- Part 1 – Can A DOT Medical Examiner Refuse You A Medical Card Unless You Have A Sleep Study Done?
- Part 2 – DOT Physical And Sleep Apnea Testing: Are Medical Examiners Caught Between A Rock And A Hard Place?
- Part 3 [You Are HERE] – Commercial Driver Awareness About The Sleep Apnea Issue
- Part 4 – OSA: How To Know If You Have It
- Part 5 – Commercial Drivers Can Manage Sleep Apnea And Maintain Their CDL
The sleep apnea issue could affect both your livelihood and your life.
Ask yourself – “Am I ignoring or denying personal health problems (longer term life risk) because I can’t afford time off work (shorter term financial risk) or to lose my job?”
By being aware of the different circumstances and perspectives around sleep apnea, you get to manage this before it becomes an issue. Then you can do what you need to do to protect both your earnings and your health.
CHECK OUT THESE STEPS
Step 1: You’re At Reasonable Risk for Sleep Apnea.
A combination of symptoms and / or diagnosed medical conditions indicate that you may be at high risk for sleep apnea.
You can bet on these pointing at a sleep study test in your near future. And the Medical Examiner is justified in requesting a sleep study test.
Step 2: You May Suspect You Have Sleep Apnea But You Haven’t Been Diagnosed Yet.
Obstructive sleep apnea is a medical condition that can have serious life-threatening consequences if not treated.
If you have reasonable suspicion that you have sleep apnea, it’s recommended that you investigate it further, see your physician and do a sleep test if necessary — BEFORE it becomes an issue for your medical card — and while you still have time to look into OPTIONS that work best (financially, time wise, and health wise) for you.
Step 3: You Can Manage Sleep Apnea and Maintain Your CDL.
Obstructive sleep apnea does not necessarily disqualify you for CDL medical certification.
Treatment with a prescribed CPAP or Bi-PAP machine, and some manageable lifestyle changes, can help you take back control of your health, and maintain your commercial drivers license.
If You Feel You Are HONESTLY NOT AT RISK And Screening Seems To Be Overly-Cautious Or A Conflict of Interest…
If a medical examiner is picking single strikes e.g. neck size or BMI to send you for a sleep study, you should question the motive.
The examiner may be being overly-cautious, or work for an organization that has laid down a list of screening factors and is not considering the bigger picture. Or, the examiner may have ties with a sleep clinic, and have a conflict of interest.
Be aware that there are no FMCSA rules at this time regarding sleep apnea screening i.e. prescribing who should be tested. This does not mean you have a “get out of jail free” card to avoid the issue if you are at risk.
If, after understanding the indications of risk for sleep apnea, you feel that you are honestly not at risk, then you now have the information to stand your position if a medical examiner tries to assert screening guidelines rather than assessing your overall health situation.
Put In A Nutshell
You may be reading this article because you’re concerned about your livelihood – how sleep apnea could affect your DOT medical certification and that your CDL is at risk. If that’s the case, then you should be concerned about your health too – that this issue could become life-threatening.
Who Has Their Hand On The Steering Wheel Of Your Life?
If you don’t have your hand firmly on the steering wheel of your life, you can be sure someone else is going to be putting their hands on it.
Commercial driving is an extremely challenging lifestyle. Will you let its constraints – health challenges, rules and regulations – control the way you live? Or will you take back the steering wheel of your life and manage your life and your livelihood, despite its challenges?
By knowing what the problems are, you can take action to make the outcome different, and maintain your CDL without hassles.

You can find Dr. Seals at Chiro Stop in Salt Lake City, UT.
Another money racket this rule should be imposed on all driving license police fireman all drivers. Screwed again
I know I’m late to this discussion but I’d like to add my experience.
I’m an EMT that’s been working on ambulances for 36 years. Since the DL51’s are renewed every two years I’ve been thru the exam 17 times with no issues until my most recent exam.
It started w/ a drug and urine test (my employer requires the drug test which is fine), then on to the exam. The doctor tells me my heart rate is elevated (that’s normal at the doctor). He stops the exam and orders cardiology referral.
I get home and all vitals normal.
I see my primary and get an EKG and echo on my heart then return for DL51 exam. I got three months until sleep apnea testing is done then I return for another exam.
What’s the next hoop I’ll have to jump thru?
He asks about my sleep…I work a 24 hour shift where it’s normal to not get a lot of sleep which means I sleep when I get home.
Let’s see what happens next
@ Mike McR
Unless you hold a class A cdl, then you should not be held to a class A standard. Lower class license fall under your states guidelines and variances. The examiner should know the differences and pass or fail according to the guidelines that you fit into. Go somewhere else for a second opinion in this case.
I took home sleep study. It said severe apnea. Now I am going to take in lab study. I was given CPAP and am compliant but can’t sleep. Can I get another physical and be cleared with that. Should I take the I’m lab study. I can’t wear the CPAP. Don’t know if In lab study comes back positive. Am I stuck. What if I change jobs and don’t tell them and pass new physical. Does dot know about it.
I was told to take a rest because my BMI was 36 and neck 17.25. I took the test and got a AHI of 10.4 and was told I have it. Was looking and they say DOT should be 20 and above for a cpac. I have lost 25 pounds and now have a BMI of 34.4. If the test said that I should have a cpac or lose weight which one should I follow?
@Jeff
Since there were no new rules regarding OSA and you lost weight, then try going somewhere else for a second opinion. If you feel that you do benefit from the CPAP, then by all means use it. Drivers who have OSA and use the units won’t leave home without it.