6 replies to this topic

[USMCF18Driver]

I was recently "almost" diagnosed with IH. I was made aware of this by my sleep doc after I did a night sleep test, and was called back because I fell asleep too quickly. They repeated the night sleep test and had me do a nap test (MSLT) the following day. When I showed up to speak with the doc after the MSLT, I was expecting him to tell me everything was normal. I thought I had not slept at all during the test. I was wrong. I had fallen asleep faster than 4 minutes every time. I did not have any REM during the naps. We determined that I probably had hypnagogic hallucinations during the interview also. The doc told me I was probably narcoleptic, but with a lack of cataplexy and REM during the naps he was calling it idiopathic hypersomnia for now. An official diagnosis could end my career.
I don't necessarily disagree with the doc that this is probably something I have, but I am trying to find a way to avoid a diagnosis. If anyone has experience with a maintenance of wakefulness test please comment. Also, I don't know where the best place to start researching the science of N or IH is. Any help would be great. I am specifically looking for research data that I might be able to use to show if I could be a statistical outlier. I am trying to prove that despite falling asleep quickly and the HH I can stay awake and focused without the Provigil the doc has me on now. Does anyone know where I could see mean times to sleep along with the standard deviation? Which research universities or docs are considered the leaders in this field? Is any of their research available to the public?
On a side note, if this does end my military career I want to continue flying. Is there anyone out there that is a pilot or knows of one who worked through the FAA medical process and is a private or commercial pilot? I think that process could be a doozy. Thanks in advance for any help.

[SleepyRaffie]

Hi,

First off, I hope that you are able to keep your career.

I was just diagnosed about a month ago. I was a flight instructor for five years (I stopped about six years ago) with the goal of flying for an airline. A large part of the reason I did not continue was the schedule. It seemed too much for me to take. I always had been told I was sleepy because I am lazy. I was able to stay awake in the airplane without a problem.


As far as getting a medical- the most recent statistic I found was from 1999 and there were two first class, three second class and 14 third class medicals granted to PWN. It did not say if they were medicated or not. Normally any of the medications would be disqualifying. There is no question that you would have to get a discretionary issuance which would have to (at least when I was teaching) go through Oklahoma City. This can be time consuming. I had some students that I trained for SODA's (Statement of Demonstrated Ability). It took them months to get through the paperwork and then they had a flight test with the FAA to demonstrate their ability to perform the duties of Pilot in Command in a manner consistent with safe flight. For example- a pilot who was blind in one eye had to demonstrate things that normally required depth perception like landings. It would seem that you would have to demonstrate the ability to stay awake.


I also knew a flight instructor who had uncorrectable vision who applied for and got a discretionary second class medical. He then went for a first class and they yanked his medical entirely. He then went through a lengthy process to get his medical back. IT can be a real pain.

It is interesting to me that two PWN had first class medicals in 1999. This allows you to exercise the privileges of an ATP. I have my doubts whether any airline would hire a PWN though.

This may be all things that you already know, but though it seems to be very rare, it is encouraging that there some PWN with medicals. So it can be done. Also, you can always fly with a CFI. Many that are on the fast track to the airlines will cut you a deal, especially if it is cross country time. The good ones will not interfere with your flying if you are safe.

Hope this is somewhat helpful,

Colleen

[818sis]

Let me start by saying that I am in no position to give advice for this. I'm not a pilot or doctor.

But I have a question - Why can't you continue with the diagnosis of IH and stay on the Provigil?

In my extremely limited experience (I was diagnosed with IH one month ago, and have been on Nuvigil since then), I would feel more comfortable with you as my pilot if you were on Provigil. One reason I was diagnosed was because I have to drive a lot, and I was falling asleep while driving, despite more and more caffeine. I never actually fell asleep, but I knew that was coming if I didn't figure it out. But on Nuvigil, this is not a struggle anymore as long as I get a normal night's sleep. So, it is my responsibility to get a good night's sleep every night because I don't want to put myself or others on the road in danger.

However, if you have cataplexy, I would be a bit more nervous with you as my pilot. Maybe there are PWN with cataplexy who are pilots who could comment? But it doesn't sound like you have that.

[USMCF18Driver]

Thanks for your post Colleen. The precedent that there are pilots out there with IH is encouraging, and now I know a little bit more about the process without having to dig through the FAR's... If meds are a disqualifying agent, I will probably stop them. Provigil does not seem to work at all for me anyway. 200mg twice a day. First two days were nirvana, now I am back to normal. I can self medicate on coffee like I have done my whole life.
818sis- The reason they will not let Navy/Marine Corps pilots be on medication for this (in my opinion) is because we are always on a highly variable sleep/work schedule with long days and short nights, and we might fly one day starting before sunrise and ending in the afternoon, but the following day start flying in the evening. Before I went to the doctor my performance was suffering towards the end of long days. Everyone was tired, but I had more significant performance drop off towards the end of the day. Ultimately, they may use it to extend normal pilots duration in critical times of war, but for a pilot to need it to maintain, that is another story. There are some rumors that modafinil is used (rarely, and along with stimulants) for some pilots on extremely long missions in wartime... However, my evidence right now comes from wikipedia... When I asked my flight doc about it, I was basically disregarded, but I am pushing back on it.

[SleepyRaffie]

My pleasure. I have heard that the FAA has become more flexible with meds as of late and that they allow some to fly on them once it is proven that there are no significant side effects. It might be worth your while to call a Flight Standards District Office and ask some anonymous questions about how the process of getting meds approved works. You could also call an AME and see what they have to say. If you find something that really helps, it would be a shame to go off it.

Colleen

[SleepyRaffie]

Also, if a medication is helping with your wakefulness, you will be a safer pilot in the long run.

Colleen

[Heidi L]

Yo Dude. As someone who used to live in the touch and go path at El Toro Air Base-

STOP EATING CARBOHYDRATES.
That low-fat diet the military has you on is causing your symptoms.

Orexin cells are glucose sensitive. High carbohydrate intake lowers your Orexin production.
You also need to be checked for food allergies and strep infection. You may be in the first stages of Narcolepsy.

Please read my website. www.zombieinstitute.net
We can not afford for people like you not to have the correct information.