FAQ provided by the FAA to AME’s regarding the new sleep apnea guidelines. (click on hyperlink for full version off the FAA website)
Edited version below.
The airman was assessed 5 years ago for OSA but did not have a polysomnogram. The evaluation was negative. Is he required to have an updated sleep evaluation or a sleep study? No. If there has been NO CHANGE in his/her risk factors, follow Group/Box 2 of the flow chart and submit a copy of the previous assessment. However, if there has been a change in risk factors (e.g. elevated BMI, new atrial fibrillation, refractory hypertension, etc.), triage using the flow chart to determine if the airman needs a repeat assessment.
Does the FAA require a specific type of sleep study if one is warranted? Yes. The FAA requires that the test be either a Type I laboratory polysomnography or a Type II (7 channel) unattended home sleep test (HST) that provides comparable data and standards to laboratory diagnostic testing. It does not have to be a chain of custody study.
I evaluated the airman and triaged him into Group/ Box 5. He had a sleep study and is doing well on CPAP treatment. Does he have to wait for a time-limited certificate before he can return to flight duties? No. Once the airman is compliant with and doing well on treatment, he has met the requirements for 14 CFR 61.53. The airman may return to flight status with the current certificate issued by the AME, PROVIDED that ALL the required information regarding OSA evaluation and treatment has been submitted to the FAA for review.
If I give the airman Specification Sheet A or B and he does not submit the required evaluation within 90 days and after the 30 day extension (if requested), what will happen? The airman will receive a failure to provide (FTP) denial.
How long does an airman have to be on CPAP with a new diagnosis of OSA before they can return to flying? The airman may submit the completed compliance statement and required documents to the FAA for review as soon as they are tolerating the therapy without difficulty and have no symptoms of OSA.
The airman has mild or moderate sleep apnea. Is he required to use CPAP? In most cases an AHI of 15 or more will require CPAP.
If the airman has a sleep study and is diagnosed with OSA does he/she get a new certificate? Yes. Once a diagnosis of OSA is established, a Special Issuance is required. When the airman submits the required supporting documents to the FAA, he/she will be evaluated for a Special Issuance.
If an airman has a previously unreported history of OSA being treated with CPAP, can the AME issue? Yes. Issue a regular certificate (Group/Box 2), if the airman is otherwise qualified, and submit the required information for FAA decision.
What if the airman is high risk and has had a previous sleep study that was positive, but not one of the approved tests? He is currently on CPAP and doing well. Does he have to get a new sleep study? Submit the required information for FAA decision.
The airman had a sleep study in the past and did not have sleep apnea. It was not an approved test type. Will he have to get another sleep study? The AME should follow the triage flow chart. If the airman is determined to be Group/Box 5 or 6, he/she will need a sleep evaluation. If a sleep study is warranted, it will need to be an approved test type (see FAQ #8). Submit the required information for FAA decision.
The airman has OSA and was on CPAP in the past. He has now lost weight and is only on a dental device? Submit the required information for FAA decision.