OSA: Switching from CPAP to Dental Appliance
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I have an existing diagnosis for sleep apnea. In 2018 I received a special issuance for my third class medical while using CPAP. My sleep apnea has always been very mild (my last sleep study showed an AHI of ~6 without treatment) and even without treatment I have no or minimal symptoms. I was previously traveling often for work, and that combined with issues using it while sleeping with my spouse always made it a challenge for me to use it consistently.

I'd like to resume flying, and have a job opportunity available which would require a second class medical. I haven't used the CPAP at all in the last year. I'd like to explore changing to a dental appliance which I think I'd do much better with. What should I expect the FAA to require? Will another sleep study likely be required?

The existing SI notes on the first page "...authorization is contingent upon daily usage of your PAP device." Can I assume a whole new SI will be required for a new treatment method?
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As of Dec 31, 2021,  it is anticipated that AAM 331 will require you to use one of the two "use reporting" appliances:(Somnodent, or Braebon).  You don't need a new sleep study because you don't need a new study after you start on CPAP. However, the qulaity of the letter is critical- and I have never had a dentist succeed as they by an large have not read the AASM consensus paper form 2009 and they just don't know what to say.

If you want to use one of these devices, purchase the reporting station but be SURE the person writing your annual letter is a board certified sleep doc.  It'll be all that FAA has to go on....and yes you will need a new authorization. 

I CAN tell you if you want an AME to issue it without the authorization, I require an at home sleep study with the dental device in place, AHI <5.  That way I can defend the issuance "after the fact".



Bruce