Obstructive sleep apnoea case-based scenario

Bill, a 39-year-old business owner, flies a light twin aircraft to manage the needs of his clients. He is also a keen sportsman and had several operations on his knees throughout the years.

Bill knew he snored but wasn’t aware of how often he stopped breathing during his sleep.

'Between the demands of the business and my problematic knees, I have been steadily putting on weight,' he said. 'My wife kept telling me that my snoring was getting worse the heavier I got.'

Receiving a diagnosis

Bill finally saw the doctor about his snoring.

‘The doctor said my blood pressure was higher than normal,’ Bill said. ‘I also weighed more than I had on my last visit and was in the obese range.'

The doctor asked Bill a lot of questions about his sleep and tiredness during the day. She decided to refer him to a specialist sleep clinic.

Due to the health and safety risks associated with untreated sleep apnoea, Bill was not to fly or drive heavy machinery.

Following his appointment with the sleep clinic appointment, Bill received a diagnosis of sleep apnoea.

Visiting the DAME

Bill met with his Designated Aviation Medical Examiner (DAME). He provided the DAME with a copy of the specialist report to notify CASA of the change in his condition.

Bill was told not to fly until he got a clearance from either CASA or the DAME himself. Sleep apnoea is a significant condition in pilots due to the:

  • risks associated with daytime sleepiness
  • increased risk of heart problems and stroke.

The DAME reassured Bill that many pilots resumed flying without any troubles once the apnoea was under control.

Cleared for flying

The doctor at Aviation Medicine (AvMed) reviewed Bill’s specialist report. It indicated that the sleep apnoea was of significant severity and treatment had not yet begun.

CASA advised Bill to remain grounded until he could provide an updated report from the specialist showing the condition was under control.

Bill returned to the sleep clinic. The specialist fitted Bill with a small machine that provided a slightly increased air pressure to his nose and mouth while he was sleeping.

'Within a few days of using the machine, I felt dramatically better in the mornings,’ Bill says. ‘I had more energy and even my libido had improved. My blood pressure readings also began to drop back to normal.’

Bill provided a new report to his DAME and CASA that showed his sleep apnoea was under control. As soon as CASA received the report, Bill received clearance to fly.

Last updated:
27 Sep 2021
Online version available at: https://www.casa.gov.au//resources-and-education/publications-and-resources/aviation-medicine-fact-sheets-and-case-studies/obstructive-sleep-apnoea-case-based-scenario
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