, or some other things and for some reason don't already know about it, then you've probably paid for a diagnosis at some point.
The difference here is that FAA is going to start telling us we will need an OSA evaluation, and that may be the only thing I'm aware of that works this way. In other diseases, we either already know or there is a cheap, quick way for the AME to discover it. This is different, this is FAA saying, "There's a chance you have something, we won't issue until you come back with more info. Here's my bill, and your tests may run $xxxx and cost you 4 months in deferral purgatory."
I really don't think FAA medical wants this headache any more than the rest of us. I'm hoping that's the case and they allow some low cost screening test and revamp the OSA SI process to allow the AME the latitude to issue in-office the first time. I'm also waiting to find out how they deal with negative test results. What if you meet the criteria for a screening and it comes up negative? Will you have to repeat it at each medical?