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Ever been bitten by a "Sleep Test" ?

cdeerinck

Well Known Member
I recently went to a doctor because when I made the appointment, I had wheezing coming from my lungs after I got done with my open water ocean swims for a few weeks. When I heavily exhaled, I could also hear some bubbling in my lungs, which had happened many years ago when I had some type of lung infection which antibiotics cleared up. By the time of my appointment, it was already gone, but I kept the appointment anyway.

For some reason the doc prescribed asthma medicine even though I have never had asthma.

I mentioned that when I did have the wheezing, that a few times I got extremely sleepy, and had shortness of breath while laying down. For this, she suggested I get a) blood work, b) a chest x-ray, and c) a sleep diagnostic.

After leaving, I began to feel like the doc completely missed the mark, regarding what had occurred, and was overcompensating with tests after the symptoms were gone.

But one thing really concerned me, and that was that if the sleep test somehow showed anything like sleep apnea (which I have never suffered from), that this could somehow make its way into my medical records, and possibly interfere with getting a Class III medical, which I have due in a few months.

I am inclined to not do any of what the doc suggested, given that my symptoms actually were gone before I even went in.

Have any of you ever done a sleep diagnostic test, and later had issues with your Medical based on having done it?
 
sleep test

Given you are an open water swimmer,forgive me for asking is your neck size > = 7" ?, I don't know of anyone who was prescribed a sleep test who passed it.It's designed to justify prescribing sleep Apnea tests and treatments and CPAP machines,that require constant cleaning or risk lung infections,given that you have had them before? Blood tests are a different story.A full set of blood work can give you a heads up as to issues your having and areas to improve before they become issues.Not a fan of x-rays, MRI is the preferd diagnostic but its a good place to start.You can live for quite a wile with out food&water.Air not too long.It may not be a bad thing to have the puffer on hand if you find you can't breath after a hard work out or eating peanuts. Warm water in hot years = lots of bacteria you don't need to come in contact with. Not a Doctor just my experience IMHO.
RHill
 
I've had sleep apnea and had no idea that I had it. I believe this is true for everybody who has it. There are hints other than body mass (I was lean, not chubby), such as, snoring. You may be fooling yourself, just as I was fooling myself. Better to find out and get it fixed than not.

Good luck!

Ed
 
I can shed some light on this subject. I have been diagnosed with sleep apnea and use a CPAP. I did have to show to the FAA that it does not affect my flying. I have never tried to get a Class 1 but I am successful in obtaining a class 2. The only limitations is it expires all classes at one year Vs the standard down grade to a class 3. The first year took a few months for the FAA to review my Doc's report and then approved and sent a letter stating that the Flight Doc can approve every year after as long as my sleep doc showed treatment was effective. So now each year before I renew my medical I make a swing by the sleep doc and show him the CPAP readings and he writes a letter that I give to the Flight Doc. Haven't had any issues but depending on treatment effectiveness your mileage may vary. By the way I'm 6'1 and 200 pounds so it's not always from being obese.
 
Im not a provider, but I used to own a couple of sleep diagnostic centers and worked with a lot of pilots. OSA (obstructive sleep apnea) is kind of a grey area with the FAA. At one point the diagnosis was on the list to get approval for local clearance and then leadership changed and it fell by the wayside.
It all depends upon the AME. Some are old school conservative and turn it into a big hassle and others get you cleared right away. Some Docs reverted back to the old procedures that took a long time. Others clear it locally and I?ve necer seen that kicked back by the FAA (that?s not to say it hasn?t happened).

I strongly recommend Dr. Burr Ross an AME in Phoenix. His medical group owns sleeps centers and he is very progressive with pilots. (His wife is a retired airline captain).

It?s not something to ignore. A sleep study can save your life.
 
From what I have seen, very few people walk into a sleep study and don?t walk out with a sleep apnea diagnosis.

I do believe that some folks should be treated but I also believe that the whole sleep medicine industry is a money making machine that is totally out of control.
 
I call it voodoo medicine. The results are preordained. When I got the appt for the sleep study I also got a second appt for titration of the CPAP. A while after using the CPAP they had me take a Maintenance of Wakefulness test - that's sit in a dimly lit room all day and don't fall asleep. I passed no problem but could have done so prior to the CPAP. But since it was AFTER the CPAP they claimed victory and said the CPAP was working. Once you are tagged with OSA it will never go away and you will be filing reports every year for a special issuance.
 
For this, she suggested I get a) blood work, b) a chest x-ray, and c) a sleep diagnostic.

I would do a) and b) and then see what the results are. If they kick off something that the FAA doesn't like it should be fixed anyway. :)
 
Most people who end up in cancer centers are going to be found to have cancer.

Polysomnography is done with over 30 digital channels of EKG, EEG, plus audio and infrared video. All studies are digitally recorded and if someone thinks that theirs has been ?faked? or predetermined, they can request a copy of the recording and take it to an independent expert for review. The largest payor for PSG?s is Medicare and Medicare fraud is prison time.

If one is diagnosed with OSA, they have it. The proof is irrefutable.

