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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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If you have a commercial drivers license but only do classroom and yard teaching, an instructor, and never drive on the road, is there any type of waiver to be able to keep your license even with a medical problem as long as you only teach in classroom and not go on the road?
@Carol
You need to check with your local drivers license department for the best answer. Most states require a valid medical certificate to maintain a valid class A license, but check with your state DLD first.
Question is it true that if you use a Cpap machine you can only get a one you med card? And if so can you get a waiver for two year card with high usage from download from Capp machine?
@J
FMCSA has made its position clear, that they want a re-examination done once a year if you use a CPAP, even with 70% or better compliance.
I have a question…my husband has been a truck driver (local) for a long time and has weighed the same for years (actually has lost 20 now) but he has NEVER EVER been required to do a sleep study by a DOT doctor for just saying he has a 17″ neck and is overweight. Now in checking into this, our insurance will not pay for any of the sleep study and he is almost at the end of the 3 month temporary card they gave him. Should he go somewhere else? He has never had any daytime sleepiness, is an excellent driver with no accidents or tickets. This has never come up before and there is another driver at his work that is bigger than him and he wasn’t required to do this study. This is just an opinion by some flunkie DOT doctor by looking at my husband. What should we do? He will be out of a job soon if we don’t get this resolved!
@ Ms. Moon
Go elsewhere for a second opinion.
I went for my dot test today and was rejected based on the fact I snore along with my anti depressant medication which has drowsiness listed as a side effect. These doctors that we are required to go to now are ridiculous.
My regular dr. Has to write a statement stating that I’ve had no side effects such as drowsiness from my medication. Now call me an idiot, but what is the difference between me telling my doctor or me telling the DOT doctor that I don’t get drowsy? Oh, and how many medications of there list drowsiness as a side effect?
I’ve never fallen asleep at the wheel never been tired during the day besides a nap on Sundays once in awhile. I only drive locally in a landscape truck with materials. However because our possible WEIGHT can go over 10000 pounds I need a medical card.
I understand the philosophy behind everybody having some type of physical to be issued a medical card however some of this is completely ridiculous and quite honestly a waste of the working man’s money, when we have to pay for the unnecessary sleep apnea test. And how come they can issue a temporary Dot card based on having to get a sleep test if it’s really that much of a hazard? It’s rather contradictory?!
Hello I was wondering if any one could tell be if you have sleep apnea an have had a Cpap for years is it true you only get a one year dot medical card? I have had a Cpap for years use it every day I’m otherwise a healthy man in my late 30’s this time I went in to redue my dot medical card an the dr lady said that cause I have sleep apnea I can only get a 1 year card. That cause the apnea the DOT only allows one year card.
I also was told by her that I could not get a second opinion. Witch seemed odd to me? Is that true what ever they say is it no second opinions?
@Seth
Second opinion is not going to help here.
@Seth
One year according to the FMCSA guidelines is all any CME is going to provide you with.
Why would you ever choose a female doctor, can’t understand that one.
I have Sleep Apnea. I use a CPAP machine. I made the mistake (I believe) of using an over the counter nasal spray (phenylephrine) to open up my sinuses, making use of the machine possible.
I’ve read some things that this medication could/would show a false positive for Amphetamines.
My MedCert is up for renewal….anyone else have some experience with this? Have you had a false positive? I’m kind of backed into a corner here….
@Mike
If it is an over the counter medication, simply keep the medication packaging do you can support the MRO’s questions if it does come back positive. The MRO can re-test the split sample and confirm that is the medication in the sample and you may be able turn a positive test to a negative test result.
How many time a year do I have to have my C Pac machine read to be in compliance with DOT
@Brenda
As long as you demonstrate a 70% compliance for a minimum of thirty days, you should be OK. It is nice if you have a couple readings throughout the year, but it isn’t mandatory.
Ok .So I was diagnosed 10-12 years ago with sleep apnea. I get a cpap machine : (if anyone has snoring problems or they are tired all the time i recommend the cpap/sleep test or machine after getting used to the machine i would get out of the truck at bottom of grade and push it up the grade hahahahaha i sure felt like i could push the truck up the hill.) I use to sleep 10 hr a nite, after the cpap i couldn’t sleep more than 5 hours a nite if i wanted to. Sorry had to let it be known.
I had a heart attack almost two years ago. I went to renew my dot card and they told me I had to do a sleep study for sleep apnea, because my neck is 17″ and I take two blood pressure meds. One is 10 mg lisinophril and the other is 5 mg amlodipine. My doc did two, because the amlodippine is for spasms of the heart mainly. My question is, does taking these meds and my neck size warrant a sleep study? I’m not obese, but I am a fairly muscular and I’m tall (6’2″ 220 IBS). I need to know, because the owners of the company have strong ties with the company that does physicals and I want to see if they are making me jump through hoops for no reason.
@Will
If you do not demonstrate any other symptoms within the OSA protocols, then someone is overstepping their bounds with the FMCSA guidelines and you should go else where for a second opinion.
“@Will
If you do not demonstrate any other symptoms within the OSA protocols, then someone is overstepping their bounds with the FMCSA guidelines and you should go else where for a second opinion.”
Can I get a link to those OSA protocols?
Also I am looking for this study not the tech pamphlet: Pack AI, Dinges DF, & Maislin G. (2002) A Study of Prevalence of Sleep Apnea among Commercial Truck Drivers (Report No. DOT-RT-02-030). Washington, DC: U.S. Department of Transportation, FMCSA.
Thanks.
-john
Are the results of sleep studies automatically reported anywhere or is it up to the driver to honestly report potential conditions?
@Heather
It is reported to the FMCSA database and can be viewed if there are any questions.
And you need to bring a report or printout from your unit to demonstrate proper compliance usage.