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FAA Medical Certification | Obesity & OSA

Obesity & Obstructive Sleep Apnea


In February 2015 the FAA issued guidance to Aviation Medical Examiners in which is likely to increase denials, deferrals and Special Issuance for Obstructive Sleep Apnea (OSA).  OSA is a condition which often interrupts breathing during sleeping hours and can result in incapacitation during the daytime.

In November 2013, the FAA proposed guidance to Aviation Medical Examiners that would have grounded pilots with a body mass index (BMI) of 40 or more until they successfully completed treatment and obtained a Special Issuance medical certification from the FAA. The FAA concluded that OSA is almost always found in obese individuals who have a Body Mass Index (BMI) over 40 and a neck circumference of 17 inches or more.

BMI Calculation:


Aviation Medical Examiners have become more attentive to signs and symptoms of sleep disorders and Obstructive Sleep Apnea.  This will increasingly delay or disqualify pilots.

While the FAA has and likely always will use Special Issuance medical certification process to certificate pilots with OSA, AME's have been admonished to no longer use BMI alone to assess whether the pilot applicant has OSA. AME’s will continue to screen for the risk for OSA using history, symptoms, and physical/clinical findings using the American Academy of Sleep Medicine (AASM) guidance. Pilots who are at low to medium risk for OSA may be issued a medical certificate and will then receive a letter from the FAA’s Federal Air Surgeon requesting that an OSA evaluation be completed within 90 days.

If the pilot is considered fit to fly by their treating physician, the pilot may continue flying during the evaluation / treatment period. Pilots diagnosed with OSA and undergoing successful treatment should present documentation of effective treatment to the FAA as soon as possible to avoid a lapse in FAA medical certification.

While the FAA has revised the screening approach to help AMEs find undiagnosed and untreated OSA, untreated OSA will continue to be a generally disqualifying medical condition requiring a Special Issuance medical certificate. AMEs are advised by the FAA to be alert for OSA and other sleep-related disorders such as insomnia, restless leg-syndrome, and neuromuscular or connective tissue disorders, because they could be signs of problems that could interfere with restorative sleep, which are needed for pilots to safely perform their duties.


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Updated 4/4/2015                                                       


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