I have OSA and I am about to get a CL3 Exam.

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I am due to get my first class 3 medical exam. I was diagnosed 11 years ago with OSA and have not had a sleep study since then. I use my cpap but it does not record data as far as I know, there is no sd card that I can see. I am thinking of getting another sleep study to verify that I still need the CPAP as I have lost 60 pounds since I took it. If deemed that I still in fact need the cpap I will get a new machine capable of recording the data. From what I understand I can get a 1 year hold on having to submit the report in order to prove compliance. Any thoughts?
 
I don’t know. The protocol does not seem to account for someone who proactively performs a sleep study, is negative, but has risk factors.

https://www.faa.gov/about/office_or...es/aam/ame/guide/media/FAA OSA Flow Chart.pdf

going by this flow chart, you were previously assessed and meet the ** footnote, then you move onto risk factors. Even if you were assessed negative enough the day before, my read is the flow chart directs the AME to defer if you have the right(wrong) risk factors. Yes, that seems absurd, so I would hope the flow chart is recognized to be flawed.

Your sleep study should be as close to your exam as possible, within 30 days probably. Assuming a negative report, you’ll need to bring a paper copy of the report to the exam. Tell the team doing the study that it’s for the FAA and they should include the desired verbiage.

But a counter point - if you still need the cpap, you want it as soon as possible. After your medical, you’ll have 30 days to show a compliant report, so there is no time to waste with supply chain inefficiencies...not being able to get a unit is not an excuse.
 
I am going to call and set up the sleep study tomorrow. I have a CPAP just not one that can prove compliance. That is the whole reason for obtaining a new one. If I have the AME exam prior to the sleep study can he still issue the 3rd class in the office and then I will receive a follow-up request from the FAA?
 
Unregistered said:
I am going to call and set up the sleep study tomorrow. I have a CPAP just not one that can prove compliance. That is the whole reason for obtaining a new one. If I have the AME exam prior to the sleep study can he still issue the 3rd class in the office and then I will receive a follow-up request from the FAA?
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As you make your selection for the new machine....
  • Compare pricing from reputable online vendors (such as www.cpap-supply.com and www.cpap.com) before purchasing from the sleep doctor or a durable medical equipment provider
    • Often the prices from the doctors and the DME's are so inflated for their profit, it's crazy and disheartening others pay that much.
  • Make sure the machine you get writes the data to an SD Card like you would use in a digital cameral. I have the Philips Respironics Dreamstation and it does.
    • Why the SD Card? That makes it easy to offload the data into a report generator like OSCAR or SLEEPYHEAD. Both of these online apps will build a report that the AME and FAA will accept.
Your sleep doctor will need to write a report to hand into the FAA. As with many things going into FAA Medical, there is a wrong way, a decent way, and the correct and proper way of writing these out.

Check in with our resident AMEs Doctor's Lou, Bruce, and Brad for suggestions on a "boilerplate template" that lists the required items. @lbfjrmd @bbchien @Brad Douglas MD MPH AME

Also make sure the doctor writes the letter in plain language that anyone can understand. No showing off that he owns a wall full of medical thesauruses (or is that thesaurusi?) and isn't afraid to use them.
 
Unregistered said:
I am going to call and set up the sleep study tomorrow. I have a CPAP just not one that can prove compliance. That is the whole reason for obtaining a new one. If I have the AME exam prior to the sleep study can he still issue the 3rd class in the office and then I will receive a follow-up request from the FAA?
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I don't seeing the AME for the exam first will work. You'll have to note on your Class 3 application that you have an OSA diagnosis and it's being treated with CPAP. The AME will ask, "OK, where's the paperwork that shows compliance?" Then you're stuck.

What you CAN do, is ask the AME for a consult first.

You won't have any record of CPAP compliance until you get some time on your new machine. There will be a form to fill out that's going to ask you to "self certify" that you have been compliant even though your machine hasn't been recording. Depending on the brand (like DeVilbis) you might be able to generate a report using an online utility and some codes that are shown on the machine display. Most others, especially the new ones, will use as SD card. Be careful if it's a DeVilbis, though, that "SmartCode", or whatever they call it, does have some bugs.