Where things turn Voodooey IMO is on the treatment side where there is a war between CPAP and surgery science of which both have success stories but neither has a spectacular track record. Even though skinny people can have OSA, the single most effective prevention and/or treatment for the masses is losing weight.
 
Most people who end up in cancer centers are going to be found to have cancer.

Polysomnography is done with over 30 digital channels of EKG, EEG, plus audio and infrared video. All studies are digitally recorded and if someone thinks that theirs has been “faked” or predetermined, they can request a copy of the recording and take it to an independent expert for review. The largest payor for PSG’s is Medicare and Medicare fraud is prison time.

If one is diagnosed with OSA, they have it. The proof is irrefutable.

Where things turn Voodooey IMO is on the treatment side where there is a war between CPAP and surgery science of which both have success stories but neither has a spectacular track record. Even though skinny people can have OSA, the single most effective prevention and/or treatment for the masses is losing weight.

I'm not a doctor, but like reading stuff with data... :)

If I'm reading this chart correctly, the data shows evidence as moderate for some treatments and the word insufficient appears in lots of places

http://annals.org/data/Journals/AIM/927677/7TT3.png

Even weight loss came out as "low" strength of evidence. By engineering standards it's awfully close to voodoo. :rolleyes:

Quote - Overall, low-quality evidence showed that some intensive weight-loss programs may effectively reduce signs and symptoms of OSA in obese patients with or without diabetes.

The data source appears reputable.

http://annals.org/aim/fullarticle/1...lts-clinical-practice-guideline-from-american

It makes for interesting reading.

As far as the testing goes, I'm not sure if I could get wired up like this and go to a strange bed in a strange building with technicians hovering around and sleep "normally" :)

316px-Polysmonograpy_equipped_patient.jpg


Not me... a wiki pic.
 
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Let's see how much I remember from 18 years ago...
* The interruption to breathing during the night I thought was called an hypopnea, but I see that it can also be called an apnea;
* Everybody has these. Everybody. Sleep apnea means that you have too many per hour;
* An apnea means that just when you're about to get to very deep sleep, you relax, the airway is obstructed, you quit breathing and then a jolt of adrenaline gets you breathing again... and keeps you from getting deep sleep;
* If you have dreams, you don't have sleep apnea. In my case, I'd gone decades without dreams;
* There are three mechanisms for sleep apnea: soft palate blocks the airway when relaxed, same for the tongue, or the airway collapses under suction. I had all three, with the first being predominant. Mine was successfully cured by surgery (UPPP - uvulopalatopharyngoplasty), with an extraordinarily painful two week recovery period. Two weeks to the day later, the pain turned off completely and life resumed. I don't think that insurance pays for UPPP any more...
* A common result of successful treatment is that people become nicer. Actually, what is going on is that chronically sleep derived people get grouchy. In my case, I observed that there was suddenly less heavy traffic in the area. You get the idea;
* Stats are that maybe 10% of the population has undiagnosed sleep apnea. But if the victim doesn't observe any symptoms, denial reigns;
* In my opinion, there's a strong case for everybody getting a sleep test at least once in their life. Certainly if an ATP requires five hours in a Cat D sim, a sleep apnea test ain't that big a deal;
* When I went to see the sleep doctor, I filled out a five or so page questionnaire. That gave a diagnosis that was confirmed by a sleep study at home with all the toys hooked up. C'mon guys, man up, it's not that big a deal;
* And some of the effects of long term untreated sleep apnea are ugly;
* One symptom of sleep apnea is that you fall asleep easily. Why? Because you're sleep deprived all the time. Falling asleep in a plane is obviously not good.

So getting sleep apnea treated can save your life, both in the sense of keeping your pulse going longer and in the sense of allowing you to enjoy life without being a sleep-deprived grouch.
 
A friend was diagnosed with sleep apnea and the FAA contacted him for the data his machine recorded.

It turns out that when he goes on vacation he has to rent a battery powered machine to keep the FAA happy.

What BS!
 
yep

Don't do the sleep study! It is pseudo science. There are about 20 items on the sleep apnea checklist that they are supposed to check LONG before a sleep study is recommended...

Notably, they look first and foremost at your BMI...and, as we all know, your BMI tells you ABSOLUTELY NOTHING about your health. Don't believe me? Here is an example:

Two men, exactly 6 feet tall. Both weigh exactly 200 pounds. Both have the EXACT same BMI...27.12. According to the FAA BOTH of these men are OVERWEIGHT.

Now a description of the men:

The first one is an olympic gymnast.

The second one is a couch potato, laying on the couch, watching TV, and eating a bag of chips.

So what does BMI tell you? NOTHING. Unfortunately, most doctors seem to look at BMI as the primary indicator of sleep apnea.

Next, you go to the sleep study, in a strange room, strange bed, they wire you up, turn on the cameras, and say, "OK, get a good night's sleep"...yeah, right.

Then, after a crappy night's sleep, the diagnosis is sleep apnea...thank you, that will be $6000. Now go get a CPAP machine for $1200...

Then after a couple of weeks, you find it near impossible to sleep. You go back and they say that you need to try a BiPAP instead...

Meanwhile, you have to list all of these visits and diagnosis on your medical, where they stay FOREVER...and it is within the FAA's authority to REQUIRE you to wear the machine, and submit the recorded data.

