Narcolepsy and idiopathic hypersomnia
What the FAA's documents say about narcolepsy and idiopathic hypersomnia, in plain words, with the FAA's own words one press away.
Covers: All classes
Show the FAA's words: which classes the FAA's table covers
NARCOLEPSY and IDIOPATHIC HYPERSOMNIA All Classes
Short version
The disposition table has two rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row AA current or historical diagnosis, treated or untreated | Defers to the FAA | FAA review |
| Row BA diagnosis on medical records, with new information which rescinds it | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Narcolepsy and idiopathic hypersomnia
- Row A · FAA review
A current or historical diagnosis, treated or untreated. The row's note says this condition is incompatible with aviation safety. The table lists what to submit for FAA review, and the examiner defers and submits the information to the FAA.
A. Current or historical diagnosis Treated or Untreated Note: This condition is incompatible with aviation safety. Submit the following for FAA review: … DEFER Submit the information to the FAA.
- Row B · Special Issuance
A current or historical diagnosis on medical records, with new information which rescinds this diagnosis. The table's example is a pilot previously diagnosed with narcolepsy where additional evaluation determines the cause is another condition. The table says it will need the information for that other condition, and, if additional testing, evaluation(s), or documentation verifies the diagnosis of narcolepsy was rescinded, no longer requires treatment, or has resolved, it lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance.
B. Current or historical diagnosis on medical records WITH NEW information which rescinds this diagnosis. Ex: Previously diagnosed with narcolepsy but additional evaluation determines cause is another condition. We will need the information for that condition and the following: If additional testing, evaluation(s), or documentation verifies the diagnosis of Narcolepsy was rescinded, no longer requires treatment, or has resolved, submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance.
The FAA pathways for narcolepsy and idiopathic hypersomnia
- How this pathway works: Special IssuanceAuthorization for Special Issuance of a Medical CertificateRow B
- FAA reviewYour AME defers. The FAA decides.Row A
Which one describes yours?
The FAA's table sorts it these ways. Choose yours to see its plan.
Your step-by-step plan
Step 1: Row A: what to submit
The most recent progress note and sleep testing.Progress note
The most recent detailed progress note, from a clinic visit with the physician who treats or diagnosed this condition.
It must include
- A detailed summary of the history of the condition
- Current medications, dosage, and side effects, if any
- Physical exam findings
- Results of any testing performed
- Diagnosis
- Assessment and plan (prognosis)
- Follow-up
Sleep testing and other testing
Copies of the most recent sleep study, MSLT and any other testing already performed for this condition.
Copies of the most recent
- Sleep study (sleep lab polysomnography)
- Multiple Sleep Latency Test (MSLT)
- Any other testing already performed for this condition
Show the FAA's words: Row A: what to submit
1. The most recent detailed, Clinical Progress Note, generated from a clinic visit with the physician who treats or diagnosed this condition (narcolepsy or idiopathic hypersomnia). It must include a detailed summary of the history of the condition; current medications, dosage, and side effects (if any); physical exam findings; results of any testing performed; diagnosis; assessment and plan (prognosis); and follow-up.
FAA source: Narcolepsy and Idiopathic Hypersomnia. FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
2. Copies of the most recent • Sleep study (sleep lab polysomnography); • Multiple Sleep Latency Test [MSLT]); and • Any other testing already performed for this condition.
FAA source: Narcolepsy and Idiopathic Hypersomnia. FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
Note: This condition is incompatible with aviation safety.
FAA source: Narcolepsy and Idiopathic Hypersomnia. FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
Step 2: See your AME
The table lists what to submit for FAA review, and the examiner defers and submits the information to the FAA.Exam day- The table lists what to submit for FAA review, and the examiner defers and submits the information to the FAA.
Show the FAA's words: See your AME
A. Current or historical diagnosis Treated or Untreated Note: This condition is incompatible with aviation safety. Submit the following for FAA review:
DEFER Submit the information to the FAA.
FAA source: Narcolepsy and Idiopathic Hypersomnia. FAA date 25 January 2023; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Row ADefers to the FAAFAA review
The table lists what to submit for FAA review, and the examiner defers and submits the information to the FAA.
