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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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Not sure what to do now. My son went for his physical at a place near the company he drives for and they gave him 3 month certificate based on him needing a sleep study because of his neck size and weight. They told him to go back to his primary doctor. He went in and talked to a sleep specialist who told him that he may not have sleep apnea but the only way is to test. Because of his deductible, it will cost him $1900 to have the split test.
After reading what was said on here and waiting 30 days, he went to a local DOT doctor for a physical and filled the form with the exact same information and was given a 2 year certificate as he has no problems with blood pressure, urine test or any of the other tests and is not on any medication. His employer’s safety department will not accept the new certificate because 2 different doctors have 2 different opinions. They want him to do sleep study and/or have the 2 doctors discuss it and come to an agreement. He told them that all he did was go for a 2nd opinion and disclosed the same information. They still refuse to accept the 2 year certificate.
I’m not sure how he needs to handle this because his other certificate expires at the end of July. He is talking about just going to another trucking company but do not know if this is going to be an issue once he turns in the 2 year certificate to the state (which his employer told him not to do). Any advice would be appreciated on how to handle this and what will happen if he uses the new certificate.
@Julie
The last DOT examination done will have been reported by the medical examiner to FMCSA and over-rides the previous one. That’s how the system works.
It is your son’s responsibility to get a copy of the last medical certificate to his local drivers license department, to be filed with his driver’s license.
Thank you. That is what I needed to know. So he should go ahead and send it to the DMV and it will override the other? It sounds like the argument is with the company on what they will accept which is why they told him not to file it with the state DMV. He has already been looking at some different companies that have more local routes than he does now. I just wanted to make sure that his new certificate will be valid if he leaves his company. I appreciate your advice. There are way too many competing interests in this whole sleep apnea/DOT physical problem.
I was told to do sleep test. So I took my referral back to my primary doctor and he told me I didn’t need the test. So he cleared me to wrk and I took it back to the clinic and they’re saying no no I need to have it done!! But there the ones telling me to get cleared by my primary Doctor which I did now they’re telling me I have to get it done. Is this true can they tell me to do it after being cleared by my doctor ? I really can’t afford this test or afford to lose my job???
@Matt
Go somewhere else for a second opinion.
No new rules on OSA according to the FMCSA. See articles on Sleep Apnea Screening.
I do not hold a CDL but am a contract driver for a RV delivery company in Indiana. They do not require a CDL to drive for them. Am I still required to do the Sleep study to get my DOT physical card?
@Monte
Your state drivers license department will have your answer. You should not be falling under FMCSA class A interstate regs. So explain to the CME what you do and since there were no new rules regarding sleep apnea test, then you should not be held to those guidelines.
what dot law gives a doc the right to force all of use drivers to get tested and hold us from making a living everything i have found states a guide no law and not requirement for fmcsa.
@Robert
There is no law. Read these articles to better understand Sleep Apnea Screening.
Is a surgical implant known as, inspire sleep, done as an out patient be an alternative to the cpap machine
@Mike
Only if it fully corrects the OSA. You may need to retest following the surgery to confirm.
Hi my husband was just told he has mild sleep apnea. He was at 93% the whole night he took the test at home . His doctor did not write him a passing letter and is considering cpap
Anyone else go through this?
Oh Yea, This is a big liberal government take over policy to punish the people who work that pay for the people who don’t. Get ready commercial drivers.. This ones on us.. Anyone that has a commercial drivers license and who is going to vote for Hillary Clinton should reconsider quickly. Do you really want more of what the last 8 years have given us ?
So true!
I didn’t meet the 30 day requirement to be recertified, Sleep Doctor said I need to take another Sleep Study and Awake Test to obtain Compliance Letter. Are both test required by DOT ?
@Jeff
This sounds like something that the sleep doctor wants to be sure that you are OK, before he signs off on the sleep test results. FMCSA wants to see a 70% compliance if the diagnosis confirms a sleep disorder.
Per company CDL doctor my husband was told he had to have a sleep apnea test done. He has no symptoms, no snoring, no stop breathing etc. I sleep next to him every night he sleeps like a rock. He is never tired during the day or takes naps. He gets 7-8 hours of sleep every night.
He was told he had 60 days to see a Dr and get the test done. Needless to say it is peak allergy season and he has severe spring allergies, can barely breath, stuffy nose, sneezing and everything else. He had to take the sleep test while suffering with his allergies, He flunked of course, they told him he stopped breathing 29.5 times in an hour. The first night on the machine he scored a 99 out of 100. with a stopped breathing of .5 per hour. He has noticed no difference in how he feels, since he always got a good nights sleep. My question? Should the sleep test be given to sever allergy sufferers in allergy season? or should it be given after the allergies go away.
@Carol
Ideally it would be given after allergy season. And if he did not demonstrate any signs or symptoms of sleep apnea he does not need to subject himself to a sleep test. There were no new rules regarding sleep apnea testing from FMCSA.
The company physical is every March, no way to change it, during allergy season and he was given 60 days to see a Dr and get tested. No one seemed to care if he has allergies, we got the paperwork/results from his test today and nowhere does it state he was suffering from allergies during the test, or taking numerous medicines for his allergies. Even sadder is they made him do the test on a work night, He works for the electric company and they were doing 13 hr days, he barely got any sleep at the test (less then 4 hrs, do to not being able to sleep on his back, pulling the wires off every time he rolled over etc. he is a stomach sleeper) They then sent him off to work a 13 hr day when he was so tired from lack of sleep, he actually had to take a nap to make it through the day. So unsafe on there part.
He has been using the machine and now wakes up feeling tired, instead of rested. He told me today he has never felt so tired during the day. We go online every morning to his sleep results and he gets a 100% every night, with less then 1 stop breathing every night. Sad part is there is no one to talk to about it, they just do the test, tell you your results, give you a machine and send you home. The rest is up to you. You are then told you have to use this machine for as long as you continue to be a lineman. Makes him think about becoming a dispatcher.. so sad when he loves his job.
He was made to take the test because he has a very large neck, 19″ always has, even when he was young and in great shape, he is overweight, but doesn’t snore or wake from not breathing. I have slept next to him for over 26 yrs, the only one to snore in our bed is the dog!
on another note.. are you required to use this stupid machine when you are on vacation?
@Carol
You really need to find a new CME and get a second opinion.
Vacation, if he is on the unit it needs to show a 70% compliance over a thirty day period.
Also what class license is your hubby? There is no reason for a lineman to be tested at the level of an OTR driver, and it sounds like that’s what’s happening to him.
He has a class A, even though the truck he drives is only 18,000 lbs. (he is a troubleman so he drives the smaller truck), but he has to be licensed to drive the 45,000lb trucks even though he doesn’t.
They really need to set different standards for over the road truck drivers and those that use them as their daily work trucks.
He has no choice of company Dr, they come to his work to do the physical every March. I just wish there was someone to talk to about it. It is- go to this Dr. get tested, here’s a machine, we’ll see you in a year.
If this is such a big thing you would think there would be follow up visits to explain the results, if there is any way to get retested after allergy season, and if you can do something to not need this machine.