Drivers who come in to my office for a DOT physical exam often ask: “Why do I need a sleep study? DOT doesn’t require it.”
So here is the information a driver needs to know regarding if you need a sleep study or not:
The FMCSA states that DOT medical examiners should follow “best practice” guidelines when evaluating a driver for sleep apnea and ordering a sleep study. Here are the “best practice” guidelines that are recommended:
A driver with symptoms:
If the driver has one of the following 4 symptoms it is recommended that driver be tested for sleep apnea:
- Driver complains of consistent daytime sleepiness or fatigue.
- Driver has been involved in a sleep-related accident.
- Driver states that someone has observed the driver stop breathing while sleeping.
- The driver reports that he snores loudly (snoring is heard thru a wall or door).
A driver without symptoms:
If the driver has none of the above symptoms but they have multiple risk factors for sleep apnea, it is recommended that the driver be tested for sleep apnea. Here is a list of those risk factors:
-
- BMI of 33 or greater.
- Neck size of 17” or greater for a male.
- Neck Size of 16” or greater for a female.
- Driver has one or more of the following disease:
- Driver has High Blood Pressure
- Driver has Diabetes
- Driver has Heart Disease
- Driver has Hypothyroidism
- Driver has history of Stroke
- Male driver over the age of 50.
- Female driver post-menopausal.
- Driver has a Mallampati Score of 3 or 4.
Best practice recommendations for drivers that have had a prior sleep study:
A second sleep study is recommended if the driver has developed additional risk factors since the first study was done, or the driver has had a 10% increase in weight.
As always I am here to help and I truly care about the safety and wellbeing of every driver. The fact is, most health problems will not prevent you from passing a DOT physical, as long as you are treating the health problem. If you have any questions or concerns about any health issue please call me (314-739-7979) and I will take the time to talk to you on the phone, even if you are not coming to my office for your physical.
Dr. Knuuttila, Knuuttila Chiropractic
DOT Physical Exams in Bridgeton, Missouri
(see more than 50 driver reviews)
My husband went to the company doctor for his DOT physical and was seen by the dr’s FNP. She told him he needed a sleep study done because of his BMI and neck size and only issued him a 3 month card. He has no symptoms or signs of sleep apnea. She told him she could not order it, he would have to go to his PCP for the referral or get a letter stating the PCP could not find cause. Made an appointment with the PCP who had him fill out a questionnaire. The questionnaire along with his annual exam records (including labs, diagnostics and physical exam) indicates he does not need a sleep study. Therefore the PCP did not order and health insurance says they won’t pay for it. The PCP’s findings were sent back to the FNP that did his initial DOT physical, along with a letter from the PCP stating he finds no cause for the study, and she refuses to go ahead and extend his physical card. Who is supposed to pay for these studies, and schedule these studies, if your primary (who you see regularly and knows your health and history) says you don’t need it?
@ ConcernedWife
DOT and FMCSA have never established a mandatory sleep study be done based solely on BMI. Your hubby is being hoodwinked. Go elsewhere for a second opinion. The company doctor works for the company, not you. Unfortunately you get to pay for it all.
She used BMI and neck size as the reasons, his neck size is 19″. However, his mallampati score is a 2. The PCP says the 2 is a key indicator he is not a candidate for a sleep study and the DOT examiner should have known that. Combine that with the questionaire and the PCP won’t order it, and health insurance won’t consider it. His company has told him that you can’t get a second opinion on a DOT. I will relay all this info to him so he can have another discussion with his supervisor. Thank you.
@ ConcernedWife
Our first question is who has the national registry number? The doctor or the FNP? You have the right to a second opinion anytime. Your physician is correct and the doctor on the registry should take this information into consideration. It sounds like a conflict of interest if the CME is mandating a sleep study without considering the additional information which has been provided.
It is most definitely a conflict of interest. We have since found out that the doctor sent the trucking supervisor a letter stating they were going to require the sleep study, even with the PCP’s letter in hand. Then in the same letter proceeded to give the trucking supervisor the cost of having the procedure done at their facility. Talk about a huge conflict of interest there.
@ ConcernedWife
This is why we said go elsewhere for a second opinion. If the company will not allow a second opinion, then the company is in on it somehow. You always have the right to a second opinion according to DOT/FMCSA if you feel the CME is incorrect.
WHAT DOCTOR ? GOING THROUGH THE SAME THING …
This is in Cape Girardeau, MO….Southeast HealthPoint.
