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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 mild case of sleep apnea can the medical examiner require you to use a cpap machine if your registration dr just told you to lose weight and quit smoking
I am very interested in becoming a OTR driver. I was recently told I have Sleep apena, was given a CPAP and I can not sleep with this thing. had it for 5 months and can Only sleep all night with it, if I take a sleeping pill. Other wise I wake up and freak out, rip the mask off and throw it. I’ve recently been in contact with a sleep center that offers sleep appliances. In hopes I can sleep with it and get some good sleep. Do you know if these are approved by the DOT, or does it have to be a CPAP machine? If it has to be a CPAP, then I’ll have to figure something out, the mask they said would fit me SUCKS!
@Cory
If you are working with a sleep facility, then anything that they finds that works for you and that they will provide a medical release for should be fine. Make sure you have the doctor sign off on a medical release form explaining his findings and what modifications he felt worked best for you.
Is a complete new DOT physical required after satisfying the sleep apnea testing?
@Judy
Yes, unless your previous medical examination was put in ‘pending’ status, and you were not issued another medical card. ‘Pending’ – it’s up to the discretion of the medical examiner.
I have printed out a “Compliance Summary” from my CPAP machine, regularly, with one going to our company doctor when it’s time for my CDL physical. What are the numbers on this report that the examining doctor looks at to see if I am “fit for duty”?
@John
CME and FMCSA want to see a medical release from your doctor and a 70% compliance of use with your unit.
I have a driver that is 5 feet three and weighs 305 pounds. BMI is off the chart and neck size over 16″. and is 42 years old femaleShe denies snoring, sleepy, tired, drowsy, etc. I sent her for a sleep apnea evaluation. Now she keeps calling telling me that I mis-read the FMCSA Medical review board sleep apnea Guidelines. Is she correct?
@Stuart
It’s a tough call. If all you use for the sleep apnea determination is BMI and neck measurements, then she is correct. FMCSA does not have any new guidelines regarding the use of these two measurements.
And at the same time you can’t find the FMCSA guidelines anywhere, since they are being revamped (for the last two years).
You need to be using other criteria to make your final decision. Drivers should be demonstrating a multiple of signs/symptoms before call for the testing. Do more research on the other signs and symptoms so you could make a better decision if the test is need for sure. FMCSA is looking at a list of about five things that must be considered before requesting the testing. But a good google search will be a huge help.
Hello I recently was in an inpatient drug rehabilitation program for 30 days and while I was there they suggested that I should get a sleep test sleep study. It was a 30 day inpatient facility and while there I went and got the sleep study done. I was there at the treatment center to get off of a prescription drug that I had been taking for a while. Back to the sleep study the first night when I was there I guess it was to check if I had sleep apnea which I did not. So the following day they did the five nap sleep study 20 minutes for each nap and told to try to fall asleep. Well each nap for 20 minutes only I did fall asleep before the Time was up. I am a UPS driver and have been for almost 13 years. I started at 21 and 35 now. The sleep study results from the naps said the “The findings are suggestive of a diagnosis of narcolepsy”. Now being told to try to fall asleep I found that seems to be now unfair. I went to my doctor to get my DOT physical and was just trying to be honest and I guess I offered to much information about my sleep study and the results were temporarily not fit for duty. What do I need to do to get that stupid narcolepsy word to go away. I don’t fall asleep when I’m walking or anything I do get tired and fatigue at times but not nothing to wear I would be endangering The lives of the people in public. I have never had an accident zero in 13 years while being employed there. I am a little lost on what I need to do to try to get this issue resolved. I’m reaching out and looking for some help but I think when you are told to try to fall asleep which I did but the results say I have narcolepsy. And now I can’t drive which is bullshit. I feel like I was being too honest and now I’m paying the price but any help from here and from what I’ve gathered from this site it seems to be a lot of great help for drivers.
@Jesse
Go get a second opinion from another CME or another doctor. Somehow you have been tagged and are having difficulty overcoming the earlier findings so see if you can start fresh with a second opinion.
Can you go out medically with sleep ampnia from the georgia department of corrections?
@Brian
Only GDC can answer this.
Does mild OSA (found out because I was snoring), that is treated with an Oral Appliance require a retest every year? My last sleep study was great, and the examiner said he could only give me one year card. I am not overweight 5’9″, 185# (workout 3-4 days a week), and my neck is not too big.
@Jesse
If the oral device is working and you can support the findings with a medical release from your primary physician, then you should not need to redo the testing each year.