Living With and Managing Sleep Apnea
JIM: I had this problem throughout my life. Driving was always a problem, and I tried to make sure that no place I ever had to go was very far away because I knew I'd fall asleep. Carol Lynn was complaining about snoring and, more specifically, snoring and then long periods of nothing,
and then a gasp when I would, you know, start breathing again. Obviously, I wanted to enjoy my life with my children more than I felt that I was enjoying it. It's Saturday morning, and the kids are at your bed ready to do something, and I'm just like, quot;I gotta sleep, guys. I'm sorry. I can't play with you. I can't do this.quot; And I look back and I'm like, quot;This just can't be right.quot;
I had been talking to my about possibly having depression symptoms. I remember the other thing that I said to the when I went was that I no longer had any dreams. If you're not getting into REM sleep, you have no dreams. And so she's the one who then said, quot;Okay, we're gonna send you for a sleep study.quot; I spent the night there.
The amount of times that I was technically waking, and as low as my blood oxygen levels were, it was extreme. I was diagnosed with severe obstructive sleep apnea. Surgery, as it turned out, really wasn't a good option for me. The next step was that my did prescribe a CPAP machine. CPAP stands for continuous positive airway pressure.
The idea is they have to get the air pressure to your nose or your mouth or both in order to keep your airway open while you sleep. Because it wasn't comfortable for me to use, I was not using it as well as I should have been, in some cases not at all for weeks at a time. And things got worse, other symptoms appeared. I felt confused and out of it and just not right.
And I realized that I really needed to figure out a way to learn to live with this contraption. Now I'm at the point where I am consistently using it and have been for a long period of time. I definitely feel better. I'm looking forward to feeling better yet. Certainly, I have more energy to do activities with the children than I did before, and we do more.
OSA Screening Guidance for AMEs
*Music* *Airplane Sound Effect* Hello. Welcometo this update on Obstructive Sleep Apneascreening guidance for Aviation Medical Examiners. According to the Federal AirSurgeon, the new guidance willsignificantly improve the safety of the NationalAirspace System while
simultaneously improving pilothealth and career longevity. Today, I'll walk youthrough a triage function resulting in six possibledeterminations. But first, a littlehistory on this topic: In 2008 the NTSB providedrecommendations to the FAA to mitigate the safety riskof Obstructive Sleep Apnea. In response to theserecommendations, the FAA developed lectures onsleeprelated disorders
and in particularObstructive Sleep Apnea, to be delivered at alltraining events. Unfortunately, after fiveyears of awareness training, the number of pilotsidentified with OSA was virtually unchanged. It's important to note thatthe NTSB has recently placed OSA on their quot;Most Wantedquot;list for transportation safety improvements for 2015.
As a result, the FAA hasdeveloped new guidance to address thisgrowing concern. This tutorial outlines the processthat AMEs are expected to perform at eachpilot examination. The process is aresult of input given by industrystakeholders and medical practice guidelinesestablished by the American Academy ofSleep Medicine, or AASM.
AMEs will perform what isessentially a triage function screening and assigningpilots into one of six OSA groups while enteringexam results into AMCS. We do not expect theAME to perform a sleep medicine evaluation,nor do we encourage it. When performing the triage, itis important to keep in mind two principles. Number one: Apilot should not be denied or deferred unless the AMEbelieves he or she represents
an immediate safety hazard. This should be rare regardingOSA. And number two: No pilot willbe deferred based on Body Mass Index alone. Let's go over how anAME will assign pilots to the OSA groups. When examining pilots for OSA,AMEs should apply al judgment using criteriadeveloped by the AASM.
Aviation Medical Examiner Guide Updates
*Music* *Airplane Sound Effect* Hi, I'm Judy Frasier. I'm one of the certification physicians at AMCD, and we're here to talk about some of the AME guide updates. This is in response to questions from the AMEs who are asking for an annual update. So this is the first, hopefully in a series, for
your information. Right now for AMEs, conditions are currently followed by. AMEs have conditions they can issue a regular certificate based on requirements in the AME guide. If they don't meet those they can go to an AASI or an SI, which are all timelimited and require special authorization. A partial list of current conditions AMEs can issue after taking a thorough history and determining if the
condition is stable is listed here. There is a new instructional category in the AME guide and these are conditions that an AME can issue if they're within specific parameters as designed on worksheets in the AME guide. These are the conditions that are currently allowed that have worksheets or instructional information that you, the AME, can issue in your office.
This should speed things up for you because you don't have to call AMCD or your Regional Flight Surgeon for authorization if conditions of the worksheet are met. So what has changedé In the old AME guide if you went to hypothyroidism for all classes you would be asked to submit all pertinent records, a current status, names of meds and thyroid function testing.
Then it would be worked at AMCD or the regional office, and your airman would be given a special authorization that was timelimited. What's new in the guide is there's this new category, and we're asking you the AMEs review the information. If it falls within worksheet parameters, you can issue. you can issue a regular certificate. If anything falls outside of the worksheet criteria, you'll
turn in the information as you did in the past, for a special issuance. So the conditions AMEs can issue are CACI, PreCACI, for example hypertension required an initial work up, lab, EKG, a current status and a history. Now by following the worksheet, that is no longer required and the AME can determine if the hypertension is stable.