BMI and sleep Apnea

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Beefitarian
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BMI and sleep Apnea

Post by Beefitarian »

I thought there would a thread about it already. This came up at the all you can eat buffet lunch last tuesday. The FAA is introducing some changes that might have serious ramifications for husky guys.

https://www.faa.gov/other_visit/aviatio ... 201304.pdf

Seems to be partially based on, "You're neck is this size or larger, bmi more than this? You have apnea." so you might not get your next medical.

Will Transport Canada follow their lead?
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Re: BMI and sleep Apnea

Post by ahramin »

I was wondering that too beef. Seems fairly drastic and I didn't hear any warning that this was coming out. I wonder if a RESMED lobbyist has been taking any FAA personnel out for business meetings on golf courses in the Bahamas lately.

For now I suspect TC will follow a wait and see approach before considering any further moves. With all the opposition from ALPA, AOPA, EAA, and myriad other alphabet groups I suspect this proposed rule will quietly disappear once the BMI/Neck Size qualifier turns out to be something made up on the back of a napkin rather than a scientific metric.

Too bad really, I could use the massive improvement this would make on the seniority list.
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Re: BMI and sleep Apnea

Post by Castorero »

I don't understand why one would wish to fight this proposed directive from Friendly Fred.

What he is saying is that anyone with a BMI over 40 and the neck circumference to match will TEST positive for OSA.

Given the impact that OSA has on your well being, once tested and proven, why fight it?

Would you fight treatment for diabetes, hypertension, thyroid disease, prostate cancer etc, picked up by a screening test and proven by subsequent investigation?

I doubt it.

Once screened, Fred wants you to see a certified specialist, not your next door neighbor, for confirmation and treatment. This is a good thing, really.

Besides, treatment of OSA will bring your sex life back from the dead, literally :)
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Post by Beefitarian »

I hope you're right.
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Re: BMI and sleep Apnea

Post by ahramin »

My experience with these certified "specialists" is that it's a wonderful new growth opportunity money grab. A person with absolutely no symptoms of sleep deprivation goes in for a sleep study, gets dozens of wires attached, gets told to go to sleep 2 hours earlier than normal sleep time, and gets woken up at an abnormal hour. Not surprisingly, everyone doing these test turns out to have some form of sleep disorder or other that they can then spend money on. "Mild" sleep apnea seems to be the most popular diagnosis for people with nothing wrong with them, which they will then sell you a $2000+ machine to fix (don't worry I'm sure we can work out a deal with your health insurance company to get you the best possible machine that's still covered).

My 118 pound girlfriend snuffles, snorts, and snores like a trucker but she's so chipper and cheerful all day on 7 hours of sleep a night that you want to strangle her. I'm sure that a sleep study for her would end up recommending treatment in some expensive form.

So yes, most of the people over the magic BMI and neck size will have sleep apnea, but are they more at risk of sleep deprivation symptoms than anyone else? Where's the science? Where is the study showing that this particular group has worse performance in the cockpit than a control group due to sleep apnea?

Like I said, this will probably go quietly away when the associations start demanding the scientific justification for the new rules.
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Post by Beefitarian »

I know many people who have been surprised at how much a CPAP machine changed their life. Even our dog snores sometimes and his BMI is pretty low.
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Re: BMI and sleep Apnea

Post by Castorero »

Ahramin,

I would like to take bait and debate your last statements, but am on my way to a little trattoria on the other side of Ponte Vecchio, plus the fact that I didnt get much sleep last night, and I probably would not make much sense.

Suffice it to say that the science is pretty solid, objectively.

Like Beef said, most people that are affected have no idea they have a problem until they scare the crap out a casual or significant other who ends up lying awake watching over somebody who is a reluctant breather and who looks like they may have taken their last breath.

These same people, who are the lucky ones, and end up on Cpap dont want to go back the way they were, because their life is much better on many levels.

Just ask them, they are around, here and there.

