Here is another reason (besides gaining more useful load) to drop those extra pounds. Not surprising giving the state of Americans regarding eating/exercise habits and obesity. From Avweb today:

Pilots and controllers who may be obese will have an extra hoop to jump for their medical certification to ensure they don't have obstructive sleep apnea (OSA). Federal Air Surgeon Dr. Fred Tilton has notified (PDF) Air Medical Examiners (AMEs) that they will soon be required to measure the body mass index (BMI) of all pilots and controllers during their medicals. Anyone with a BMI of 40 or more (up to 25 is normal) and with a neck circumference of 17 inches or more will automatically have to be evaluated for OSA by a doctor who is a "board certified sleep specialist." Anyone who has OSA has to get it treated successfully before he or she can fly again because OSA is a disqualifying condition. And, chances are, if their BMI is that high (five feet eight inches and 260 pounds) and their neck is that thick they do have OSA, according to Tilton. "OSA is almost universal" in those individuals, Tilton tells the AMEs. OSA disrupts restorative sleep and causes daytime sleepiness, cognitive impairment and can even cause sudden cardiac death, but Tilton doesn't say in his brief note what data (how many OSA-related accidents have been recorded, for instance) his staff have used to draft the new rule. But it doesn't end with the obviously fat.

Tilton says that while the initial action will target those with the BMIs above 40, his plan is to root out all sleep apnea victims and ensure they don't fly until they're treated. "Once we have appropriately dealt with every airman examinee who has a BMI of 40 or greater, we will gradually expand the testing pool by going to lower BMI measurements until we have identified and assured treatment for every airman with OSA," he wrote. That means even the moderately overweight (BMI of 30 or less) can likely expect the referral to a sleep specialist because Tilton says that up to 30 percent of those who carry an extra 20 or 30 pounds have OSA. For unknown reasons, pilots will be targeted first. There are "logistical details" to be dealt with before the rule is implemented for controllers but Tilton said the plan is to include them, too. National Air Traffic Controllers Association declined comment.

I saw this too - I just had a my medical today, and every year it gets more difficult to deal with the FAA. My doctor told me that the FAA will probably be contacting me about a very minor health issue that I've reported every time I've had an FAA medical and they've never had a problem with. He's had several other guys with this and other issues that have had the FAA contact them this year for the first time wanting more info. It seems they are really getting picky now. Eventually they will reach their goal of eliminating every one for some sort of medical issue!

Sorry to hear this. I know it doesn't help, but Dr. Tilton is a good guy. He used to be Dee's boss when she worked at the FAA. Level-headed and an active pilot. But then there is the rest of the bureaucracy.

I know a lot of guys and gals at work that this is going to be an issue for. Some I wonder how they get a medical in the first place.

This is a bit rediculous. Recently I was discussing apnea with a friend who had been diagnosed. He was telling me that the CPAP gizmo records usage and the FAA can demand access to that data. The proposed requirement for continued certification is 7 hours a night, 70% of all nights. Folks that fly freight or international, with extremely variable schedules in time zones all over the planet, will tell you that they don't sleep 7 hours a night. They also would find it difficult to impossible to use it 70% of all nights. And with a 17" neck size triggering mandatory evaluation I see mass medical groundings on the horizon.

I'm not a fan. Sleep apnea has been a buzzword in the medical field for the last few years and while I believe it does exist and the treatment (CPAP) can be very helpful, I do not agree with a blanket policy to try to weed it out. I would be interested in research behind this decision. If obesity is the problem let's deal with the problem instead of trying to cure the it by treating the symptom. Unless of course the sleep apnea really is causing obesity then sign me up! I'd love to shave that extra 10lbs of insulation I can't seem to get rid of!

