ED Decision 2025/002/R
SCREENING OF THE OBSTRUCTIVE SLEEP APNOEA (OSA) SYNDROME
(a) AMEs may consider the following algorithm when screening their applicants regarding the OSA syndrome:
Assessment of OSA risk may be considered at every medical examination of pilots through scores that combine history questions with physical findings such as the STOP-BANG score.
(b) AME guidance:
Indicators to initiate OSA evaluation
— History interview including at least the following:
— Daytime sleepiness (i.e. Epworth Sleepiness Scale)?
— Snoring (what does spouse/partner say?)
— Psychosocial issues due to sleepiness, heavy snoring
— Observable apnoea episodes
— Contributing factors:
— BMI >30
— Previous bariatric history
— Neck circumference: ≥ 40 cm
— Diagnosed arterial hypertension
— Heart troubles
— Arrhythmia
— Congestive heart failure
— CHD
— Previous TIA, stroke
— Diabetes Type 2
— ENT
— Nasal obstruction
— Orthodontic/Retrognathia
— Oropharyngeal examination –e.g. modified Mallampati Score or Friedman tongue position
Methodology (if indicated):
— Nocturnal oximetry
— Respiratory polygraphy
— Polysomnography in certified sleep laboratories
— Eventually evaluation of vigilance:
— Maintenance of Wakefulness Test (MWT)
— Multiple Sleep Latency Test (MSLT)
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