Sleep Apnea : Further FAA Medical Workup

AASI Protocol Instructions for Airman and AME

Mar 2014

Guidance is compiled and interpreted by professional pilots and physicians at from the 2014 AME Guide page 286, FAA and FDA web data ( &, instructions specified in the Aeronautical Information Manual, Federal Air Surgeon Bulletins from 1999-2015, and 14 CFR Part 61 and Part 67 (the FARs).

AME Assisted Special Issuance (AASI) is a process that provides Examiners the ability to re-issue an airman medical certificate under the provisions of an Authorization for Special Issuance of a Medical Certificate (Authorization) to an applicant who has a medical condition that is disqualifying under Title 14 of the Code of Federal Regulations (14 CFR) part 67.

An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR § 67.401. The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination.

If this is a first-time application for an AASI for sleep apnea, and the applicant has all the requisite medical information necessary for a determination, the AME must defer and submit all of the documentation to the AMCD or the Regional Flight Surgeon for the initial determination.

AMEs may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following:

  • An Authorization granted by the FAA; and
  • A current report (performed within last 90 days) from the treating physician that references the present treatment, whether this has eliminated any symptoms and with specific comments regarding daytime sleepiness. If there is any question about response to or compliance with treatment, then a Maintenance of Wakefulness Test (MWT) will be required.

The AME must defer to the AMCD or Region if:

  • There is any question concerning the adequacy of therapy;
  • The applicant appears to be non-compliant with therapy;
  • The MWT demonstrates sleep deficiency; or
  • The applicant has developed some associated illness, such as right-sided heart failure.

Download an FAA AASI Cover sheet for the the submitting AME to use (2014 PDF format)

This page discussed Sleep Apnea : Further FAA Medical Workup

Reminder: use to familiarize yourself with aviation medical regulations and guidelines, but always discuss your specific situation with one or more AMEs before dedicating resources toward expensive clinical workups. Find an AME now