January 23, 2015
By Elizabeth A Tennyson
A new FAA policy on obstructive sleep apnea that addresses many of the concerns raised by AOPA is scheduled to take effect March 2.
The new policy closely follows draft guidelines released in April 2014 and will not disqualify pilots from receiving a medical certificate based solely on body mass index (BMI). Pilots believed to be at significant risk for the condition will receive a regular medical certificate and be required to undergo a follow-up assessment. Those who are diagnosed with the condition must receive treatment to continue flying.
The issue of sleep apnea came to the forefront in 2013 when the federal air surgeon described a planned policy change in an FAA medical bulletin. Under the original FAA proposal, pilots with a BMI of 40 or greater would have been required to undergo testing for sleep apnea by a board certified sleep specialist. The FAA said it planned to expand the policy to include all pilots with a BMI of 30 or greater.
But AOPA strongly objected to requiring thousands of pilots to go through expensive and intrusive testing based exclusively on BMI. The association and other aviation groups turned to Congress for assistance, and the House passed a bill that would have required the FAA to go through the rulemaking process before introducing any new policy on sleep disorders.
In December 2013, the FAA stepped back from its initial policy announcement and began working with stakeholders, including AOPA, to address concerns about sleep apnea.
Under the new policy, announced Jan. 23, the risk of obstructive sleep apnea will be determined through an integrated assessment of the pilot’s medical history and symptoms as well as physical and clinical findings. Aviation medical examiners will be provided with guidance from the American Academy of Sleep Medicine to assist them in determining each pilot’s risk.
Pilots who are determined to be at significant risk will receive a regular medical certificate and undergo a sleep apnea evaluation. That evaluation can be performed by any physician, including the AME, and does not require a sleep study unless the physician believes one is needed. Pilots will have 90 days to complete the evaluation and forward the results to the FAA’s Aerospace Medical Certification Division (AMCD), the regional flight surgeon’s office, or the AME. Thirty-day extensions will be available to pilots who need more time to complete the process.
If the evaluation does not lead to a diagnosis of obstructive sleep apnea, no further action will be required. Pilots who are diagnosed with the condition can send documentation of effective treatment to the AMCD or regional flight surgeon to arrange for a special issuance medical certificate to replace the regular medical certificate issued previously.
“The effectiveness of the new policy will depend on how aviation medical examiners implement it,” said Rob Hackman, AOPA vice president of regulatory affairs. “We continue to be engaged in this issue and we encourage AOPA members to tell us about their experiences once the policy takes effect.”