Look for the science, and maybe we can chat about it later , after I get more than two hours sleep...
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Post by Beefitarian »

Trattoria? Them's eatin words!
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Re: BMI and sleep Apnea

Post by ahramin »

Well, I just slept off the longest day in an airplane I've ever had (without the help of a supercharger attached to my face) but I'll qualify my earlier statements. I have 2 friends who use superchargers, and they both swear by them. One's a fat guy would would perfectly fit the new criteria the FAA wants to put in place, the other is a tall skinny guy. They both report massively improved mood, alertness, and brain capabilities during the day plus less waking during the night. The skinny guy in particular simply won't get into the plane to go anywhere unless he's got his machine with him.

My girlfriend and I are a long way away from the FAA criteria, yet both of us stop breathing in our sleep. Neither of us has any problems getting through a long day on 6-8 hours of sleep. On clinical advice from Dr. Sleep Specialist after an overnight sleep study and a consult with Dr. Sleep Apnea Surgeon, I tried a CPAP machine. It disturbs my sleep badly - especially the getting to sleep part - for several reasons chief among them being that as I fall asleep it stops me from breathing. I scuba dive, I've been in a high altitude chamber, I have no problem with pressure breathing, but this thing is simply not conducive to easy breathing. After weeks of tuning the machine, Dr. Sleep Specialists admitted that it was not a good solution for mild sleep apnea and suggested a sleep shirt for $150. Quite a savings over the $3000 CPAP machine but still a rip off in my mind. I declined for social reasons but I've been favoring sleeping on my side just in case.

There are certainly many people who have sleep apnea which adversely effects their lives and who would benefit from treatment. In my experience though, going to these sleep specialists has nothing to do with quality of life or even quality of sleep, and everything to do with selling you something regardless of whether you need it or not. Everyone who comes in the door gets "my goodness ... you have sleep apnea" followed by "you should get a CPAP machine". When a goverment agency comes up with a plan to get many asymptomatic people in their doors, I start to wonder who has been doing some lobbying.
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Re: BMI and sleep Apnea

Post by Castorero »

Beefitarian wrote:Trattoria? Them's eatin words!
Ah...yes, pass the Parmeggiano...

Italy is the last place in the world to be if you want to shave something off your BMI, but what the heck, you only live till you die, so no worries.

It was a short walk from Piazza della Repubblica to Trattoria Camillo.
A jaunt past store windows sporting mannequins defying the looks of Vogue starlets, past Savonarola's barbecue, through darkened porticos, arches and alleyways pregnant with history and passive indifference.

A surreal walk through a different time and a different place. Then... just around the corner, a plume of smells escaped onto the street past well fed eaters on their way out to somewhere, yes this was it, Camillo's.
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Re: BMI and sleep Apnea

Post by I WAS Birddog »

...I was recently diagnosed with sleep apnea....I thought it was a result of a deviated septum from all the street fist-a-cuffs in my younger days.
After further investigation it turns out what I have is a sub-condition called "young children-apnea". Little people living in your home that interrupt your sleep (and studies) because they won't ever STFU, ever, and have more chaotic energy than an exploding star. :D

My sleep specialist suggests I get a vasectomy and then jump on a time machine and turn the knob backwards. That'll fix my sleep apnea!!! :wink:

http://www.youtube.com/watch?v=x81M3g3zjXc
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Re: BMI and sleep Apnea

Post by MCB »

These masks are Tony Soprano approved

http://youtu.be/8NajwAMLn3o
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Re: BMI and sleep Apnea

Post by rapid602 »

I have had sleep apnea for years .. and use the Super Charger lol ... when I got sleep apnea my wight went from 180 to 296 .... CPAP ... my next size was 21 inches.... I am now hovering 200 and my neck size is 17 inches..... That cpap rocks I can stay up for like 36 hours at a time and drive late at night on a 4 lane dived highway.... prior to using that gem I could not get through a two hour movie after supper. in the sleep lab I quit breathing 289 times in 6 hours, the longest was 1 min and 6 sec, and my O2 saturation levels were at like 39 just above a stroke. The last time I was in a lab for my Pilots Medical the doctor scored my sleep level at 97%. appearenly that is good. Now I sleep so deeply that recently I sleep through a smoke detector.

