Good post.
My SI is due to sleep apnea. A few years ago, even before I began my primary training, I was sick of being tired half the time during the day and hit my doctor up. After several tests, a sleep study was recommended and I came up with moderate OSA. I'm 5'8" and 185#, muscular build so the overweight thing doesn't apply. I simply have a restrictive airway.
The CPAP therapy did wonders for me. I don't care what the FAA says, I did and will continue to wear my mask no matter what, it's got nothing to do with flying.
But, of course, they don't trust me to do this, so I have to provide proof once a year. Which entails a lot of pain-in-my-ass stuff. And 2-3 times the cost of a normal exam with the AME. For what? To ensure I'm doing something I'm going to do anyways? Big bro at its worst.
I'm fairly young in my mid 30s, I workout like mad, pulse is real low, two EKGs in the last 3 years came back competely normal. I'm at ZERO risk for medical incapacitation but the FAA doesn't agree with me. So, get your wallet out if you want to keep flying. And pray that the AME doesn't find something to flunk you, because even though I have access to a fancy LSA to rent cheap, I can't even fly that if I fail the exam.
If I was 65 with high blood pressure and a history of heart issues, yep, I see the validity in requiring frequent exams.
If I could do it again, the AME wouldn't have heard a word about my OSA.