Sound like a nightmare? I am not making it up, it happen to one of my best friends...

Oh, he still doesn't sleep well...
 
Health issues and aviation create a fine line to walk. Try not to lose your medical. But absolutely do everything you can to maintain your health. You can't fly from 6' underground in a pine box.

I'd have a low key discussion with a GP, and see what s/he thinks.
 
Let's see how much I remember from 18 years ago...
* The interruption to breathing during the night I thought was called an hypopnea, but I see that it can also be called an apnea;
* Everybody has these. Everybody. Sleep apnea means that you have too many per hour;
* An apnea means that just when you're about to get to very deep sleep, you relax, the airway is obstructed, you quit breathing and then a jolt of adrenaline gets you breathing again... and keeps you from getting deep sleep;
* If you have dreams, you don't have sleep apnea. In my case, I'd gone decades without dreams;
* There are three mechanisms for sleep apnea: soft palate blocks the airway when relaxed, same for the tongue, or the airway collapses under suction. I had all three, with the first being predominant. Mine was successfully cured by surgery (UPPP - uvulopalatopharyngoplasty), with an extraordinarily painful two week recovery period. Two weeks to the day later, the pain turned off completely and life resumed. I don't think that insurance pays for UPPP any more...
* A common result of successful treatment is that people become nicer. Actually, what is going on is that chronically sleep derived people get grouchy. In my case, I observed that there was suddenly less heavy traffic in the area. You get the idea;
* Stats are that maybe 10% of the population has undiagnosed sleep apnea. But if the victim doesn't observe any symptoms, denial reigns;
* In my opinion, there's a strong case for everybody getting a sleep test at least once in their life. Certainly if an ATP requires five hours in a Cat D sim, a sleep apnea test ain't that big a deal;
* When I went to see the sleep doctor, I filled out a five or so page questionnaire. That gave a diagnosis that was confirmed by a sleep study at home with all the toys hooked up. C'mon guys, man up, it's not that big a deal;
* And some of the effects of long term untreated sleep apnea are ugly;
* One symptom of sleep apnea is that you fall asleep easily. Why? Because you're sleep deprived all the time. Falling asleep in a plane is obviously not good.

So getting sleep apnea treated can save your life, both in the sense of keeping your pulse going longer and in the sense of allowing you to enjoy life without being a sleep-deprived grouch.

For most of the population, falling asleep at the wheel on a long drive would be a more common effect, and usually could be self-diagnosed before actual sleep and an accident occurred. :)

Perhaps a better survey question may be "Can you drive for xx hours on a freeway non-stop?"
 
It is pseudo science.


So what does BMI tell you? NOTHING. Unfortunately, most doctors seem to look at BMI as the primary indicator of sleep apnea.



Oh, he still doesn't sleep well...

1. It is well established through repeated meta analysis. It's solid science.

2. It is misunderstood by most. "Sleep apnea" is best thought of as an umbrella term. Is it obstructive, central? Both? (Its not just old, fat, men.)

3. BMI is not a diagnostic criteria for sleep apnea, obstructive or otherwise. It is, however, a risk factor.

4. If you thought a medical was hard to get with OSA on your record, try getting one after a stroke, or cardiac event.

Avoiding a potential diagnosis because one is fearful of loss of a medical can seriously shortchange a person in the long run. It always amazes me that some pilots will pull a cylinder at the first symptom (couldn't resist), yet not treat their bodies with the same abundance of caution.
 
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Data needed to help them make a decision about your safety...

I'm not a doctor and don't offer advice proposing to be a doctor but I do know a little bit about government bureaucracy and the need to keep you "safe", so I would suggest that you don't do the sleep study.

That being said, if you feel you need better sleep, just purchase a machine without the govt knowing about it. If it helps, then great. If it doesn't help, then sell it and move on.

Hope all works out well for you and that you fly many more years.
 
1. It is well established through repeated meta analysis. It's solid science.

.....

3. BMI is not a diagnostic criteria for sleep apnea, obstructive or otherwise. It is, however, a risk factor.

.....

As an engineer I would read the medical report as far less than "solid science" :)

http://annals.org/aim/fullarticle/1...lts-clinical-practice-guideline-from-american

Read it completely, it's interesting.


If BMI is a risk factor, lowering should be more effective...:)

Quote - Overall, low-quality evidence showed that some intensive weight-loss programs may effectively reduce signs and symptoms of OSA in obese patients with or without diabetes.

IIRC the FAA obsession with BMI and sleep apnea a few years ago came about from a few serious accidents involving profession vehicle drivers/train drivers who were on long variable shifts, often at night.

Just checked - It was 2013 -

http://www.vansairforce.com/community/showthread.php?t=106736

http://www.vansairforce.com/community/showthread.php?t=107787

I don't remember it being linked to accidents involving pilots with Class III medicals.
By definition this group is not professional. If you feel tired, land - you are in charge :)
 
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But one thing really concerned me, and that was that if the sleep test somehow showed anything like sleep apnea (which I have never suffered from), that this could somehow make its way into my medical records, and possibly interfere with getting a Class III medical, which I have due in a few months.