I’ve had my CDL that I paid for. For 23 Pluss years and safe. Now sleep study.for what .these physicals are getting out of hand. Why do I have to pay for it .the doctor should pay. Lose your career because a doctor says your to have asleep apnea test . I have no diabetes.i have no highblood pressure. Now this
And not payingfor a 2nd opinion.bmi indext is false also . They don’t measure the cercumfrence of wind pipe. ps the wright to work . this is united States.
@ T
DOT/FMCSA has not established a mandatory sleep study based exclusively on a single bmi test. There should be a multitude of signs and symptoms before this test is requested. Get a second opinion, you have that right.
I had 2 doctors tell me that they can’t issue me a new DOT card because I need a CPAP machine. My DOT card expires next week and I can’t even go to work with out it. There also a recall on the ones they want me on and they are telling me 10 weeks before issuing a machine for me. Is there another way around this?
@ Michael H
If two CME’s have indicated a need for a CPAP, then you must be exhibiting a multitude of signs and symptoms for OSA. You can try and explain the situation to one of the examiners and have him provide you with a short / temporary medical card until you can get a machine.
I am a utility worker. I have a class B cdl license because the company i work for require of me to have it. But i only drive a pick up Ford 550, do i need to renew my dot card and take the physical exam, or can i apply for an exemption. i reside in miami Florida
@ Sam
Most states require a valid medical card to maintain a cdl. Even though you only drive a pickup truck, it is a vehicle that is used for commerce for the company. Best to check with your local drivers license department and see if they have an exemption for you.
Went for a DOT physical and doctor said I might have sleep apnea and gave me a permit for 6 months can I just go to another doctor to do another dot physical try to get one for 2 years I feel great sleep great
@ Jose t
You can go and get a second opinion.
My new company doctor told me I need a sleep study done and gave me a 3 month certificate expiring 9/22 but my original certificate was for 2 years expiring 3/24. I didn’t take the job. Which certificate is valid.
Also can I go back to the first Dr and get another DOT physical if the 2nd one is valid
Did you ever find out am on the same problem as you cab you let me know what happen please
I was told I need a sleep study before I get my card, but he gave me a three month card. Imho the dr was a quack, conveyor belt Dr. Do I have to get a sleep study done or can I get a second, I had one done in 2015 and have since lost weigh. I’m 52, 6’3″, 18in neck, and 300lbs. I sleep just fine at night, and have never had an issue.
@ Scott
Go get a second opinion.
If I get my bmi under 33 but I have been diagnosed with obstructive sleep apnea can I come off the cpac?
@ Jimmy v
That would be your doctors call, not DOT/FMCSA.
So I had a sleep apnea test done and the AHI is 11.5 which is boarder line sleep apnea do I still need treatment ? I’m on a strict diet and fmcsa says olny moderate and severe sleep apnea needs treatment not mild case
@ Eric
The examiner must take a much larger view of your condition. If you have no other symptoms that indicate OSA, then you should be fine.
I checked off “sleep apnea” on the questionarre due to my PCP mentioning it in the past. Of course, this brought up a red flag to the NP doing my exam. She issued me a 6 month card. Fast forward to last week when I finally did an at home study. The study came back as “Quite severe OSA” does this disqualify me in the state of Rhode Island? I was told that anything above moderate will.
@ Jamie
Not if you are using a cpap with a 70% compliance record. According to the federal DOT/FMCSA.
Doctor came in the office and said he was over worked and been busy all day he hasn’t had a chance to change his gloves, now that’s exactly what the doctor said when he came in the room, then looked at my daughter and said you have to get a sleep study, nothing else, never asked her anything about herself. I believe this is a bad dit doctor that’s just tired, so being she has to wait 5 months to get one where and how is she to pay her bills? Did I mention, no health complications at all.
@ Dawn
Simply go somewhere else and get a proper medical examination. Sleep studies are not mandatory for DOT/FMCSA unless there are a multitude of signs and symptoms.
I was told I needed a sleep study even if I already had one in 2015 I may benefit from a cpap but not required to have one.
@ Denise
Go get a second opinion elsewhere.
In 2011 I was diagnosed with sleep apnea. I have been taking Modafinal for 6 years and have my compliance with CPAP machine checked yearly . Will this be a problem.
Thank you
@ Samantha
You should be fine. Bring documentation and readouts with you to your next exam.
I have been recommended by my companies DOT Doctor to have a sleep study. He only gave me a 90 day card. My temporary DOT Card expires Aug 6, 2021. I finally got in to see the sleep study specialist who is awaiting approval from insurance. The Doctor said I should have sleep study done but won’t have the results back until after my DOT Card expires. Can the DOT Doctor give me an extension so I can still work until my results come in?
@ Bobby
You will have to check with the CME who requested the sleep study.