I just danced this dance. For several months.
Yes, the recording CPAP machine records your time/frequency of use, it also records your breathing patterns while you are asleep-to be evaluated by both your sleep specialist AND the FAA. Too many "episodes" of delayed breathing and you get to move on to full face mask or a Bi-PAP (pressure assisted both in and out) (or whatever) till you meet standards. My special issuance 3rd class requires 6 hours of sleep per night 75% of the time for the 6 months prior to my next (yearly) exam-and hopefully renewal. That will be a challenge for me. I am typically a 4-5 hour per night sleeper with an occasional 7 hrs to catch up.
It is not all bad. On the good side, I am sleeping the best I have slept in a couple of decades. I can drive a reasonable distance without getting sleepy to a point of being dangerous on the road. Also, I have a lot more daytime energy and enthusiasm. Flying, I never had a problem getting sleepy. I guess I enjoy/love it enough to compensate.
Some thoughts:
Medicine is like the rest of America. Very much fad driven. Time will tell where the middle of the road is (I hope..).If you go in for a consultation you will get bombarded with all kinds of statistics about people with untreated seep apnea having WAY more strokes and nighttime heart attacks. That likely is true (science/epidemiology back it up), but my dear old dad is 93 next month, and has been stopping breathing in his sleep since my grade school days, and (knock on wood) he has experienced neither. I will admit he has NO energy, and has not had any for decades, but he refuses to have a sleep test. Evidently his system has adjusted to the low night time oxygen levels, and his sleep apnea has not been severe enough to "take him out".....

That's my story, and I'm sticking to it....

I'm not a fan. Sleep apnea has been a buzzword in the medical field for the last few years and while I believe it does exist and the treatment (CPAP) can be very helpful, I do not agree with a blanket policy to try to weed it out. I would be interested in research behind this decision. If obesity is the problem let's deal with the problem instead of trying to cure the it by treating the symptom. Unless of course the sleep apnea really is causing obesity then sign me up! I'd love to shave that extra 10lbs of insulation I can't seem to get rid of!

My 1st cousin is skinny, and he needs/uses a CPAP.
It is not just weight related. It also runs in families-and that got me. Also I could afford to shed a few...

Littlecub wrote:

I'm not a fan. Sleep apnea has been a buzzword in the medical field for the last few years and while I believe it does exist and the treatment (CPAP) can be very helpful, I do not agree with a blanket policy to try to weed it out. I would be interested in research behind this decision. If obesity is the problem let's deal with the problem instead of trying to cure the it by treating the symptom. Unless of course the sleep apnea really is causing obesity then sign me up! I'd love to shave that extra 10lbs of insulation I can't seem to get rid of!

My 1st cousin is skinny, and he needs/uses a CPAP.
It is not just weight related. It also runs in families-and that got me. Also I could afford to shed a few...

You make a valid point. If sleep apnea is like a plethora of other medical conditions and is influenced by factors like heredity and lifestyle and skinny people can have it too, then why not identify and treat the signs and symptoms of sleep apnea instead of targeting big people with big necks. My weight and height gives me a fairly high BMI even though my percentage of fat is only 16% and I work out 4-5 days a week pretty hard. And yet just like the "big" person I may or may not have sleep apnea and we could both pass our 3rd class medical tomorrow and not be the better for it. Either one of us could walk out and die of a heart attack in the parking lot. We need to be more realistic and stop chasing our tails. Maybe next year a glass of wine will be on the "good" list again too ...

CW

I would be interested to know if/how many accidents have been attributed (partly or entirely) to this malady. Show me some data before making such a far-reaching decision.

Greg

here we go again... Guvmint jerks telling us how to live our lives.... I don't care how nice a guy this doc is and was to your wife.. stay the F.....ck out of my life.....and is sleep apnea covered by Opey Dopey Care....

Man, 7 hrs 70% of nights is a lot of sleep. I rarely sleep 7 hrs, usually 5. Not cause I have sleep apnea, cause I just don't sleep. Havent since I staryed working out of high school, and body just never adjusted to needing more. Most days, if I force myself back to sleep, I feel so crappy when I want to get up that I hardly can get out of bed.

I went to the sleep specialist for a sleep test when my skinny 1st cousin's wife (RN-plus medically very savvy) told me how much better my cousin felt after a couple months on the CPAP machine.
I went for the sleep study in consideration of my health and quality of life. I am not in the FAA's (current) target BMI group-but not a long ways from it.
I disclosed the diagnosis in my airman's medical questionnaire, was denied, and spent 3+ months round n round with the FAA before receiving my special issuance medical- good for 1 year from the date of exam/denial.
I am glad I am on the CPAP. It has improved my quality of life. I did that as an adult, making an adult decision.
I, too, am not fond of the intrusion of the "powers that be" into my life and minor health issues.
I had a problem for a couple decade and I had no idea I had it. I flew safely during that time. Now I have taken remedial action, and am doing very well, thank you, other than the hoops and $ I have to jump through/spend to satisfy the regulatory bureaucracy-that is largely unnecessary.