Since no one else has mentioned it yet - Unless you are flying internationally, if you are only worried about renewing your 3rd Class medical you can always switch to Basic Med. Then you can get the recommended tests if you wish (I'm not qualified to suggest either way), and no matter what the results you can still fly with Basic Med so long as you can get a physician to sign off on the simple Basic Med medical.

Best of luck with what ever you decide.
 
And...

Some of us ARE professionals...

Next time you go to your AME, ask to see the sleep apnea "checklist". The very first item is , you guessed it, BMI.

I challenge anyone to make a case that BMI is a valid indicator of health. It accounts for NOTHING but height and weight. Don't believe me? here is the formula:

BMI= weight (kg) / height (m)^2

It says NOTHING about bone density, muscle mass, fat percentage, heart rate, blood pressure, etc. Refer to the previously detailed example.

Pure and simple, it is a "one size fits all" height weight chart...

Unfortunately, "one size" DOES NOT fit all...
 
BMI ha ha

Some of us ARE professionals...

Next time you go to your AME, ask to see the sleep apnea "checklist". The very first item is , you guessed it, BMI.

I challenge anyone to make a case that BMI is a valid indicator of health. It accounts for NOTHING but height and weight. Don't believe me? here is the formula:

BMI= weight (kg) / height (m)^2

It says NOTHING about bone density, muscle mass, fat percentage, heart rate, blood pressure, etc. Refer to the previously detailed example.

Pure and simple, it is a "one size fits all" height weight chart...

Unfortunately, "one size" DOES NOT fit all...

I have been doing construction my whole life. If I every meet my BMI Take me to the hospital because I am sick. Terrible measure of health, better is if you can run a 5 k without walking.
 
As an engineer I would read the medical report as far less than "solid science" :)



If BMI is a risk factor, lowering should be more effective...:)


I don't remember it being linked to accidents involving pilots with Class III medicals.

We're not allowed to test materials (humans) until they fail, as you engineers can. It's just not how medical science works. I won't debate you on a 5 year old lit review, fact is the ACP (the publisher) still recommends sleep studies for exactly what the OP described. Thankfully if you don't like it, if you check back in a year the guidance may change, another difference from engineering I would expect.

Eliminating/reversing a risk factor for a pathology does not equal treatment as you imply. Wouldn't that be great though! Think smoking and lung disease.

I don't care what the FAA thinks. Really. I hate to hear about pilots avoiding therapeutic interaction with their HCPs out of fear of the dreaded medical loss. It's scary, I understand. But ignoring a problem that can be remedied / mitigated seems taboo on our airplanes, but all too often A-OK with our bodies. Go get seen, question results, and THEN make your informed decision. Just don't avoid all-together.
 
yep

Once you go and get seen, it's too late as you then must indicate it on your medical...
 
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Your doctor is your consultant on your personal health care. You are your own primary care provider. It is your decision on doing the test. Since you are questioning your doctor, maybe you have some personal insight that maybe you should do the test and are reaching out to the masses that are more than likely going to try and talk you out of it.

You decide and don’t let anybody besides you make the decision.

But since you ask, my opinion is sleep apnea just one of many new found, never an issue before, medical conditions. I am sure there is science being thrown around to validate claims. And remember the medical industry’s primary purpose is to return on investment for their stakeholders.
 
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My wife says I snore and stop breathing for a while at a time while sleeping. I had a sleep study and couldn't sleep during it. At about 4 in the morning I asked to leave because I was wide awake. They told me I couldn't because I was being charged for it so I might as well stay the whole time. I finally fell asleep for maybe less than an hour. I personally didn't think that was enough time to classify me as having apnea but they did.
I'm 6'1 and 195 lbs so not overweight. I can drive for over 8 hours without falling sleep. I really don't believe the faa issue with apnea is realistic. Not many pilots are flying for 6 or 8 hours without stopping. If you're flying for 2 hours and falling asleep then yeah you might have an issue.
I'm with the guy who said just buy a machine and see if it helps if you're having an issue. They try to tell you that only the doctor can adjust your machine but that's not true.
Good luck. If you take the test just be prepared to be wearing a mask every night.
 
Some of us ARE professionals...

I challenge anyone to make a case that BMI is a valid indicator of health.
BMI= weight (kg) / height (m)^2

It says NOTHING about bone density, muscle mass, fat percentage, heart rate, blood pressure, etc. Refer to the previously detailed example.

Pure and simple, it is a "one size fits all" height weight chart...

It is a predictor of future health, and well established risk factor for most bad things. Agree with all else quoted.

The only single piece of data used in isolation of all others to describe health, is an existing pulse.

He is already required to list the reason for the visit he had, the HCP name and date...the cat is already out of the bag.
 
We're not allowed to test materials (humans) until they fail, as you engineers can. It's just not how medical science works. I won't debate you on a 5 year old lit review, fact is the ACP (the publisher) still recommends sleep studies for exactly what the OP described. Thankfully if you don't like it, if you check back in a year the guidance may change, another difference from engineering I would expect.

Eliminating/reversing a risk factor for a pathology does not equal treatment as you imply. Wouldn't that be great though! Think smoking and lung disease.

