Flight Surgeon Rekindles the debate about Sleep Apnea Policy and Procedure

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UPDATE: FAA Asks Industry to Review Sleep Apnea Guidance


The FAA Flight Surgeon has reacted to the criticism of his announcement of a new medical standard for sleep apnea in a way which industry will probably grade as half good. He has asked for industry input on his revised Obstructive Sleep Apnea rules, but his process fails miserably.

In the above-linked Update, Frederick E. Tilton, M.D. requested that the key industry medical representatives for their review. That’s better than his previous unilateral issuance of the sleep apnea criteria. Somewhat defensively, it was stated: “Untreated OSA has always been and will continue to be a disqualifying medical condition.” The revised policy was summarized as

· the BMI calculation is no longer , in and of itself, disqualifying; the AME must make a recommendation based on all of the risk factors;

· no longer will a pilot, who is identified as an OSA candidate, have to go to a sleep specialist; any physician now will be authorized to make an assessment;

· the pilots may fly during the evaluation period including the Regional Flight Surgeon’s review; and

· the pilot will receive a Special Issuance letter which will specify the procedures to be followed.

One of the previous criticisms of the AMEs was the added work required; it will be interesting to see if the revised procedures are accepted.

The second aspect of this Update fails dramatically in that it is neither in the format of a rule making and it fails by a substantial margin to meet the Administrative Procedure Act’s comment period of 30 days. The aviation associations uniformly commented that such a radical change needed to be processed under this statute and to confirm this position both Houses of Congress are considering legislation which would mandate such protections. The Update specifies that comments are due within 14 days. The informal process will hardly satisfy those who found fault with the past effort.

Stay tuned; this should be an interesting debate. In fact, it appears that the Flight Surgeon has operated in a way to test the industry’s patience.

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