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Q&A
Is sleep apnea a disqualifier?
What is EDS? Is EDS a disqualifier?
If I’m overweight do I have to have a sleep apnea test?
Is there a BMI limit for commercial drivers to pass the DOT physical?
What does neck size have to do with the DOT physical exam?
What does snoring have to do with the DOT physical exam?
I take Restoril for sleep. Will that be a problem for the DOT physical?
Is sleep apnea a disqualifier?
Sleep apnea does not necessarily disqualify you for medical certification. Treatment with a CPAP machine and some basic lifestyle changes can help you get a restful sleep and maintain your commercial driver’s license. Many drivers who have suffered fatigue for a long time , and then were diagnosed with sleep apnea and treated, report that they’ve felt like a new person since they’ve been on a CPAP machine.
You will need to bring a medical opinion letter from your treating physician before you can be considered for DOT medical certification.
Narcolepsy is a disqualifier regardless of treatment, because it poses a risk of EDS and may also bring on sudden muscular weakness.
What is EDS? Is EDS a disqualifier?
EDS stands for Excessive Daytime Somnolence or Sleepiness. Because fatigue and driver drowsiness are safety concerns, the medical examiner must rule out EDS before certifying. A driver who has EDS will be temporarily disqualified until the condition is being successfully treated. The medical examiner will want to see a medical opinion letter from the treating physician before issuing a medical card.
If I’m overweight do I have to have a sleep apnea test?
No. Being overweight, of itself, does not mean that you should be tested for sleep apnea. Overweight is an initial indicator for the medical examiner to make sure that other conditions aren’t present which may affect your ability to safely operate a CMV.
The medical examiner will evaluate your overall physical condition and health history. The medical examiner has a responsibility to have you tested for sleep apnea if he/she has reasonable suspicion that you may have sleep apnea. Many people suffer for years from sleep apnea and don’t know they have it until a doctor catches the symptoms.
Sleep apnea is not only associated with sleep deprivation. It’s also associated with an increased risk of cardiovascular disease, stroke, high blood pressure, arrhythmias, and diabetes. The most serious complication is a severe form of congestive heart failure. Sleep apnea sufferers also have a 30% higher risk of heart attack or premature death than those unaffected.
Is there a BMI limit for commercial drivers to pass the DOT physical?
There are currently no set specifics on BMI measurement in the DOT regulations. However, companies may set their own policies and have their own standards for these indicators, which may disqualify you to drive for that particular company.
What does neck size have to do with the DOT physical exam?
Neck size, weight, and BMI are all just indicators that the medical examiner looks at to determine if you may have a condition such as sleep apnea that would impact your ability to safely drive a commercial vehicle now or for the period for which the medical card may be issued. There are currently no set specifics on these measurements in the DOT regulations.
Other indicators of potential obstructive sleep apnea are enlarged tonsils and large tongue volume. Individuals with low muscle tone and soft tissue around the airway (e.g., because of obesity) and structural features that give rise to a narrowed airway, are at high risk for obstructive sleep apnea.
Because sleep apnea is associated with increased risk of other debilitating diseases, it’s the responsibility of the medical examiner to rule out suspicion of sleep apnea, for driver certification.
What does snoring have to do with the DOT physical exam?
Snoring, in combination with obesity, can be highly predictive of obstructive sleep apnea risk. That said, even the loudest of snorers may not have a breathing obstruction. The sign that is most suggestive of sleep apnea occurs when snoring stops. If both snoring and breathing stop while the person’s chest and body try to breathe, that is literally a description of an event called an ‘apnea’. When breathing starts again, there is typically a deep gasp and then the resumption of snoring.
For the DOT physical exam the medical examiner evaluates your overall physical condition and health history to determine if there are signs of a medical condition that may affect your ability to safely drive a CMV. If the medical examiner has reasonable suspicion that you have sleep apnea you may have to go for an overnight sleep test called a polysomnogram before you can be further considered for certification.
I take Restoril for sleep. Will that be a problem for the DOT physical?
The medication, Restoril, may cause side effects: Hangover effect, drowsiness, dizziness, nausea, and vomiting.
These will all be questions the medical examiner is going to ask you about. This medication is usually used on a short term basis and not for a long term sleep aid. So it will depend on the type of driver you are and would be a serious consideration within the DOT examination.
