type 2 diabetes and sleep apnea

FAA Medical Certification | Obesity & OSA

FAA Medical Certification Obesity & OSA

Obstructive Sleep Apnea (OSA).  OSA is a condition which often interrupts breathing during sleeping hours. It can jeopardize health and decrease safety.

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 and the increased awareness has increasingly delayed and some cases disqualified 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.

To avoid a delay in FAA medical certification pilot’s with active medical certification who are considered fit to fly by their treating physician should present documentation of effective treatment to the FAA as soon as possible.

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. 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 pilots need to safely perform their duties.

5 replies
  1. Hortense
    Hortense says:

    I don’t know where you are getting your information, but
    great topic. I guess I need to call you to find out more about how you can help me. Thanks for wonderful information.

  2. Len
    Len says:

    Thanks leftseat – finally I’ve found someplace which helped me. OSA seems to be the FAA’s latest attack condition. How do I get out of the hot lights?

    • admin
      admin says:


      Sleep Apnea captured the attention of the medical community some time ago and the FAA has backed off of their initial constraints. There are good reasons to get good sleep and we all know that bad things can happen if you stop breathing. If you are in fact sleeping well, the FAA will probably not bother you too much but if there is some doubt as to your sleep “hygiene” you can expect the FAA will be interested. Getting past all of the paperwork can be time consuming. Call the leftseat hotline for a free discussion of your specific situation. 405-787-0303

      • C
        C says:

        BS. This is Minority Report persecution. I got a letter saying I need to prove I don’t have OSA after my medical was issues (as it has always been for 10+ years). I have zero issues sleeping and wake fully rested.

        FAA is out to get the fat people, it’s as simple as that.

        • admin
          admin says:

          Your post does not indicate if you stop breathing at night which is where the OSA diagnosis comes in.
          Those who are overweight do have a higher incidence of OSA. Many people with OSA often think they have “no issues” or “wake fully rested” but once the corrective measures are implemented and they get even more sleep and wake even more rested and their risk for many medical problems is greatly reduced. Unfortunately correcting OSA will not stop the persecution of fat people.


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