Voluntary restriction on Medical (fatigue)- How?

[UFO-flying-Airbus]

Hello all,

I'm hoping that someone might be able to help point me in the right direction with a work-related query.

I have (or appear to have) a circadian rhythm/ cognitive impairment issue which results in my being radically fatigued when being rostered for early morning flights.
I have tried many forms of redress. Diet, exercise, meditation, mindfulness, behavioral changes etc. to little avail.

The fact remains that I can only barely function in the early morning period of circadian low despite my best efforts to manage my sleep and energy levels
I am a healthy weight and run and exercise at the gym regularly.

After many years of ultimately fruitless dialogue with our scheduling department and management and countless fatigue reports I am still being rostered for such duties.

I have been informed that if I am able to procure an 'official' medical attestation to my problem I could be given a reprieve from such morning flights.
I am completely comfortable to commit to any medical restriction if that is what is required. But if a less radical solution may be available I'd be interested to hear your views.

I have a UK CAA Class 1 Medical on a UK License.

My AME has written to me on this topic and I have forwarded his mail to my higher ups which says that he affirms that I struggle with fatigue on early flights and advises that I not be rostered for them.
My manager, however, said that this is insufficient. Hence this post.

I just really need to get out from behind this as it's very distressing and quite tough on morale. I am fine after, say, 8am but if I fly earlier that that I make a disproportionately high level of slips (eg missed radio calls, selecting the wrong frequency,) and errors (eg late configuration, impaired Situational Awareness and so on). Not to mention a dull ache between the temples and a low mood.

Is there any way to get this issue addressed in my Medical Cert or otherwise?

Kind regards,

UFO-Flying-Airbus
London, U.K.

[B2N2]

Maybe you have a (natural) melatonin secretion issue.
Nitric Oxide deficiency?
Have you done sleep studies or taken supplements for either one?
Not sure if it’s of any relevance :
https://content.iospress.com/articles/journal-of-alzheimers-disease/jad131217

https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.570.3343&rep=rep1&type=pdf

[CW247]

I feel the same. Watching this one closely. Thanks

[dirk85]

An airline could argue that such a limitation would make you not suitable anymore for employment.
Especially low cost ones, where half of the duties are early.

[Big Tudor]

Would this not come under occupational health? If there is a physical or mental aspect of the job that causes challenges to you as an individual then this should be the most appropriate route IMHO.

[UFO-flying-Airbus]

Occupational Health. That sounds like an interesting point. Thanks Big Tudor. I'll investigate

[B2N2]

Be very careful with limitations on your medical, last thing you want is getting denied a Class 1.
Now I know I’m quoting US regulations but it’s ICAO and they generally don’t differ by that much, I’ll leave it to you to find the UK CAA equivalent:

No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds -

(1) Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or


If you have a functional limitation that makes you unable to perform certain times of the day…
I know it’s a stretch but there is room for interpretation that could go against you.

[DIBO]

I have tried many forms of redress. Diet, exercise, meditation, mindfulness, behavioral changes etc. to little avail.
Not answering your question, but a few suggestion to further diagnose possible causes:

take a Sleep Apnea Test
self-monitoring your blood glucose levels (at hourly intervals), As this might be unpractical during active duty, then simulating as much as possible the activities/routines of an early morning roster (driving to the airport, picking up a snack or a coffee, some task with increased stress levels / requiring mental focus, etc.). If needed repeat & compare the glucose levels with a simulated afternoon duty. At state of pre-diabetes can go undiagnosed for 10 or more years.
you mentioned 'diet', only in the calorie restriction meaning? If so, allergy elimination diets might be worth a try. Or evolve very gradually to some schedule of intermittent fasting, for e.g. with a fasting window of 7pm to 11am. You might be surprised to see the impact of the digestive tract on physical and mental acuity.

[First.officer]

Would be interesting to know if you've had any investigatory procedures? assuming you must have?.

Sounds a little like a thyroid issue perhaps. But then I am no doctor.

[UFO-flying-Airbus]

Hi First.oficer, no, nothing like that. I'm just keen to affect a change if at all possible

[Ancient Observer]

I has been years since I talked to the medics at the Belgrano, but they did not use to be averse to private conversations with pilots. They can be v discrete. But, obs, there is a risk to your license if they think you shouldn't be flying!
Someone you know will find a way in to the Medic team.

Amongst the various ideas above, the self monitoring of blood-oxygen is easy and cheap to do. Worth doing alongside the blood glucose measurement .

[Manual Pitch Trim]

I dont think its a good idea for you on your medical license. After flying 3 mornings ask for the 4th day off for fatigue. Fatigue report. Can you do fatigue sick days? Then the company might give you afternoons in your schedule, write the chief pilot. Dont mess with your medical. Your either fit to fly or not