If the examiner defersRow BDefers to the FAASpecial Issuance
The table says it will need the information for that other condition, and, if additional testing, evaluation(s), or documentation verifies the diagnosis of narcolepsy was rescinded, no longer requires treatment, or has resolved, it lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · FAA review
A current or historical diagnosis, treated or untreated. The row's note says this condition is incompatible with aviation safety. The table lists what to submit for FAA review, and the examiner defers and submits the information to the FAA.
A. Current or historical diagnosis Treated or Untreated Note: This condition is incompatible with aviation safety. Submit the following for FAA review: … DEFER Submit the information to the FAA.
- Row B · Special Issuance
A current or historical diagnosis on medical records, with new information which rescinds this diagnosis. The table's example is a pilot previously diagnosed with narcolepsy where additional evaluation determines the cause is another condition. The table says it will need the information for that other condition, and, if additional testing, evaluation(s), or documentation verifies the diagnosis of narcolepsy was rescinded, no longer requires treatment, or has resolved, it lists what to submit for FAA review. The examiner defers and submits the information to the FAA for a possible Special Issuance.
B. Current or historical diagnosis on medical records WITH NEW information which rescinds this diagnosis. Ex: Previously diagnosed with narcolepsy but additional evaluation determines cause is another condition. We will need the information for that condition and the following: If additional testing, evaluation(s), or documentation verifies the diagnosis of Narcolepsy was rescinded, no longer requires treatment, or has resolved, submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance.
If the examiner defersFAA review
The table marks Row A, a current or historical diagnosis, treated or untreated, DEFER, and says to submit the information to the FAA. The row's note says this condition is incompatible with aviation safety.
The table marks Row B, a diagnosis on medical records with new information which rescinds it, DEFER, and says to submit the information to the FAA for a possible Special Issuance.
What the FAA lists to send
- Item 1. Row A: the most recent detailed clinical progress note, generated from a clinic visit with the physician who treats or diagnosed this condition, with what the table says it must include.
- Item 2. Row A: copies of the most recent sleep study (sleep lab polysomnography), Multiple Sleep Latency Test (MSLT), and any other testing already performed for this condition.
- Item 3. Row B: a current, detailed neurological evaluation in accordance with the FAA Specifications for Neurologic Evaluation, generated from a clinic visit with a board-certified neurologist or sleep specialist no more than 90 days before the exam.
- Item 4. Row B: items the physician specifically addresses: the current diagnosis, how the diagnosis of narcolepsy was rescinded, and any occurrence(s) and frequency of cataplexy.
- Item 5. Row B: a Type 1 or Type 2 sleep study (polysomnogram) performed within the previous 12 months.
- Item 6. Row B: an MSLT (multiple sleep latency test) performed within the previous 12 months.
- Item 7. Row B: results of any additional testing already performed for this condition, such as a Maintenance of Wakefulness Test (MWT).
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks Row A, a current or historical diagnosis, treated or untreated, DEFER, and says to submit the information to the FAA. The row's note says this condition is incompatible with aviation safety.
A. Current or historical diagnosis Treated or Untreated Note: This condition is incompatible with aviation safety. Submit the following for FAA review: … DEFER Submit the information to the FAA.
- Reason 2
The table marks Row B, a diagnosis on medical records with new information which rescinds it, DEFER, and says to submit the information to the FAA for a possible Special Issuance.
B. Current or historical diagnosis on medical records WITH NEW information which rescinds this diagnosis. … DEFER Submit the information to the FAA for a possible Special Issuance.
What the FAA lists to send
- Item 1
Row A: the most recent detailed clinical progress note, generated from a clinic visit with the physician who treats or diagnosed this condition, with what the table says it must include.
1. The most recent detailed, Clinical Progress Note, generated from a clinic visit with the physician who treats or diagnosed this condition (narcolepsy or idiopathic hypersomnia). It must include a detailed summary of the history of the condition; current medications, dosage, and side effects (if any); physical exam findings; results of any testing performed; diagnosis; assessment and plan (prognosis); and follow-up.
