Sleep Apnea & MMC


#1

Hello,

Can anyone tell me if there are any issues getting a MMC with sleep apnea? The Coast Guard has been most unhelpful in explaining what the criteria (if any) is for obtaining a MMC if a person has obstructed sleep apnea.

Any insight would be appreciated.


#2

No personal experience but a couple guys on my ship report delays getting through the medical with this issue. It’s not a “no sail” item though.


#3

Do you know if they use a CPAP?


#4

Know quiet a few guys that use CPAP’s and still sail under their license


#5

A guy I work with has a CPAP and I guess every month he has to bring the machine in for the doctor to download something from it and then send it into the NMC. He did say that if the CG wants, they can tell him he can’t sail anymore, I don’t know how true that is. Seems a little far fetched but it honestly would not surprise me haha


#6

Look up Sleep Apnea in NVIC 04-08 at:
https://www.dco.uscg.mil/Our-Organization/Assistant-Commandant-for-Prevention-Policy-CG-5P/National-Maritime-Center-NMC/medical_certificate/
It will tell you what the CG wants from your Dr.
Any other medical issues? Look it up there. I printed it out and showed my Dr. what they want for my conditions. He gave me the documentation it references, and never had an issue getting my medical certificate.


#7

There could be issues. Obstructive sleep apnea is a potentially disqualifying condition, but you could be eligible for a waiver if the condition is being treated and you can provide evidence of the efficacy of the treatment.

Generally, sleep apnea that is being effectively managed by regular, coonsistent CPAP usage will get a waiver. The waiver will be predicated on continued use of the CPAP, and will likely require you to regulalry consult with a sleep medicine professional and provide evidence of regular usage and efficacy. Most CPAPs have the capability to provide this data. If the sleep apnea is being managed by other means than a CPAP, you still have the ability to demonstrate effective treatment and to get a waiver.

As noted, it’s a disqualifying condition, and whether to grant a waiver is a subjective decision requiring review by NMC medical staff.

It’s feasible. As noted, it’s a potentially qualifying condition. If one doesn’t comply with the conditions of the waiver, including regular use of the CPAP and periodic review of the condition and the efficacy of treatment, the waiver may become invalid or not be renewed. I question whether they were threatended with revcocation in the blunt manner you stated, but the gist is feasible as a waiver is definitely subject to compliance with its terms.

For sleep apnea, see page 28 of Enclosure (3). Providing the NVIC to your doctor is good advice, it will speed the process if you can get and obtain the needed information before you apply to NMC.


#8

And to add to all the great advice above, sleep apnea is definitely something that must be treated. There are conservative measures like weight loss or dietary changes that can be tried, but the gold standard is CPAP or BiPAP. Obstructive sleep apnea can lead to fatal complications: hypertension, stroke, heart attack, etc in addition to the obvious sleep disruption. They make nice compact machines today that pack and travel with you easily. I know a lot of mariners who use them.


#9

My relief captain has sleep apnea. He brings his cpap machine right on board. I’m not sure if he is sailing on a waiver or not, I never asked him. He did mention that he has to produce compliance reports, he has the ability to do this himself but he prefers that his cpap supplier do it. All the machines have a cell phone built in and the insurance people can check compliance. If you don’t use the machine insurance wont pay any more.


#10

This may be a bit off topic but I never heard of sleep apnea until about 20 years ago. I did work with 1 person in 40 years who would just fall asleep for no apparent reason but he also was overweight and in poor condition. I had friends who snored terrible but all were fat, might have been coincidence but now they have machines you can buy so that one can bear to be in the same room with them.I am not being judgmental just curious. Outside the USA I do not hear much conversation about this apnea being an issue. I wonder sometimes if the system is set up to make money off the symptoms rather than look for a cure or at least encourage life style changes to lessen the problem.


#11

Perhaps the system is set up to make money off of people snoring & not being able to breath while sleeping but it might be unhealthy people of yesteryear & fatties in undeveloped courties just die peacefully in their sleep?

I wouldn’t want to use one of those CPAP machines on board ship. Change of lifestyle, diet & exercise would be better. I worked with an obese mate several years ago who slept days & worked the night hours. We had to do maintenance on the tie breaker between the emergency & main switchboards during an inspection that involved us going black ship for about an hour. The mate was asleep & only a few people knew he used the CPAP & they didn’t fully understand what it was. The mate forgot how to breath/sleep without that machine & woke up almost dead. He made a big fuss over us almost killing him. After that we would always mentioned during meetings for someone to go wake up the mate during a blackouts to keep him from expiring in his sleep.


#12

A ship is a working piece of machinery that requires a qualified and fit crew to operate and do so safely. It is not a nursing home. If you can’t respond immediately and in good condition to emergency drills, fight fires or assist in abandonment you need to find another career.I really do not know why this is a point of discussion.
If the situation has developed to the point the industry is getting wavers for sleep apnea suffers I guess that means there are no more qualified mariners available. I find that difficult to believe


#13

Maybe sleep apnea is one of those conditions that are manageable in smaller degrees but critical when more advanced? The guy who I worked with who had to be plugged into a wall outlet every night to stay alive was in bad shape. He had a beachball head, a slightly smaller squished beachball neck & an almost perfectly round body. He looked like a living, clothed snowman. He had fat on his eyelids. This was before the USCG medical board & bi-annual medical certificates. Hopefully it’s harder now a days for people with one foot in the casket to get aboard ship.


