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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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Can i get retested for sleep apnea, and have it removed from my CDL, if I loose a 1/2 inch off of my neck size, and loose about 20 pounds. Thank You Keith
@Keith
If the test comes back negative for sleep apnea, then yes, why not.
But it wont. I asked the people where I had my study done and they told me 99% of people that have it done get a machine.
NATURAL! NO COST, NO MED’S,NO PM PILLS with natural deep sleep.
While laying in bed, breathe in nose, hold for count of 7, exhale through mouth slowly. Repeat this 3 to 4 times and goodnight. Sleep like a baby. Wake up feeling refreshed and ready to start day. ( From Yoga breathing class).
I was diagnosed with a mild form of Narcolepsy more than 3 years ago and have been on medications since that have brilliantly controlled my symptoms. I have never actually had a narcoleptic episode, however I suffered from excessive EDS and had enough REM cycles in a sleep and nap study to qualify for a Narcolepsy diagnosis. Both my primary care doctor and sleep specialist feel I am capable of driving a commercial vehicle and performing the duties of an Emergency Medical Technician safely. When looking at the DOT guidelines, it says that the guidelines RECOMMEND disqualifying anyone with a Narcolepsy diagnosis regardless of treatment due to the likelihood of EDS. I have already provided a letter from my sleep specialist saying he feels I am capable of performing these duties safely and will get both my primary care physician and sleep specialist to fill out the Medical Release Opinion form. Do you know if there is any other information that I could provide the Medical Examiner with that may help argue my case? If not, is there any way that I can get around or combat this because I have multiple physicians I have worked with for years saying I am capable of both driving an ambulance and performing the job specific tasks safely while the Medical Examiner is the only person who is both new to my history, and disagrees with the other two practitioners?
@Kelsey
Start with what classification of your drivers license – Do you have to have to drive an emergency vehicle?
The FMCSA guidelines are aimed more at the over-the-road drivers.
So with a lesser class license you may only need a medical card and not the class A version of a medical certification.
Also if you only drive intra-state you may fall under the states rules and not in the federal regulations. Each state is different so check with your state DLD.
Do I need data off my cpap every time I renew my medical card? If so how many months back do they need?
@Dwight
You would want to take a copy of the last couple months report each time you have a DOT medical examination done. The examiner is looking for proper compliance, so you might want to take a medical release form from your doctor stating that you have been compliant and how long you have been on the unit and how long he has been monitoring you.
Arizona wants 1 year report. Unless you just started then 3 months. Until your next physical.
I recently started at a new company in July, and of course getting my d.o.t physical done I got ordered to get sleep test, well my general manager (who I’ve known since childhood ) said no biggie just wait till your insurance starts then get dr. Appt scheduled, well went to schedule appt I could only get one that was 9 days past the expiration date that was juse the consultation then order the test after. I was told oh they give extension all the time, we’ll fast forward. I was denied the extension, been unable to drive since Sept 1st, can’t get anyone to help figure out what to do, now my company says if I can’t get it figured out I have to resign or I’m terminated by 5:00 pm on Sept 11th could I go and try to pass there b.s again and try bypass the sleep test . Been driving 19 years , all my actual physical results were in the great range, the only reason for test was neck measurement, but I have been a body builder for years it’s from working out and taking care of myself, ,,,, is there anything I can do?? Sorry for babbling but I’m running out of time and just needing a miracle
@Rob
Why not just go somewhere else and have the DOT examination redone.
There were no new laws regarding sleep apnea and this neck measurement and BMI are the laziest way to trick you into getting the test when you may not need it.
Now if you do have issues with daytime sleepiness, then by all means get the test done as soon as you can.
To better understand this contentious issue, read this series of articles on Sleep Apnea Screening.
Hello, I also was told YOU HAVE TO HAVE SLEEP TEST by CME, The Sleep doctor did the oxygen finger test, looked down throat and said I dont think you have it., but we have to prove it to DOT.. Anyway, sleep test done at home came back with 17, I told them i am NOT SLEEPY and per Guidelines i do not need CPAP machine if AHI <20 and no daytime sleepiness. So the CME gave me my one year card due to Blood pressure meds. Now, when I go back into to renew for my 1year again do i state anything about test showed <20 AHI and no treatment needed. Or do i just leave this blank on form. I will be going to new CME. Thank you for helping me understand .
@Steve
The one year card due to blood pressure medications is correct.
You have had the test for OSA and it was negative, so I would just mark “NO” for snoring or sleep disorders. That should fly just fine on your next DOT physical exam.
during june i had a prob with driving did blood and stress tests passed both advised to see a neurologist and did a EEG 7/27at hospital -passed but on the sleep night test 7/28 at clinic wr doc works out of, was told i had sleep apnea and put on a cpac for 30 days
no medical rel giving and out of work for 2.5 mo so far
how to i get a 2nd option w/o being taged shoping
55 age with 21yrs exp +2yr current =23yr driving CDL
solo 3300mi /wk for 5mo gets hard and it seems like I’m being hit and made to pay $ for co. working my ars off at the same time told i cannt work
@Mike
If they put you on a CPAP unit, then you need the 30 days to show compliance.
If you want a second opinion, then go find a CME that understands the guidelines and test with them.
Doc shopping only occurs when you go from one office to the other in a quick fashion, usually with an intention to hide relevant health information.
Just wait till your existing card is about to expire and then go somewhere else for another opinion.
Is it mandatory for a CME to only give a 1 year medical card to a driver with treated sleep apnea? I have had both 2 year and 1 year while being treated.
@Brett
New FMCSA guidelines recommends that drivers being treated for sleep apnea should be re-examined every year or medical cards are not to exceed one year at the time.
So I just listen to a live radio show with the FMCSA this morning with many questions and concerns reguarding this statement of weather or not that the medical examiner is required to only give a one year card if diagnosed with sleep apnea.
There reply from the FMCSA was stated by there representative that there is no restriction of us with getting a two year card when we present them that we are under the care of a sleep specialist and are compliant then there is nothing law or written anywhere that states we only get a one year card! So can you show us in writing where it says anywhere that you can only give us a one year card ore any other medical examiner when FMCSA stated otherwise!
@Chris
Look in the FMCSA guidelines for the certified medical examiner handbook on the FMCSA’s own website.
It is a recommendation from the FMCSA that is being held to. With proper documentation and at the discretion of the examiner, a two year or a one year card will be given.