I don't care what the FAA thinks. Really. I hate to hear about pilots avoiding therapeutic interaction with their HCPs out of fear of the dreaded medical loss. It's scary, I understand. But ignoring a problem that can be remedied / mitigated seems taboo on our airplanes, but all too often A-OK with our bodies. Go get seen, question results, and THEN make your informed decision. Just don't avoid all-together.

Yes, it is different from engineering and I guess that is why the university buildings are "Medical Arts" rather than "Medical Science" :)

However, I would question the validity of any test in a strange environment to measure "normal sleep". This is simply part of the science and techniques of measurement.

Unfortunately it appears there is somewhat of a $$$ element in it - someone has to keep those sleep centers and equipment makers in business.

Two other previous comments mention this major testing issue.
 
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Yes, it is different from engineering and I guess that is why the university buildings are "Medical Arts" rather than "Medical Science" :)

However, I would question the validity of any test in a strange environment to measure "normal sleep". This is simply part of the science and techniques of measurement.

Two other previous comments mention this major testing issue.

My late father was a structural engineer, and avid flyer, and this was a big source of anxiety and frustration with him when he was told he needed a sleep study. He made me pull the lit on them, and try to "sell" it. Bottom Line: You need only a few NREM/REM sleep cycles for them to get enough data (minutes not hours) Edit: The data recorded is typically not under conscious control. He was also skinny, so couldn't be OSA right?! He didn't go.

Died at 63, heart disease. Correlation is NOT causation, of course. Maybe it would have made no difference. Point is, you only get one life. Have these conversations with your Doctor, and if you believe he/she is only in it for the money find another one.
 
Been dealing with this...

For about 8 years. Not a good scenario in my case. Had my 2nd class pulled about a year ago. Letters of appeal to Oklahoma would take 6-8 weeks to get a response of another denial without any info of what they needed to move forward. Finally was able to sit down with an FAA doc on opening day at Airventure and present some of my info. He looked at it for about 3 minutes and told me I can give you your medical right now. You can fly a plane home if you want. Why does it have to be so hard to work with Oklahoma???

Also, the FAA puts out a publication called Safety Briefing. I sent an email asking them to publish data showing how much safer the American public is since the big sleep apnea push by the FAA. Their latest issue had an article talking about sleep apnea. They stated in the last 15 years there have been 9 incidents/accidents attributed to sleep apnea. 4 were in other transportation modes other than flying. (Their numbers) That leaves 1 every 3 years for aviation. The FAA could surely expend their safety focus on other matters.

I totally agree that some people need treatment and have met many that benefit from cpap. Just know it's easy to be pulled into the whole special issuance medical ordeal by just uttering the wrong phrase or having the phrase "daytime drowsiness" automatically and erroneously added to your physicians report.

My bad. The wording is the NTSB has found OSA to be a contributing factor in 9 accidents since 2001 in 4 transportation modes.
 
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...

Also, the FAA puts out a publication called Safety Briefing. I sent an email asking them to publish data showing how much safer the American public is since the big sleep apnea push by the FAA. Their latest issue had an article talking about sleep apnea. They stated in the last 15 years there have been 9 incidents/accidents attributed to sleep apnea. 4 were in other transportation modes other than flying. (Their numbers) That leaves 1 every 3 years for aviation. The FAA could surely expend their safety focus on other matters.

I totally agree that some people need treatment and have met many that benefit from cpap. Just know it's easy to be pulled into the whole special issuance medical ordeal by just uttering the wrong phrase or having the phrase "daytime drowsiness" automatically and erroneously added to your physicians report.

This may be the data the FAA mentioned... three years old so maybe another aviation incident, not accident, got added.

https://www.ntsb.gov/news/speeches/CHart//Documents/Hart_150211.pdf

The mentioned one was for Class I medicals I believe.
 
A PSG is just a combination of an EKG and an EEG for much longer duration.
OSA is the most common diagnosis but there are over 200 diagnosis codes related to PSG’s and a lot more uses for PSG’s than just sleep. A lot of studies are done on children who were about to be diagnosed and medically treated for ADD when they actually have a sleep issue. A lot of cardiac and bariatric surgeons use them prior to surgery just to get an expanded picture of the health of their patients.

In 8 years of my affiliation we saw dozens of pilots and the only one to lose his medical long term was for a previously undetected heart problem that was a ticking bomb requiring immediate surgery.

BTW, I’m not a doctor, but trying out a CPAP machine on your own is a huge mistake. People asked us for that option a lot and there is a reason that it is against the law. It is a pump of adjustable pressure designed to keep the airway from collapsing. Everybody’s needs are unique. A titration is the way to get the pump to the correct setting as too little pressure and too much are either ineffectual or dangerous. It could be akin to stabbing a magneto without timing it and hoping you got it right or hanging a 14v alternator on a 24v ship.

I fly for a living as well as an avocation. Every visit I tell my AME that I live to fly but would rather live than fly.
 
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One final thought in passing. In most states you can walk into a sleep center, negotiate a cash price for a PSG and interpretation, (probably $1000-2000), and have an anonymous sleep study with no paper trail. I am neither recommending nor encouraging that, just saying that it happens. (Often with professional athletes).
Nevertheless, it is against federal law to submit an FAA medical application will known erroneous answers so never do that.
 
