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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 was diagnosed with sleep apnea and had to get the CPAP machine. I can’t sleep with it. I went through another state and another company got approved for med card for one yr. I did not tell them of the sleep apnea test. I can’t sleep with it. It makes me sleep worse. Am I good to go. Or will they find out about previous test.?
@Davey
Your last medical card over rides the previous medical certificate, but now you have not provided correct and truthful information on a federal form. It could be found out and then what????
Had Dot physical 7/13/2016. Got 3 month card so I could get sleep apnea test and equipment. Doc told me to come back within 3 months with my printout and if compliant a year card would be issued. Went back 9/22/2016 with my printout that shows 80% time useage of greater than 4 hours. Had to have an new complete DOT physical (with the accompanying full physical fee) before PA would issue new card. Why complete physical?
@Bonnie
The new FMCSA forms require the CME to redo the exam with a new set of forms. There is no longer the option to update a previous exam. The new medical certificate overrides the previous one.
if im on the cpap machine and my med card expires do i have to take the sleep study test everytime i recertify or just show that im using the cpap machine
@Carlton
You just need a recent print-out to show proper compliance with your unit.
You do not need any such thing. Fact: FMCSA does not require any specific treatment or equipment in its regulations and Advisory Criteria. This may be a standard of practice in the medical community, but it isn’t an FMCSA requirement.
I went for dot today. My cpap printout states as follows.
77% of days used overall. 219/240
62% of days greater than 4 hrs use
14% of days lesser than 4 hours
Is this in compliance? My NRCME wasn’t even sure so he gave me a 2 month MedCard too keep me going. He it’s to follow up and let me know and explained if he made mistake, he will issue me a new one for a year. If it’s not in compliance, he was nice enough to give me an extension of a 30 day CPAP report and if it’s satisfactory with 70% of days greater than 4 hrs, he will extend my expiration to a year. I use this machine all the time, even during short naps, I get better rested. I don’t understand why it’s lower. I don’t however use if when I get home, but Im only home 2 days a month on average.
I have new health card that is only a month old. I went to a trucking company and they diagnosed me with sleep apnea during a new dot health screening. I did not take the job or their health card. I am going to get me a CPAP machine at a dot certified sleep doctors office tomorrow. If the doctor that diagnosed me said he was faxing the results to the dot, will that affect my current health card while I am in the process of getting my CPAP machine, I have a job that I applied for and got before I was diagnosed with my month old 2 year health card and at the time I was not diagnosed. like I said I made an appointment and I am getting the machine but can I drive until it comes in. my employer doesn’t pay for health cards I had to get it my self. pre diagnoses ?
@Matt
If you did not get a long form from the last CME that stated you were disqualified or gave you a short term card to get the cpap in order, then it would seem that a ‘complete’ exam was not done. Results are not ‘faxed’ to DOT, they are entered into an online database.
Check with your local DMV to find out which medical card they have on file.
Does the DOT have any regs on which CPAP machines are acceptable or will any machine be ok as long as the driver can get a reading from it for compliance? Thanks again..
@Employer
As long as the machine can give a reading to show compliance, that’s okay.
I took a sleep study on my own and it was determined that I have sleep apnea. I was placed on a cpap machine. Am I under any violation
@Kelcey
No, but now you need to show compliance on the cpap.
I have a driver who tested positive for OSA and now has a machine and is doing well with his compliance 10 days in. Unfortunately due to financial hardship it took a while to get a machine organized for him. His DOT expired on 8/11 after a 3 month cert. We work with a sleep specialist and in the past we have provided weekly downloads of CPAP compliance to enable our drivers to stay on the road. The ME’s we have worked with seem to be happy with this arrangement so long as we send the downloads regularly every Friday for the week. This drivers ME will have non of that and just wants to see 30 days. My question is, are we able to send him to another doctor as his cert has expired. We will of course disclose whats been happening with our driver and all relevant medical records. There may be another ME out there who will work with us to try and keep our driver on the road or he will suffer further financial hardship. Thanks for a fantastic website, we need you guys every day….
@Employer
You are welcome to send your driver to any NRCME examiner.
Also explain to the driver that FMCSA guidelines do request a thirty day on the unit compliance report, but your input should be taken into consideration.
We did send this driver to another facility and he has been given 3 months to produce his 30 day compliance (of which he is almost halfway there) he will then get his years cert. He keeps his job, we keep our driver safely on the road. Thanks again!!
@Employer
You are welcome. Thanks for keeping your drivers safely driving.
I have a driver who went to a Concentra for his DOT. He was told he needed a sleep study but that they would not accept a home test. We work closely with a company who does a great job with our drivers. They do 2 home sleep tests, unless the first one is totally conclusive as positive for OSA. Concentra told me that the DOT will no longer accept home studies. I can’t find anything to support this can you clarify for me please? My driver (and many others) simply cannot afford a lab test, he is struggling to afford the home test. I feel my only option is to ask if I can refer him to somewhere that will accept HST. I was wondering if anyone else was having the same issues with Concentra, could it be a new’ Company policy’ we have to deal with?
Thanks again..
@Employer
It falls in a very gray area.
FMCSA stated that the home studies were not as accurate as the lab studies.
Now, if you are working with a company and the overseeing doctor can and will support the finding, then the CME should be able to accept the results.
The CME just needs supporting information to be able to provide the best decision about the drivers safety.
Some of the ‘doc in a box’ facilities are tied together with sleep study companies and will not budge on the issue: follow the money.
But good supporting information from the study with a medical release from the provider should be all you need. If the driver is found to have OSA, then he would want to move forward with whatever the doctor is recommending.
I have a current fed med card without the diagnosis of sleep apnea.
I have taken upon myself to go have a test taken to find out if I have it.
I was scared about having my fed med card revoked till the study took place so i told the doctor i didn’t have a cdl not knowing the seriousness of my actions.
What do I have to worry about taking a test on my own free will?
I had to schedule months in advance for the test also
@John
You have not had the test and there is no functional diagnosis to worry about at this time. Once you get your test results back, there may be a thirty day waiting period, if you test positive for OSA. That waiting period is for you to get accustomed to the new device. Then you need to redo your fed med card.