I believe this is a well intended program that is essentially "out of bounds".
I think that the FAA medical branch should saturate us with information about the condition, its consequences, and its rewards, but then treat us as adults to do the right thing. [added paragraph as edit]

Back to the "I have to relate to the world as it is, for I am not capable of changing it" mode....

Most days, if I force myself back to sleep, I feel so crappy when I want to get up that I hardly can get out of bed.

Hopefully they will recognize some way, before long, that we all are different, in oh, so many physiologic ways, that it becomes a soft guideline, instead of a hard standard.
My sleep doc says he is pleased if I use the machine every night, and get 4+ hours of sleep most nights. I can easily live with that. I hope the FAA becomes this enlightened!

I've been a night cargo pilot for 34 years. The last 20 in international long haul. I never sleep more than five hours when I'm exhausted and less when I'm not that tired. I went for a sleep study two years ago and ended up getting a turbination(sp) I had one nostril almost completely blocked off and they opened it up with surgery. By disclosing this on my next physical I was denied and forced through all the hoops again. I passed both the sleep study and the "staying awake" test(forgot the official name) I'm retiring in 2014 and not sure I want to fool with another medical. LSA is looking good. If you fly for a paycheck be careful and ready if and when you choose to disclose on your physical. The 40 BMI number they are starting with initially is a pretty large person. In the end we just have to like it.

I wonder what the FAA estimate is for the number of professional pilots that will lose their jobs because of this

Littlecub wrote:
I believe this is a well intended program that is essentially "out of bounds".
I think that the FAA medical branch should saturate us with information about the condition, its consequences, and its rewards, but then treat us as adults to do the right thing. [added paragraph as edit]

I think this is spot on. I also think that there really are multiple issues here and a one size fits all approach doesn't fit too well. I might be able to buy off on something like this if it is supported by research, but applying it to the recreational pilot doesn't make sense.

As for sleep for the 121 folks, our world is about to change in January. As a poor "we have to do something to appease the public" reaction to the Buffalo crash, all the rest rules are getting a major revamp. Some of it is good, but in the end, you can't regulate personal responsibility and a reg isn't going to make me get more sleep. And of course it is so convoluted that our system chief pilot has bluntly said that it will be almost impossible for a pilot to keep track when he is legal.

http://www.aopa.org/News-and-Video/All- ... olicy.aspx?
I did not paste this as you really need to read all the comments connected to the article
AOPA has Demanded a delay and cancellation of this, as there is absolutely no reseach to back up the kneejerk reation!!
I do like one of the comments below the article where they thought the DOC who issued this will now retire and then open up a bunch of FAA approved sleep clinics??
Also for the nay sayers that AOPA does nothing for us GA pilots, I think this is really a help.

iceman wrote:here we go again... Guvmint jerks telling us how to live our lives.... I don't care how nice a guy this doc is and was to your wife.. stay the F.....ck out of my life.....and is sleep apnea covered by Opey Dopey Care....

Agreed. More effort should be put into education.

BTW, just to give y'all some round numbers....
I have self insured medical insurance with a $3K deductible ($922/mo for wife & I)
2 nights sleep studies about $1500 per night.
I nose hose with CPAP machine attached $1500
Follow up visit for the new FAA "current status/compliance" letter needed this year was another $150+ or so.
The insurance company (Lifewise) would NOT even count ANY of it towards my yearly deductible.

On the plus side of the leger:
I know a great guy/sleep specialist doc here in Central WA.
As stated earlier, quality of life is significantly better.

Thanks to federal mandates that have been extended, but our blue state has decided to "carry on" anyway, our insurance broker is telling us we will either get an insurance cancelation letter or a hefty+ increase in premiums very shortly (effective end of year).

This thread ties in with the one I just posted.

AOPA webinar

https://goto.webcasts.com/starthere.jsp?ei=1018196

The Importance of Avoiding Falsification on 11/18/2013.

They talk a lot about medical issues. You can get your butt in a sling real fast with the FAA. They will revoke your pilot certificate too. Not just your medical. The FAA is saying if you don't follow the rules you can't be trusted to fly.

If you are not aware, revoke means you start all over.

G'Day