#14

Believe it. I’ve had at least three instances in the last decade where a crew member was too big to fit in turnout gear. This usually means we have to put someone with less experience onto a hose team. We have ordered the largest sizes available and come to the conclusion that the manufacturers have set the body mass index for acceptable firefighter size. Who am I to argue. Professional firefighters have fitness standards, why don’t we?

At a certain point you will become a hinderance and a liability in an emergency situation if you are so big you can’t walk up a flight of stairs. You may as well grab your jumbo Gumby suit and wait by the lifeboat like a passenger.


#15

There are standards, but they may not be particularly stringent. See Section VIII of the medical application form. Lax as they might be, being able to walk up a flight of stairs is one of the standards.

Sleep apnea ipresents a bit of a problem. Although some medical providers now routinely ask questions about sleep apnea symptoms, it’s still often contingent on the patient to seek out treatment, it’s commonly undiagnosed. f some consideration of waivers for effective management (CPAP, among others) it is quite possible the situation would be exacerbated. If you had symptoms of sleep apnea, and knew it might effectively end your career, how likely are you to seek treatment? But you’d continue to work with the untreated condition. And CPAPs do work, I use one and my symptoms immediately diminished when I started. In may case, weight gain in my dotage has certainly made things worse, but I probably had it in my 20s (BMI of 23).


#16

blackouts happen. Seems like if you rely on the power being on for your life, you should at least have a UPS or an alarm.


#17

“If you had symptoms of sleep apnea, and knew it might effectively end your career, how likely are you to seek treatment? But you’d continue to work with the untreated condition”

I would think that if we weren’t just tossed out on the street after a few decades of sailing because the rent-seekers in the Occupational Health Quack Shops checked the wrong box on our forms, we might be a little more forthcoming.

In other words, we get SSDI as soon as we get NFFD…none of SSA’s BS, no hiring a lawyer. Second issue and up on your MMC? Give us your Direct Deposit info,sir.

We’ve been pimped out to the Quacks to the point that a lot of us suffer from “Doctor Fatigue”. The unions want an annual physical at their clinic. Then the company will send you to another physical at THEIR clinic, and if you sail MSC Contracts, you might just have to get an MSC physical at THEIR Veterinarian.
Do I need to mention the World Famous Podiatrist of Cut Off, LA who argues with cardiac care specialists?

His name rhymes with “bidet”…

And of course, nobody will accept the signature of another licensed doctor because it isn’t THEIR Pet Quack…so it’s about anything BUT Mariners’ health and more about “making rain” for favored Clinics Inc. isn’t it?

Enough of this nonsense! Throw all these rent-seekers over the side, and the various companies and unions and whatnot can just forward the forms and pay MY doctor to fill them out.
If it’s perfectly okay with you, I’d prefer to choose the person that gets to stick their finger up my behind,(a petite woman with very slender fingers, thanks very much!).


#18

I hear that in most of the world a seaman just needs a valid medical certificate, no company doctors, no union doctors, no occupational quack shops. I hear that in some countries it is illegal for a company to require a seaman to have physical. They must accept the government seamen’s physical.

That is the way it should be in the US. If you have a valid seamen’s medical card, no more occupational physicals.

The UK MCA medical certificate (Form ENG 1) seems to be the international standard. Many countries are on the MCA list of acceptable equivalents, but the US is not. The USCG has failed again.


#19

I disagree, I worked for a tug company that only dealt in oil & chemical barges. The company required each employee to take an in-depth annual physical that included full blood work to see if you were exposed to any chemicals during the last year. The physicals were so grueling only 20-30 occupational health clinics in the whole nation could conduct them. I couldn’t be happier. I knew I was healthy & all my coworkers were too. Usually about 2-3 months before physical time I would notice shipmates, stretching, eating healthier & exercising to be healthy enough to pass it. The USCG physical is a joke, almost anybody can pass it. Why would you want that to be the benchmark for a healthy coworker?


#20

You know, other than the physicals to maintain credentials, I found, that for the most part, seamen avoid doctors, at least I know I did, and certainly to my detriment. . . . I only recently started back to seeing a doctor regularly, even though I have always had good health insurance. My last full physical before last year was in 97 when I hired on as an energy loss adjuster. At the time, the company was owned by the Salvage Association, and I was subject to a grueling 4 hour physical. After that, I just ignored doctors, symptoms and issues. As I am getting up there in years now, and certainly out of shape, I started back, about a year and a half ago, to seeing a doctor regularly, and just in time. I spent all of last November in the hospital and probably would have died if I were somewhere else, and not already in the system. It was quite a wake up call. Even after congestive heart failure and a pulmonary embolism, I have been back at work and slowly working up to where I was some years ago. I have dropped around 50 pounds (and could lose more). At least I am not going to sea and in charge of a watch or engine room. Of course I was a much younger man when I did, but I could not imagine still doing it, from the physical demands alone. Maybe the day to day routine stuff doesn’t require much physical ability, but as a engineer, when the shit hits the fan, the work can be VERY demanding; and hell, isn’t that why there are engineers on board? Y’all still sailing, don’t ignore the medical folks. Especially if you have some years in. Just sayin’. . . .