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You pay them to keep you well, why buck their advice? In any case, I wish you well.

Because not all of them are good? I've run into a couple of quacks, one of whom had I followed his advice would have resulted in a permanently "frozen" and immobile wrist joint after a break (it required extensive surgery by a hand surgeon).

I'd say...move on. You're asympomatic now, have a good probable cause of the wheezing/whatever, and if it comes back, deal with it then. That's what I'd do in this case, based on what you wrote, but YMMV...

ETA: Oh, and go the Basic Med route to keep the FAA's nose out of your personal medical history. Just make sure your anus is in good shape, as that's on the Basic Med checklist for the doc :)
 
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Clarification

I like to think I am normally a good communicator (don't we all), but I think perhaps I did a bad job with this post, and with my new doctor.

To clear up a few points:

* I am confident that I do not have sleep apnea. I don't have any trouble sleeping, and when I wake up, I feel refreshed and generally great.

* About 3-4 weeks ago, when I started swimming, I got some type of lung infection, or walking pneumonia. Maybe from swimming in the then 81 degree San Diego ocean water. Only while that was going on did I have 2 or 3 instances of getting very tired. It never happened before, nor has it happened since the problem went away. I strongly feel it was due to the problem that was in my lungs, and not an inherent problem in my physiology.

* I have never had asthma either, but the doc prescribed an inhaler. On the label it says "Take 2 puffs every 4 to 6 hours as needed". The "problem" is that it has never been needed, so it just sits there unused. The "shortness of breath" that I described to the doctor only occurred while I had the lung issue. Even though I told her that, she prescribed it anyway.

* I have many concerns about the doctor's recommendations because they all seemed like she was missing the point of what I was trying to communicate. This never happened with my old doctor. So independent of my concern here, I think I need to source a new doctor anyway. She is an ex-military doctor, but not a flight-line doctor, and made a few comments that I didn't really appreciate. One was "since your a pilot, you will tell me everything is fine, even when it isn't". When I asked her if she could do a Class III or Basic Med, she had no idea what was required, and suggested that I "go to a place that does occupational medicals, because they do that kind of thing".

Several of you have described exactly what I was concerned about, that being stuck in bureaucratic ****. It is bad enough to have to go through that, but having to do that because I picked a bad doctor would be insane.

So while I appreciate people telling me not to ignore my symptoms (which I generally agree with wholeheartedly), please understand that I don't have any!

While I was going through the 3-4 weeks with this problem, I grounded my self because I believe in the "IM SAFE" mentality.

The reply from RV7A Flyer hit the closest to home for me. He appears to have heard exactly what I tried to say, and summed up exactly what I plan on doing now. I too have had some bad doctors in my past. I separated a shoulder once, so they gave me a sling, and told me not to move my shoulder or elbow. After they said I was done with the sling, I couldn't move my elbow through its full range of motion. They then did an elbow x-ray and noticed that I had fractured my elbow at the same time, and told me that I should never have kept my arm in a sling... grrrrr.....

I truly appreciate the feedback all of you gave me. So thank you again!
 
Doctors

A lot of people complain about doctors,and I?ve come to realize the fact that every other one of them is below average!And they graduated in the bottom half of their class!They can?t all be the best and brightest.Also applies to pilots,and builders,so since I?m above average,maybe you?re not!
 
Definitely blood work up, chest x Ray, but do NOT do sleep study unless one of
Prior tests show need.I am not Dr., but allowed sleep study and found it was a money pit ! If your swimming the way indicated, you are in better shape than a
big % of population !
 
I like to think I am normally a good communicator (don't we all), but I think perhaps I did a bad job with this post, and with my new doctor.

To clear up a few points:

* I am confident that I do not have sleep apnea. I don't have any trouble sleeping, and when I wake up, I feel refreshed and generally great.

* About 3-4 weeks ago, when I started swimming, I got some type of lung infection, or walking pneumonia. Maybe from swimming in the then 81 degree San Diego ocean water. Only while that was going on did I have 2 or 3 instances of getting very tired. It never happened before, nor has it happened since the problem went away. I strongly feel it was due to the problem that was in my lungs, and not an inherent problem in my physiology.

* I have never had asthma either, but the doc prescribed an inhaler. On the label it says "Take 2 puffs every 4 to 6 hours as needed". The "problem" is that it has never been needed, so it just sits there unused. The "shortness of breath" that I described to the doctor only occurred while I had the lung issue. Even though I told her that, she prescribed it anyway.

* I have many concerns about the doctor's recommendations because they all seemed like she was missing the point of what I was trying to communicate. This never happened with my old doctor. So independent of my concern here, I think I need to source a new doctor anyway. She is an ex-military doctor, but not a flight-line doctor, and made a few comments that I didn't really appreciate. One was "since your a pilot, you will tell me everything is fine, even when it isn't". When I asked her if she could do a Class III or Basic Med, she had no idea what was required, and suggested that I "go to a place that does occupational medicals, because they do that kind of thing".

Several of you have described exactly what I was concerned about, that being stuck in bureaucratic ****. It is bad enough to have to go through that, but having to do that because I picked a bad doctor would be insane.