You will need a medical opinion letter from your prescribing doctor explaining his reasoning for the use of this medication and why he feels it would be safe for you to drive a commercial motor vehicle OTR. Otherwise this could be a disqualifier for OTR drivers.
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If you pass the sleep apnea test do you have to retake the entire dot physical again?
@ Richard H
This will mostly depend on the examiner and his/her interpretation of the DOT/FMCSA guidelines for a class A cdl holder.
My doctor says I need to use a apap will dot accept that as long as I’m complaint..I know the difference between apap and cpap.. but I don’t see any information on the apap for dot.. I live in PA
@ Maria
With proper documentation and compliance records, you should be fine.
Does your company need a letter from the sleep study Dr in order to consider you back in service or is a note from your pcp good enough
@ Chauncey M
This is a question that can only be answered by your company.
If I was diagnosed with sleep apnea an give 30 days to become cpap compliant, but took another sleep study that showed I don’t have sleep apnea, can I get a 2 year medical
@ Josh
Who diagnosed the OSA in the first place? The medical examiners clinic or a sleep study facility? If it’s the medical examiners office, and you do not demonstrate a multitude of OSA symptoms, then you should be good for two years, if all else is normal.
Can hypoxemia disqualify you for medical card for cdl
@ Steve H
It can if the condition is severe enough. It will raise questions with the CME and he may request additional medical documentation from your primary treating physicians.
Compliance is 70% at 4 or more hours since treatment (which diagnosed many years ago) and If I’m 70% or higher at 30 days and 365 days but only at 63% at 90 days (due to an upper respiratory tract infection and cpap made me cough to much) can I still be certified?
@ Pam
Bring your records and explain the situation. The CME should take all available information into consideration and determine the final outcome on a case by case basis.
My doctor wrote letter to the dot clinic after saying i needed sleep study saying i had no evidence to provide a need for the study. The clinic will not approve my card anyway. That was my second opinion as far as i an see. My doctor knows my health not a practitioner who just met me. Why is this not good enough.
@ allen b
Most likely the facility doing your medical card is in bed with a sleep study clinic and they get a hefty kick-back. Try a second opinion doctor, not a clinic.
what do the rules say when a cpap machine breaks and user has no back up machine?
my cpap malfunctioned a month and a half ago. took supplier this long to test machine and decide ro replace it. not having the machine will put me in noncompliance next month to get new medical card
@ Brad
It will fall to the CME’s judgement. If you can supply a reading off your old machine, explain your situation and show him a reading from your new machine, he should work with you.
The medical doctor told me that I would need to have a sleep study to see if I have sleep apena. Do I have to go to a sleep study doctor or can I get an over the counter sleep study kit and do it at home?
@ Jackie O
If you do not suffer from a multitude of OSA symptoms or daytime sleepiness, we would suggest a second opinion. An over the counter sleep study kit would not be accepted as medical evidence by DOT/FMCSA for a class A cdl holder.
Is there a minimum blood oxygen level for a CDL holder?
@ Dean H
Only if there are questions regarding cardiopulmonary conditions. Then it would require supporting medical documentation from your primary specialist.
I am a DOT medical examiner and my question is about Ambien. Are driver’s allowed to take Ambien nightly? I remember part of my review course mentioned taking sleep aids for no longer than 2 weeks.
Thanks
@ Dana
Due to the adverse side effects of Ambien, DOT/FMCSA recommended not to certify. And a driver starting this regime needs to be on these meds for at least 30 days before re-newing his/her medical card. The potential side effects are a high risk factor.
What Sleep study AHI am I disqualified from driving . Is it 15 or 20?
@ Terry W K
Neither, if the OSA is being treated with a C-pap. 15 is mild OSA and 30 is moderate.
If you have been diagnosed with sleep disorder in the past and have not been on a cpap for years and have had no issues since I had heart surgery do you still have to put that on your paper work?
@ Deb
Best to answer the questions truthfully and let the CME make the decision.
I live in NH and have my CDL-B for school bus. I couldn’t handle the cpap machine and mask, and the nose pillow was a hard no. Someone just told me about the mouth appliance type thing to help with sleep apnea. Does anyone know if this is an approved device for DOT/med card?
@ Jenn
Your cdl falls under your states guidelines and variances not federal DOT/FMCSA. Check with your local DLD and determine what is acceptable by your state.
What if you are a regular OTR driver?
@ Anne
And the question is ???