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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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I had a sleep study done in 2002. I had surgery to correct a mild sleep apnea and snoring, which was successful. Since 2002 I have lost 35lbs (from 225 down to 190) I began driving professionally in 2009 and have had 4 dot physicals clear me since then. I recently went for a dot physical and the doctor only cleared me for 90 days and required me to do a sleep study because of my diagnosis in 2002. Do I need to stay with this doctor or can I go somewhere else and get my med certificate?
@Rowdi
You can go for a second opinion with any NRCME you would like.
I’ve gone thru sleep study, found out I have sleep apnea , i have CPAP machine, adjusted to it well,
been on it one week, DOT Dr. refuses to give me a 30 day temp card,he says i need to show compliance for 30 days, I proved to him it was his judgment, not a LAW, so do I have to show 30 days or the 70% {21days} to get back to work. I live in Ohio
Thank You
@George
Guideline are guidelines and are left to the CME’s discretion as to how they want to use them.
FMCSA guidelines are 30 days with 70% compliance. He may be viewing this as a safety issue and may not budge from his stance.
The way the FMCSA has written this is that the risk falls on the examining doctor and any safety issue would hold him personally responsible.
Many years ago I had a sleep study done on my own and was positive for sleep apnea. I used a CPAP but found I did not tolerate it as I would awake through out the night feeling like I was strangling. They tried adjusting my machine and different masks, all to no avail. In the end I just gave up. Fast forward to today. I have lost a significant amount of weight(+ quit smoking and drinking) and am driving a school bus part time. I have some health issues (type 2 diabetes, well controlled with metformin and hypertension well controlled with lisinopril) but based on this and my neck size (I am 6’2″ and 18.5″ neck) My DOT examiner ordered a sleep study. Fine. I went to the sleep clinic where I had been diagnosed years before for an overnight study. I completed the study but the analysis takes weeks (or more) to complete, so my personal physician ordered the raw data and My license is about to expire but here is the kicker, my physician says the data shows NO incidence of sleep apnea! (episodes of not breathing), Great, except that apparently it does indicate desat down to 87% at some point. So here is my question; Does the D.O.T. consider this “sleep apnea” ? and if they do would they consider ANY other treatment than a CPAP? (i.e. Inhaler, oxygen at night, ANYTHING other than the CPAP-which prevents me from getting any sleep at all now) Needless to say I am very anxious about what this means. I have been driving (with my C.D.L. “B”) for several years without an accident and no daytime sleepiness.
Thanks for your consideration,
@L.W.
Look into your states driving intra-state only rules. You are not driving interstate and the CME is holding you to interstate regs. So check with your local drivers license department and see what they have to say.
If there is no noted sleep disorders then the CME only needs a medical release form from your primary doctor stating so.
My husband’s company had a voluntary program where they went for a sleep study in a hotel setting. All volunteers, but 1, had sleep apnea. The company provided the machine and my husband was always in compliance. Recently my husband was let go and had to return the machine. He has no documentation of the results of his study. He is with another company now, should he go for a sleep study with another physician so he can possibly get this diagnosis removed? What is his best alternative?
@Carrie
If he was diagnosed with sleep apnea, then he should work on getting a new machine, if he did not have sleep apnea, then he will need to have a doctor documentation remove the diagnosis.
So it all really depends on how he is sleeping and whether he has sleep apnea or not. Based on how he is doing now will tell you the direction to go in next.
If my BMI is above 35 witch is the number they are using and I lower my BMI below that, should I still be required to do a sleep study?
@Kennard
Read these articles and you’ll know that BMI alone is not cause to require a sleep study.
That being said, if you are overweight, changing lifestyle habits, as best you can given the lifestyle challenges of professional drivers, would be a good thing to protect your health and your livelihood for the future.
If a person is required to have a sleep study, are they allowed to have a home-based study done instead of a facility-based study? Does Vermont have any DOT Physical Doctors?
@Linda
Best supporting results are coming from the facility based studies. The at home studies are on the questionable side.
in Oklahoma have a sleep study scheduled insurance will only pay for in home test will that work.
@Eugene
What class drivers license?
FMCSA class A interstate will probably not do. Home test is not reliable.
I have a diagnoses of sleep apnea (obstructive sleep apnea syndrome and excessive daytime fatigue). I am being treated successfully by my sleep clinic with CPAP and modafinil (Provigil). I have been under a doctors care for this for 5+ years and I am 97% compliant with my CPAP treatment.
I am applying for a vehicle maintenance job that will require a Class A CDL and a DOT pre employment physical (I currently hold a Class B CDL with no medical card).
Will I be required to retake a sleep study or will a medical release from my sleep clinic Dr. be sufficient to satisfy the requirement? Also should I get the release form filled out prior to the physical or wait to see what the DOT DR. says? (I have a current letter from my Dr but I don’t know if this will be good enough to meet the requirement).
@Christian
You should not be ask to redo a sleep study. Take a copy of your last readout from your machine (within the last thirty days) and a medical release form from your doctor and you should be good to go.
I hate to bother you but I went to get my physical done and the pa said I needed a sleep study. I went to my family doctor who has had me under for surgery twice and he said I did not have sleep apnea. He said if I did he would have seen it while I was under. There is no way I can afford the sleep study and there is no way I can afford to lose my CDL. CAN I go to another doctor to get my physical done over without the sleep study? Thank you.
@David
You have the right to a second opinion. The whole sleep study issue is completely out of hand. So go somewhere else for a second opinion, and choose your DOT doctor wisely!
Thank you so much for the response. Merry Christmas and Happy New Year.