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See our BLOG Category on Sleep Apnea for articles and more information.
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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I am a non cdl driver that requires A dot physical I only drive 55-60 miles a day. I was told my BMI was hi and have to go for a sleep study Is this even legal please give me advise.
@Phillip
Well they can say what they like, but there are no regulations that will support a ‘mandatory’ sleep study. Just take your business elsewhere. Someone is over-reading the guidelines and does not understand what they are doing for a non-cdl driver.
To better understand this subject read our articles on Sleep Apnea Issues Affect Commercial Drivers.
I have driven for same company for 15 years with perfect record. I am 38 . I had to go to company doctor for my physical for CDL renewal. The doctor said because of my neck size I had to have sleep apnea text. He said it is the law. I read this site and knew it wasn’t. I went to my boss and was told I had to have the test if I wanted to keep my job. I had an at home test with wrist bracelet. I failed. I have no high blood pressure .no sugar diabetes, perfect eye site. Do not use any medication ever. I am an active outdoorsman. No sleep problems! I failed the test. I was told I slept 8 1/2 hours and failed. I talked with the guy giving me the results. He said 99%fail. He told me he personally has taken the test and he failed it. I asked him if he wears the mask, he said ,”No, he cant stand anything on his face.” I tried it for a few minutes with him and could not stand it. I have always had a fear of drowning or suffocating . I cannot use it. What options do I have? Now that I was diagnosed with an “at home study”, could I still get another opinion and drive for a different company? Or , since I took the test because I wanted to stay at my present job is it too late to do that.?? I know about the 30 day wait to go to diff doctor from reading your site. I was given 90 days to comply. Do I wait 30 days after being told I have it? Thank you for this site!
@Kathy
The at home test do not stand up in a court of law.
Your best bet, since neck size and bmi is not a law and there are no new regs for sleep apnea, then go to another facility for your next exam. Unless you demonstrate more than 4 or 5 issues regarding excessive daytime sleepiness, you should pass with out any issues. Just wait out the 90 day to about 2 weeks before it expires.
Can’t tell you what to do about the boss.
I just went to another DOT doctor and got my medical card for two years. However, since the at home wrist test does not stand up in a court of law I did not say I had been diagnosed with sleep apnea. I waited until the 2 weeks before my card expired as you suggested. However, I have been reading site and am now worried I will get flagged and accused of doctor shopping. And lose my license. ?
Also, since my company I have worked at since I was 21 wont let me get another opinion I am going to lose my job. However, I didn’t want to lose my job and my trade (CDL) also. Thank you
@Kathy
If you suffer with sleep apnea symptoms and you lied on the federal form, then you could be flagged. If you have no sleep apnea symptoms and you passed with another CME, then you will have no issues.
Just wanted to thank you for your input and all the help provided on this site.
Have a great day!
Hello, I went to an urgent care for DOT approval for pre employment, and was temporarily suspended due to history of mild sleep apnea about 10 years ago. I had a new home sleep study kit done, with the report stating no sleep apnea found, and a letter stating the same from my family physician. The urgent care to approve this DOT, rejects all this and wants a overnight sleep study in a facility done (which my insurance won’t pay for).
Obviously after all this, the possible job I was trying to get into is closed. The question is: Can I just go to another different urgent care/Dot screening facility when a new job offer comes, present the examiner with the evidence and let them make the decision, or do I have to get the original urgent care to approve me?
I understand I am in a database for sleep apnea now, but I have the current reports stating no sleep apnea, I have a clean driving record, no daytime sleepiness, I’m 5’9 and 150 lbs, ect.
Thank you very much for your help.
@Jake
‘Doc in a box’ facilities are not your best bet. Try to find a CME that works independent of the urgent care places.
You may be in the data base as an individual, but FMCSA does not get the reasoning for the disqualification.
There were no new rulings regarding sleep apnea and the CME who disqualified you is overstepping the guideline to protect themselves from possible risk. See our Sleep Apnea Issues articles.
Take your information along with your doctors medical release with you and you should do just fine.
Doc,
I received a 2 yr DOT medical card from my personal doctor who is a DOT examiner. When I went to “blah blah” trucking for orientation I was required to have another DOT physical and that examiner stated that since my neck size was 17″ and I was overweight that I needed a sleep study done to get hired at the company and they sent me home. I don’t have any of the other symptoms; I don’t snore or stop breathing, I don’t have diabetes or High blood pressure nor do I smoke or drink. Also I do not have an enlarged tongue or swollen tonsils. How do I avoid this idiocy in the future? Would a letter from my personal doctor who is a DOT examiner help?
@Martin
Since there are NO NEW REGULATIONS regarding sleep apnea, the first question would be, is this a company policy?
If it is not company policy, then go through the FMCSA website and enter into conflict your opinion. FMCSA is very aware that the whole sleep apnea scam is taking good drivers off the road and they want to follow-up with regular reports that a CME is requesting expensive test when they are unnecessary.
Next time, if the CME starts in with the neck and BMI, get up and walk out, go somewhere else.
For more information on this misunderstood issue read our articles on Sleep Apnea Screening.
Can a trucking company out of Nebraska make me take a sleep study test. I past the physical an was certified for 2 years. There company policy states I have to take one. But I haven’t sign any papers agreeing to do the study.
@ Chadd
If it is a company policy and they are paying for it, then yes they can require it as part of their hiring policy.
How is the rate of compliance on the Cpap machine. I have been using it 4 hours a night the minimum, the clinic tells me i have to be at 70 to 80- percent compliance. What does that mean ?? How do they determine that ???
@John
Your cpap should be able to download a report of usage. In that report there should be a percentage of compliance. That is what the CME is going to be looking for.
See our article Commercial Drivers, Sleep Apnea for the compliance recommendations.
If a doctor suspects a CDL driver should be tested for sleep apnea can they certify the driver anyways? and then tell them they have three months to take the test and return? How many factors do they have to take in consideration to send someone for a test?
@Lisa
It is totally up to the examiner as to what he does and for how long he does it for. If he suspects sleep apnea, then there better be a number of things that have moved him toward that conclusion. You can Google sleep apnea and see how many things the examiner should be looking for.
Also read our series of articles on Sleep Apnea Affecting CDL Medical Certification.