- Item 2
Row A: copies of the most recent sleep study (sleep lab polysomnography), Multiple Sleep Latency Test (MSLT), and any other testing already performed for this condition.
2. Copies of the most recent • Sleep study (sleep lab polysomnography); • Multiple Sleep Latency Test [MSLT]); and • Any other testing already performed for this condition.
- Item 3
Row B: a current, detailed neurological evaluation in accordance with the FAA Specifications for Neurologic Evaluation, generated from a clinic visit with a board-certified neurologist or sleep specialist no more than 90 days before the exam.
1. A current, detailed neurological evaluation in accordance with the FAA Specifications for Neurologic Evaluation, generated from a clinic visit with a Board-Certified neurologist or sleep specialist no more than 90 days before the AME exam.
- Item 4
Row B: items the physician specifically addresses: the current diagnosis, how the diagnosis of narcolepsy was rescinded, and any occurrence(s) and frequency of cataplexy.
2. It must specifically include the current diagnosis, how the diagnosis of Narcolepsy was rescinded, and … any occurrence(s) and frequency of cataplexy.
“IT MUST SPECIFICALLY INCLUDE” If this language is in your letter, it is to highlight SPECIFIC items (that may or may not be part of a standard current, detailed Clinical Progress Note). Make sure your physician addresses these specific items important for medical certification or clearance.
- Item 5
Row B: a Type 1 or Type 2 sleep study (polysomnogram) performed within the previous 12 months.
3. A Type 1 or Type 2 Sleep Study (polysomnogram) performed within the previous 12 months.
- Item 6
Row B: an MSLT (multiple sleep latency test) performed within the previous 12 months.
4. A MSLT (multiple sleep latency test) performed within the previous 12 months.
- Item 7
Row B: results of any additional testing already performed for this condition, such as a Maintenance of Wakefulness Test (MWT).
5. Results of any additional testing already performed for this condition (e.g., Maintenance of Wakefulness Test [MWT]).
Good to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
The table's words on aviation safety
Row A's note says this condition is incompatible with aviation safety. Row A ends DEFER, Submit the information to the FAA, and Row B ends DEFER, Submit the information to the FAA for a possible Special Issuance.
Show the FAA's words: good to know, 2
Note: This condition is incompatible with aviation safety. … DEFER Submit the information to the FAA. … DEFER Submit the information to the FAA for a possible Special Issuance.
Row B's list names narcolepsy only
The table is titled Narcolepsy and Idiopathic Hypersomnia. Row B's evaluation data speaks of the diagnosis of narcolepsy being rescinded, and does not name idiopathic hypersomnia. This page shows it as printed.
Show the FAA's words: good to know, 3
NARCOLEPSY and IDIOPATHIC HYPERSOMNIA All Classes … If additional testing, evaluation(s), or documentation verifies the diagnosis of Narcolepsy was rescinded, no longer requires treatment, or has resolved … how the diagnosis of Narcolepsy was rescinded
Rescinded, no longer requiring treatment, or resolved
Row B's heading is new information which rescinds this diagnosis. Its evaluation data applies if additional testing, evaluation(s), or documentation verifies the diagnosis of narcolepsy was rescinded, no longer requires treatment, or has resolved. Both are shown as printed.
Show the FAA's words: good to know, 4
WITH NEW information which rescinds this diagnosis. … If additional testing, evaluation(s), or documentation verifies the diagnosis of Narcolepsy was rescinded, no longer requires treatment, or has resolved
Two time limits in Row B
For Row B the neurological evaluation is no more than 90 days before the exam, and the sleep study and the MSLT are each performed within the previous 12 months. The table recommends the MSLT is performed in conjunction with the sleep study and interpreted by the same physician.
Show the FAA's words: good to know, 5
no more than 90 days before the AME exam. … 3. A Type 1 or Type 2 Sleep Study (polysomnogram) performed within the previous 12 months. 4. A MSLT (multiple sleep latency test) performed within the previous 12 months. To assure the usefulness of it is recommended that the MSLT is performed in conjunction with the sleep study and interpreted by the same physician.
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.