Just to comment from what the doctor told me was ... "when you have sleep apnea, your body goes into survival more and part of that is everything you eat goes into fat storage .... so treated .... with LONG SLOW EXERCISE like walking as apposed to SUGAR BURNING EXERCISE like running will do you more good." my cat 1 medicals have been a non issue but the life change is incredible. If you think you have sleep apnea or have been told to get a cpap .... then get one before you fall asleep driving or flying and end up dead or killing someone else.

Was a little long but hope this helps !!! good luck all and happy dreams.
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Re: BMI and sleep Apnea

Post by I WAS Birddog »

rapid602 wrote:I have had sleep apnea for years .. and use the Super Charger lol ... when I got sleep apnea my wight went from 180 to 296 .... CPAP ... my next size was 21 inches.... I am now hovering 200 and my neck size is 17 inches.....

Hoe-lee-schit!!!

Congratulations on the weight loss. Glad you were quickly reactive to your condition.
Question: How many years were you afflicted to reach that weight?
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Post by Beefitarian »

So I was at a job interview the other day and put on a collared shirt and tie. Anyone following the show may have noticed I have lost 50 or so pounds since joining the forum.

My neck still size appears to be over 18 inches. I'm not skinny at 240 something but I don't see my neck getting much smaller. Possibly 17 if I'm down to 200 or less. I must admit I was somewhat surprised at the 18 inch collar being so snug still.
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Post by Changes in Latitudes »

Beefitarian wrote:So I was at a job interview the other day and put on a collared shirt and tie. Anyone following the show may have noticed I have lost 50 or so pounds since joining the forum.

My neck still size appears to be over 18 inches. I'm not skinny at 240 something but I don't see my neck getting much smaller. Possibly 17 if I'm down to 200 or less. I must admit I was somewhat surprised at the 18 inch collar being so snug still.
Sometimes people have larger necks, depending on the size of neck muscles. We're all built differently and no amount of treadmilling or fasting will fix that. Also, treadmills are evil, I prefer mother nature's stationary versions.

Image
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Post by Beefitarian »

Yeah I used to use the stair climbers. That treadmill seems broken. It's supposed to go the other way. Mostly I have been walking more the last couple of years. The sidewalks here are mayhem with lots of snow that has melted and refrozen a few times.

I think my neck was around 16 inches in my twenties while I was at peak condition just under 200 lbs.
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Re: BMI and sleep Apnea

Post by crj_705 »

thanks for the great information fellow apnea guys...I've just been diagnosed with severe sleep apnea and currently get up every 2 hrs during the night. Yes, I get by during the daytime but can fall asleep if given the opportunity in mere seconds. The other night at the sleep clinic I tried the CPAP machine for the first time...I slept all night and apparently didn't move!!!! What kind of machines do you guys recommend for a pilot traveling, and are they a big problem with CATSA screeners? Thx
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Re: BMI and sleep Apnea

Post by DanJ »

I just got in CPAP this year. After years of my wife complaining about snoring, I asked my doc about it. Took forever to get in to the sleep specialist and it was the intervention of a family friend that works there that helped me get in the second time. Went in for the second study with their CPAP machine and slept like a baby, albeit for too short a time. A month or 6 weeks went by and they finally gave me the prescription for the machine. The first night I had it at home, I slept great. The next day it was like I was on speed. I used to always nap after dinner, but that has rarely happened since in the 7 months I've been on it. Also seems strange that before the machine, I used to get up to pee in the middle of the night, but not since. I was afraid that I was going to sleep so soundly that I would piss myself lol, but all it was was I was sleeping so lightly that even a mild urge to pee would wake me.

Not sure about these 2000-3000 machines people mentioned earlier in the thread. Mine was 860 plus another 320 for the mask, and the government paid either 2/3 or 3/4 of the cost of the machine, with insurance paid the rest.
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Re: BMI and sleep Apnea

Post by Castorero »

"Just to comment from what the doctor told me was ... "when you have sleep apnea, your body goes into survival mode and part of that is everything you eat goes into fat storage .... so treat it .... with LONG SLOW EXERCISE, like walking, as opposed to SUGAR BURNING EXERCISE ,like running, it will do you more good."

There is a Nugget here, that should remain in the light of day.

Hard to believe, but it really does work... walk don't run.
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Last edited by Castorero on Tue Aug 18, 2020 6:59 am, edited 1 time in total.
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