So while I appreciate people telling me not to ignore my symptoms (which I generally agree with wholeheartedly), please understand that I don't have any!

While I was going through the 3-4 weeks with this problem, I grounded my self because I believe in the "IM SAFE" mentality.

The reply from RV7A Flyer hit the closest to home for me. He appears to have heard exactly what I tried to say, and summed up exactly what I plan on doing now. I too have had some bad doctors in my past. I separated a shoulder once, so they gave me a sling, and told me not to move my shoulder or elbow. After they said I was done with the sling, I couldn't move my elbow through its full range of motion. They then did an elbow x-ray and noticed that I had fractured my elbow at the same time, and told me that I should never have kept my arm in a sling... grrrrr.....

I truly appreciate the feedback all of you gave me. So thank you again!
After reading all this. I would think that what you need is a change of you P.C.P., one you can talk to and work with, one that can listen to you and understand your needs as well as you safety. The F.A.A. has their teams from most of their branches come to KOSH each year and set-up shop in the F.A.A. Safety building next to the tower. One of the biggest teams there is their medical division. You may wish to hold off if you can tell you can sit and talk to some of them. They are most helpful and are glad to tell you off the record why they do the things that they do and require. Oklahoma city is a different world, and what they try to do is fallow a script that is set down in writing as to what they are supposed to do. I have found that the folks that work there don't like to stick their necks out even a little. I have been informed that many of the issues that the medical branch works with are known to be flowed and that they are being address, but as with many government agency it seams to take forever. As this happens only once a year you can contact you reginal flight surgeon's office and get some information off the record from them. There are I think seven regions here in the U.S.. Just a few thoughts on this and by the way a chest X-ray wont cover it, a C.T. will be the way to go I.M.H.O. Yours, R.E.A. III # 80888
 
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I recently went to a doctor because when I made the appointment, I had wheezing coming from my lungs after I got done with my open water ocean swims for a few weeks. When I heavily exhaled, I could also hear some bubbling in my lungs, which had happened many years ago when I had some type of lung infection which antibiotics cleared up. By the time of my appointment, it was already gone, but I kept the appointment anyway.

For some reason the doc prescribed asthma medicine even though I have never had asthma.

I mentioned that when I did have the wheezing, that a few times I got extremely sleepy, and had shortness of breath while laying down. For this, she suggested I get a) blood work, b) a chest x-ray, and c) a sleep diagnostic.

After leaving, I began to feel like the doc completely missed the mark, regarding what had occurred, and was overcompensating with tests after the symptoms were gone.

But one thing really concerned me, and that was that if the sleep test somehow showed anything like sleep apnea (which I have never suffered from), that this could somehow make its way into my medical records, and possibly interfere with getting a Class III medical, which I have due in a few months.

I am inclined to not do any of what the doc suggested, given that my symptoms actually were gone before I even went in.

Have any of you ever done a sleep diagnostic test, and later had issues with your Medical based on having done it?

Assuming you're generally healthy, not old like me, and don't have any other underlying medical problems, the history you give suggests the symptoms are tied in somehow to the open water swimming sessions you were doing. I'd be wondering about something like "Exercise induced Asthma" or "Swimming Induced Pulmonary Edema". You might be one of the 1-2% of otherwise healthy, (even robustly healthy) athletes who are subject to SIPE. The factors contributing to it are not well understood. Certain people in the tiathelete, breathholding diving, competitive swimming and military communities have been noted to be subject to it. Treatment and prevention has been "empirical" meaning it's based more on theories of what might be going on, but not on hard data from well designed scientific studies. It's a bit akin to some healthy people who are subject to altitude sickness, which may strike the most robust appearing person on a climb and leave other less hardy appearing individuals untouched. Just some food for thought. I am a family doctor, but retired now.
 
Just as an aside, this thread is a great example of why the FAA Medical process needs to be changed: it inherently has chilling effects. By being required to report every visit to a doctor, the FAA actually discourages people from going, particularly to specialists. I understand the FAA's interest, but it's poorly implemented and arguably results in a less healthy pilot population. I personally know people who have avoided seeking help for conditions, and the multiple suggestions in this thread to avoid even checking for fear of a questionable diagnosis, because they were afraid of losing their medicals. This is compounded by the strictness of some conditions being disqualifying, or at least requiring rigorous monitoring and sharing scads of sensitive data.


FAA, take a note from this thread and fix your process.
 
^^^This^^^ Dave is exactly right.

Amen, brother. I'd have probably ended up with a routine procedure instead of an MI if I had not hesitated to go to the doctor with some odd, non-specific symptoms... simply because I didn't want the hassle and expense of explaining it on my next medical. None were the classic "Hey, dummy, you're about to have a heart attack" symptoms, but if I hadn't had a medical to worry about I'd have called the doc 2 or 3 days before ending up in the ER.
 
