Self grounded with sleep apnea - Next Steps?

boulderpilot

Well-Known Member
Hi Doc,

I am 35 years old and last received a third class medical in January 2013. I went to visit a sleep doctor late last year because I was snoring a lot and waking up with terrible headaches. The doctor who owns a king air suggested I get a sleep study done and also try a dental appliance. I followed through on both and self-grounded myself. He told me I would have no trouble getting a special issuance if the dental appliance worked. I'm a CFI, but do not fly professionally and was moving across the country at the time, so grounding myself wasn't a big deal.

I got the appliance in the mail in January and it has worked amazingly well. No snoring. No headaches. I went to see a new sleep doctor last week and have set an appointment for a follow-up sleep study next week. Before I do the sleep study, I want to make sure I've done everything right. I've read over much of what's in this forum re sleep apnea, but have a few questions.

1. Because I already have a 3rd class medical with a few years left on it and have self-grounded myself, can I just get a special issuance without getting a new medical? If so, how do I do this? My reasoning here is that I want to avoid a certificate denial because, I would like to fly gliders and/or LSA. I think I saw this mentioned in one of the threads as a tactic for avoiding a denial. The post was in reference to ATC, I but wanted to make sure it was something pilots could do as well. What I thought it said was that a denial of a special issuance isn't a denial of a medical, so you can still fly gliders or LSA. I know the likelihood of me getting a special issuance is very high, but still want to make sure I avoid the denial if possible. Or does the denial of a special issuance on an existing certificate result in a revocation of the medical?

2. I should plan to send the FAA all of the following docs:
  1. the results of the initial sleep study showing SA
  2. the results of the latest sleep study while wearing my appliance (assuming its shows no SA)
  3. a letter from my new doctor stating that my treatment is working and that I have no daytime somnolence.
  4. MWT test (see below.)
3. I know the FAA often asks for a MWT test. My doctor did not recommend I have one. Given that I know it is commonly requested by the FAA, I asked her about it and she said didn't think the insurance company would approve it but scheduled me for one in case the insurance company says ok. If I'm able to get the insurance to pay for the test, I'm planning to do it. But if they don't want to pay for it, should I do it anyway? If the FAA is going to require the test, I don't want to have to wait around for 8-10 weeks for the FAA to ask for the test and then have to start the clock over again. The FAA doesn't care if the test is the 20 min or the 40 min right?

4. The most recent doc prescribed me 1 ambien to take for the test. I didn't do that for the last test. Does the FAA care if I'm medicated during the sleep test?

5. Both docs also said that my nasal passages are blocked from a deviated septum and have recommended surgery. They don't think it will make a huge difference re my sleep apnea but could improve my general daytime breathing and sinus inflamtion. Will the FAA require a follow-up sleep study after the surgery? If so I might just postpone the sleep study until I haver surgery in a few months.

6. Lastly, I had my medical deferred a few weeks in 2002 because I had been previously prescribed Ritalin for "distractibility" by my primary care doctor. My doctor provided a letter saying I was off the meds and in good health etc, to the regional flight surgeon and the regional flight surgeon sent me my medical a few weeks later without any limitations. I've been marking the appropriate box on the form on subsequent medicals and saying "no changes" for years, but sometimes I wonder if OKC took a look at this they would have a different opinion than the regional flight surgeon did in 2002. I know previous ritalin prescriptions have been very problematic for medical applicants. Could this review by OKC of my record re the sleep apnea bring that back up and result in a denial or revocation, or tons more testing on my part? (goes back to question 1 that I don't want a denial... particularly with some legal/regulatory movement possible on third class medicals in the next 12-24 months.)
 
1) Yes you can. Submit all of the medical records to the FAA with a letter requesting consideration for a Special Issuance. If the Special Issuance is denied, the medical is denied. A Special Issuance is a waiver to the regs regarding a medical condition. Once the medical is denied, you cannot self-certify with the driver's license.
2) That is what you need.
3) If the new sleep study is normal and the sleep medicine doctor write that you do not have daytime drowsiness, a MWT most likely will not be requested.
4) The FAA wants the test without medication
5) I do not think they will ask for anything after the surgery
6) OKC and the Regional Flight Surgeon are on the same page. Just check PRNC and the will not even look at it.
 
The sleep lab just called saying my insurance company has denied the test and they want me to do a home sleep test instead. Will the FAA accept those results?
 
I have a CPAP and just have to get a checkup every year and take a letter to my AME. I have a restriction for no class after but I keep a first class so it's not a problem.
I have more problems with my eyes.
 
I went for a sleep study at the hospital, insurance paid for it.
I am required to get a yearly follow up and get a letter from my Pulmonary doctor to take for my 1st class (every other one) and I am issued a 1st class then. No waiting.
And I sleep so much better and so does my wife.
 
I guess the insurance companies only approve studies in the lab annually, but you'd think they would approve it after treatment from the dental device to see if the device is effective.
 
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