Sleep Apnoea

[pmccarthy]

I passed my Class 2 examination OK but then got a letter saying that as my BMI is over 35 I had to have an overnight sleep test in hospital before CASA would issue my medical. I did this and was found to have sleep apnoea although I have never experienced the symptoms which apparently include falling asleep at traffic lights or when driving. I had to hire a CPAP machine for a month then go back to the specialist, who wrote a report for CASA. As a result my medical is renewed annually now and I have to get a report from a specialist at my cost each year before the examination. Also I have had to buy a CPAP machine at about $2300.

 

I don't mind having the machine, I do wake up feeling more refreshed, but I don't understand why I need to see a specialist annually and do an annual medical. I have been snoring since I was a teenager, and flying since I was a teenager, and am now 64 years old. Have never fallen asleep in any situation. Particularly unlikely to fall asleep while flying.

 

The CASA staff have been very helpful throughout this process but I just don't understand the medical basis for what I have to do.

 

I would be interested to hear from others who have been through this process.

 

 

[old man emu]

There is no scientifically proven basis for saying that a person with a body mass index (BMI) in excess of 35 suffers from sleep apnoea. It is just that at that number, the possibility that a person will suffer the ill effects of sleep apnoea increase. The BMI number of 35 is not a magic number, it is just a reference point. The stupidity of relying on this BMI particular number is that licensing authorities (CASA, and vehicle licensing bodies) are black and white about it. If you lost a small percentage of your body mass and your calculated BMI came in less than 35, these bodies would not blink, even though you might snore to wake the dead.

 

Leaving sleep apnoea aside, if someone did work on lowering their BMI, they would reduce the possibility of developing other, known, weight related problems.

 

Here are some links for further reading:

 

BMI Calculator | The Heart Foundation

 

{{meta.og.title}} (BMI and Waist Measurement)

 

It is interesting what the Heart Foundation says about the applicability of BMI:

 

BMI is a useful measurement for most people over 18 years old. But it is only an estimate and it doesn’t take into account gender, age, ethnicity and body composition. We recommend you also check your waist measurement, and other risk factors.

 

It seems that getting rid of the beer gut is a good way to beat sleep apnoea, and its mates.

 

The bad type of sleep apnoea is Obstructive Sleep Apnoea. Most cases of OSA are believed to be caused by:

 

• old age (natural or premature)
   
   
  
• brain injury (temporary or permanent)
   
   
  
• decreased muscle tone. This can be caused by drugs or alcohol, or it can be caused by neurological problems or other disorders. Some people have more than one of these issues. There is also a theory that long-term snoring might induce local nerve lesions in the pharynx in the same way as long-term exposure to vibration might cause nerve lesions in other parts of the body. Snoring is a vibration of the soft tissues of the upper airways, and studies have shown electrophysiological findings in the nerves and muscles of the pharynx indicating local nerve lesions.
   
   
  
• increased soft tissue around the airway (sometimes due to obesity), and
   
   
  
• structural features that give rise to a narrowed airway.
   
   
  

 

 

In adults, the most individual with OSA syndrome are obese, however obesity is not always present. Adults with normal body mass indices (BMIs) often have decreased muscle tone causing airway collapse and sleep apnoea. The cause of this is not well understood.

 

Then there is the FAA's attitude to BMI. Take note of the BMI value they use:

 

Obestity, Obstructive Sleep Apnea and BMI Calculation

 

OME

 

 

[Bruce Tuncks]

What they have done is to regulate for the worst case in a population. They think, probably correctly, that doing this prevents them being at risk through litigation or from their boss. And it gives them an excuse to bully people.

 

I just hate this trend and I think we should fight it as much as we can. Especially I hate how the burden of proof ( in this case " prove you won't fall asleep at the controls") has been shifted to the victim. And I hate how they have only regard for one small aspect of a person's life... it's 400% more dangerous to be inactive than to fly, but their stupid rules regard it as a great victory if a grounded inactive person dies.

 

 

[facthunter]

Gets the problem off their plate.. Nev

 

 

[David Isaac]

And it appears they keep moving the goal posts on the criteria for further medical investigation to do just that Nev.

 

 

[Litespeed]

Well it is quite simple really (cynic alert)

 

Avmed specialists and sleep specialists love to send their mates work and it is the same from most specialties in medicine.

 

They and some in CASA also probably have shares in RESMED which makes billions out of this new area of medicine- ie sleep, snoring and aponea.

 

And to top it all the (I assume) private hospital you had to do the sleep study in also makes a packet of dollars and probably gives some kickbacks to the referrer.

 

Then there is the bloke you bought the machine from- could be any of the above.

 

It is a great way of boosting economic growth for medicine and buck passing and everyone above wins but you and the taxpayer.

 

 

[facthunter]

Years ago it was BMI. Now if you've ever fallen asleep in a front of the tele its sleep apnoea. I used to fall asleep in class as a kid so I must have had it then. Next year it will be something else "trendy". Ask me IF I'm cynical. There was some stupid stuff from some overblown medico saying I was a nut case to believe what I ate had anything to do with health. So I asked for my files . Eventually after providing a small amount they advised me they had lost them. Yeah sure How convenient!

 

Medico's write brain farts and your flying permit depends on it. One previous incumbent in Avmed would list you as psychologically unstable if you disputed his decisions. I've had this stuff confirmed from people who worked there in the past... Nev