Obstructive Sleep Apnea is a condition that, if untreated, can have significant aeromedical complications such as Excessive Daytime Sleepiness (EDS), heart rhythm disturbances, stroke, diabetes, high blood pressure, as well as memory and concentration difficulties.
The FAA considers certification of sleep apnea under a Special Issuance Authorization. However, the certification procedure for sleep apnea was amended in March, 2015.
There are two important distinctions with the amended policy:
At the time of your flight physical, the aviation medical examiner will determine which of six possible risk groups you fit into, summarized here:
Group 1 includes applicants who have sleep apnea and have been granted a special issuance under the AME-Assisted Special Issuance program. For those pilots, the procedure is unchanged and you will continue to be certified under the provisions of your existing Special Issuance Authorization.
Group 2 includes applicants who are currently being treated, have been diagnosed with, or have been evaluated for sleep apnea, but who have not yet been granted a Special Issuance. Your AME will issue you a medical certificate at the time of your flight physical if you are otherwise qualified, and will provide you with a Specification Sheet A. You will also receive a letter from the FAA requesting additional information to be provided within 90 days.
Group 3 will include applicants who are determined to NOT be at risk for OSA. No further evaluation will be required.
Group 4 includes applicants who may be at risk for OSA based upon signs and symptoms (noted in *Tables 2 and 3). The AME will discuss those risks with you and provide educational materials. A medical certificate will be issued if you are otherwise qualified.
Group 5 applicants are those who are determined to present significant risk for OSA. The AME will issue you a medical certificate provided you are otherwise qualified, and will be provided Specification Sheet B. The FAA will follow up with a letter requesting that additional information be provided within 90 days.
Group 6 applicants will represent an immediate safety risk. These applicants will NOT be issued a medical certificate at the time of the exam, and will be deferred to the FAA for review. A sleep apnea assessment and documentation of appropriate treatment, if diagnosed, will be required before a medical certificate can be issued.
*The determination by the AME will be based in part on “signs and symptoms” as referenced in the American Association of Sleep Medicine (AASM) Tables 2 and 3.
The presence of any of the signs and symptoms simply indicates the possible risk for sleep apnea, and that screening questions should be asked by the AME at the time of the FAA physical examination.