This will be a Special Issuance - it's likely that your first class 3 exam will be deferred to FAA Medical by the AME. After that first one, you can get it renewed in-office.

I don't know about a "1 year hold". I *think* you turn in the data you have. I *think* at least 30 days, but probably more, will be OK that first time.

One of the resident AMEs here might be able to help.

Getting that first Class 3 and Special Issuance with OSA isn't a hard thing to do, but there are certain steps to take and some of them might take a lot of patience.
 
1 year hold? No such thing! The AME can issue you but if you can’t produce the “well treated” letter And a CPAP use report of an initial 30 days, in which more than 75% on nights show >6 hours’ usage, you’ll end up denied.


B.
 
bbchien said:
1 year hold? No such thing! The AME can issue you but if you can’t produce the “well treated” letter And a CPAP use report of an initial 30 days, in which more than 75% on nights show >6 hours’ usage, you’ll end up denied.


B.
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@bbchien I sent you an email via your website regarding another issue that I am experiencing as well. Thank you all for the time that you took to respond.
 
Tarheelpilot said:
Why not just buy a new machine so you have the data? Then do the study after issuance and work with the AME regarding getting off the cpap.
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I get what he’s trying to do: He’s lost a lot of weight and may not have OSA anymore. Get the sleep study, and if no OSA then document that and get the medical. If he does have OSA then get a new CPAP and start building numbers and then get the medical.
 
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Unregistered said:
I am going to call and set up the sleep study tomorrow. I have a CPAP just not one that can prove compliance. That is the whole reason for obtaining a new one. If I have the AME exam prior to the sleep study can he still issue the 3rd class in the office and then I will receive a follow-up request from the FAA?
Click to expand...

My older CPAP did not have an SD card, but recorded internally. You may want to check and verify that there is no data capture for compliance.
 
Rcmutz said:
My older CPAP did not have an SD card, but recorded internally. You may want to check and verify that there is no data capture for compliance.
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Older machines almost always have some sort of display that shows "compliance" percentage, but my recollection is that it's pretty limited and it won't satisfy the current FAA reporting requirements. My first one showed a couple of different values, and at the time they were good enough for FAA. By the time that one wore out, I got a newer one that captured more data even though it didn't have an SD card. That one, DeVilbiss, had some codes it would display that could be entered into their web application to print a report. That one had 2 problems: there was a bug in how the codes were generated (I can't remember exactly, but at some point an internal register would stop updating when an integer value reached a limit and that threw off all the values from then on.) There was also the problem that FAA changed some of their reporting requirements and that machine wouldn't collect enough of the right kind of data. That's when I upgraded to my current CPAP with an SD card that I can read and generate my own reports.
 
Here's my thought, get this straightened out before you go for the Class 3 exam.
 
Actually the AME can ONLY issue if the FAA sees the report - but on many NEW Special Issuances - the FAA will not allow the AME to issue without the FAA doc of the day seeing the reports - so what I usually do is I call the doc of the day, send in the report - and put the medical on hold until the Doc of the day calls me back and then either a Verbal or hold - so the AME can NOT act on his /her own until the FAA sees it.
 
Sleep apnea, the first issuance: is the one exception where the AME CAN issue. However you will immediately receive a demand letter for:
The initial sleep study
The record of at least 30 days of CPAP use from the machine in which 75% of the ningthly use "bars" are over 6 hours tall.
And the treating doc's statement that you have no long any complaint of daytime sleepiness, appear well rested, comply nightly and have on exam no stigmata of right heart failure.

Given that some people will just not tolerate a mask, I consider it bad practice for an AME to issue unless you already have this. If you turn out to be one who has trouble getting the zero PAP ramp to work for you 30 nights will be a huge battle and then you will get a denial.

There is also a "it's me in the records" affadavit you have to sign. The word is that there was a pilot who was just bound and determined to never wear the mask. He trained his Golden Retriever to wear it. When he turned in the machine report the turned in all the graphs with a respiratory rate of 40. That led to an investigation and when the admin. asst. arrived at the airman's house there was the machine on the floor-right next to the Golden's Doggy Bed.
 
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