As a practicing Otolaryngologist, I read the prior thread with some concern. There seems to be a level of suspicion regarding the patient physician relationship and the process of medical diagnosis. It always concerns me, the propagation of misinformed and biased opinions which, if not discussed with someone that actually has knowledge, can lead to medical decisions that will have real and, sometimes, severe consequences. There are so many holes and wrong assumptions in the previous thread that it would take a prolonged face to face meeting to dispel the "expert" opinions listed and lead you to real understanding of the possible causes of your symptoms. Please return to your physician and discuss your misgivings and concerns. Let he or she inform and teach you so you're an informed patient, better able to make decisions that will help you.
Respectfully,
David
 
* I have never had asthma either, but the doc prescribed an inhaler. On the label it says "Take 2 puffs every 4 to 6 hours as needed". The "problem" is that it has never been needed, so it just sits there unused. The "shortness of breath" that I described to the doctor only occurred while I had the lung issue. Even though I told her that, she prescribed it anyway.
Depending on what is in the inhaler, it could cause issue with future medicals. I've seen advice from AME to return potential problematic to the Dr. office and get a letter that it was in-used to avoid problem. I'm not sure how you do that with an inhaler (vs. pills) but the trip to the Dr. seems worth it.
 
and...

As a practicing Otolaryngologist, I read the prior thread with some concern. There seems to be a level of suspicion regarding the patient physician relationship and the process of medical diagnosis. It always concerns me, the propagation of misinformed and biased opinions which, if not discussed with someone that actually has knowledge, can lead to medical decisions that will have real and, sometimes, severe consequences. There are so many holes and wrong assumptions in the previous thread that it would take a prolonged face to face meeting to dispel the "expert" opinions listed and lead you to real understanding of the possible causes of your symptoms. Please return to your physician and discuss your misgivings and concerns. Let he or she inform and teach you so you're an informed patient, better able to make decisions that will help you.
Respectfully,
David

...and don't forget to include that visit on your next medical...:rolleyes:
 
My wife says I snore and stop breathing for a while at a time while sleeping. I had a sleep study and couldn't sleep during it. At about 4 in the morning I asked to leave because I was wide awake. They told me I couldn't because I was being charged for it so I might as well stay the whole time. I finally fell asleep for maybe less than an hour. I personally didn't think that was enough time to classify me as having apnea but they did.
I'm 6'1 and 195 lbs so not overweight. I can drive for over 8 hours without falling sleep. I really don't believe the faa issue with apnea is realistic. Not many pilots are flying for 6 or 8 hours without stopping. If you're flying for 2 hours and falling asleep then yeah you might have an issue.
I'm with the guy who said just buy a machine and see if it helps if you're having an issue. They try to tell you that only the doctor can adjust your machine but that's not true.
Good luck. If you take the test just be prepared to be wearing a mask every night.

I was around 30 and my wife convinced me to get a sleep study because I snored a lot and she was worried about me. Not overweight. Not tired during the day at all. No health issues. I just snored.

I went for the study. They diagnosed me with apnea. I got the cpap machine. I went for a follow up appointment and they asked me if I was still tired during the day. I said I wasn't tired during the day to begin with. But I am now because that stupid machine wakes me up all night long.

Took me a very long year to get used to that machine. In my case the sleep study was a bad mistake. My wife sleeps better, though, because I don't snore anymore so that is a positive (I mean that sincerely). But I still think it was a mistake for me to do the sleep study. There were probably other ways to deal with snoring.

I'm sure there are cases where an OSA diagnosis is vital. But I'm equally convinced that a minor apnea episode probably happens to everybody on occasion. And when you're wired up like that for a sleep study it's probably a near guarantee: a form of expectation bias. I'd love to see the stats for the number of sleep studies where they DON'T find apnea.

Like many things there's certainly some truth to the seriousness of OSA, but I think also like many things it's a severely over-diagnosed condition. Regarding the OP, I would save the sleep study as a last resort only if the issues are not answered by the other tests. Doctors (in my opinion) should be viewed as trustworthy advisors, not authority figures.

For those who do use a machine, try one of the on-line sources like cpap.com. You'll get the machine you want at a fraction of the cost (including accounting for insurance). And you can most definitely make all the adjustments to pressure, etc, yourself.

Every year I jump through hoops with the FAA. But I think this next time I'm going to try the basic med route. I hope that will make things a little easier.
 
^^^same as JOE ^^^^

...in addition to the above, which was pretty much my exact experience....

I now have to fill out a half-dozen pages of paper every time I apply for anything, explaining why I am nearly dead and/or asleep from my extremely serious sleep apnea.
yep. snored, but had no other symptoms. Normal weight.
Now I am treated like a leper when applying for life insurance, all the new hassle licensing....etc.etc.

ah, yeah, and I think the 'system', which I keep very clean, may have caused a chronic sinus infection. which is really great for pilots.

so take all that with a grain of salt. If you are NOT breathing well in your sleep, that's very hard on your heart, and wife.
Address that problem!....but beware of 'the system' ....as many have noted.
 
Separate bedrooms

...My wife sleeps better, though, because I don't snore anymore so that is a positive (I mean that sincerely). But I still think it was a mistake for me to do the sleep study. There were probably other ways to deal with snoring...

I know a pilot who got fed up with the CPAP machine, and he and his wife agreed the solution was for them to sleep in separate bedrooms! He sleeps better, she sleeps better...problem solved!

Disclaimer: I am unaware of any other problems this may have created! :eek:
 
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