Please read through the Q&A before posting a question. This will help everyone to not have duplicate questions. Thank you!
If you still can’t find a related answer, then you are welcome to ask your question in the comments section below.
See our BLOG Category on Sleep Apnea for articles and more information.
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.
Can’t Find An Answer For Your Question?
If you have a question that you feel has not been answered, scroll down to the Questions and Comments box and post your question.
- Before posting, please make sure you are on the appropriate Category page, so that relevant questions and answers can be found by other drivers too.
- To save us all from zombie spammers, your question will not appear on this page until it has been approved.
- Trucker Docs™ will answer your question as soon as possible.
- Visit this page again soon to see our response.
P.S. Your email address will not be published.
Your comments are also welcome.
I had a sleep study done 12 years ago. 2 years ago I went back to the sleep doctor. They wanted to do another sleep study. Insurance denied the request and stated to put me on an Apap. Always have passed dot physical with flying colors. New dr for work only certified me tI’ll sept. To loose weight and get another sleep study. I told them my insurance will not pay for it. Obamacare. My new insurance when goes into effect might. But can he require me to do that. Another sleep study and loose weight. He also kept insisting that I could use them as my primary care dr. What to do about this. Work sends all there drivers there.
@Michael
Go somewhere else for a second opinion. The CME can request another study, but it is not his role to tell you what your primary doctor should have told you. As far as the company goes, they probably have a contract with the clinic and by doing so they get a financial break.
@Trucker Docs
I have been on a Bipap machine for 5 years now and I always had a 2 year medical card, Today the company doctor issued me a 1 year medical card because I have a Bipap machine. My question is, Can the company doctor only give me a 1 year medical card since I provided them with a compliance printout from my Pulmonary Special and Provider of my Bipap machine?
@Anthony
Yes. FMCSA guidelines request a one year medical certificate for your condition, with supporting documentation at each certificate examination.
My cpap machine is malfunctioning and cannot get the print out I need for my cdl medical exam. I have a loaner machine but only will have 4 weeks of readings before my medical card expires. They say they need 3 months. What can I do?
@Troy
FMCSA really needs a 30 day readout. Yes it is nice to have 90 days, but you have a situation that should be understood by the CME. Just explain your situation and have the thirty day readout in hand when you go for your examination.
That is great news. I thought the 30 days was only for newly diagnosed sleep apnea patients who had just started cpap therapy.
I have been a long haul truck driver in Alaska for about 3 years. At the end of November my wife said I stopped breathing while sleeping as well as was snoring really loud and I made an appointment with my general practitioner. The GP suggested I go get a sleep study done. The same day I was told to get a sleep study done I went to my employer and spoke with the Dispatcher as well as the safety director. I informed them my doctor thought I had bad sleep apnea. The safety director stated it wasn’t a big deal and I would just need to comply with DOT requirements in regards to sleep apnea.
I did my sleep study on December 20th 2016 and on January 15th 2017 I was involved in a rollover accident on the haul road. To this day I do not remember the accident or the events that happened. I was looking over the peoplenet electronic logs and they were those of someone who fell asleep at the wheel. I was shocked! I could have died or killed someone else and this has shaken my world in more ways than one. I called to inform my boss that I was just diagnosed with severe sleep apnea and the same day he fired me from my job. They ruled the accident preventable. I had an appointment on the 25th of January to get set up with a CPAP and unfortunately with getting fired I am having to pay out of pocket cause they cancelled my insurance 7 days after termination of my employment.
I was confused as to how they were justified in firing me and I started doing some digging and called the medical examiners office to get my records. My last medical card was issues in October 2016. They were shocked when I told them what had transpired and how severe my sleep apnea was. In my records it showed my BMI was 35 but had the wrong neck size written down. I am a male 38 years old and considered obese. I was informed by the clinical manager that I would have to get a new medical card and be compliant with my CPAP which I have been for the 3 weeks I have been using it. I went in today to get a new medical card and was told by the CME that I didn’t need to do anything. He admitted that I was only suppose to have a yearly card if that but he left my original 2 year medical card as the current one. I am horribly concerned at this point and cant afford to pay for another medical exam for my medical card until I start working. I don’t understand why I wasn’t flagged at the appointment in October 2016 as I fit most of the criteria. I am doing everything I can to make sure I am compliant but feel like this CME doesn’t know what hes doing or is purposely trying to get my license suspended. I did speak to the FMCSA in regards to this and they told me that I needed to get a whole new physical and medical card that would be for a month or 3 months until they have more compliance records and after that I would have to renew yearly. Is there something else I need to be doing or is this CME correct in keeping the original 2 year medical exam card in place where my sleep apnea wasn’t ever listed? Any help with this is greatly appreciated. Thanks
@AKtrucker38
FMCSA requires a 30 day with 70% compliance report with your cpap unit before you can test for your DOT medical certificate. Your card will be good for one year at the time and will need a compliance report each time you test, along with a medical release form from your doctor.
Your two year medical card should have been suspended / disqualified at the time of the accident.
A new medical certificate may have been issued for a short term to get the remainder of the sleep compliance report, or you are disqualified until you can support the 30 day / 70% compliance.
I am a school bus driver in Charlotte county FL. The school district has its own clinic and the nurse practitioner who does the dot medicals is sending almost all the male drivers for sleep apnea testing and a few female drivers. most of our drivers are over 50. The CME says everyone is lying to her so she is sending most everyone for testing. My question is can she get away with doing that?
@Ron
Not if all of you file complaints about how you were treated during the examination. File your grievances with the FMCSA and put this to an end. FMCSA needs to know that someone is not following the FMCSA guidelines and besides, you drive a school bus and they are trying to hold you to an OTR interstate drivers standard. ????
I took my sleep study in August 2016. At the time I was skeptical that I had apnea, especially after the technician seemed to confirm my suspicion. Lo and behold, the doctor called me 2 weeks later to inform me of having “severe SA.” My problem is that I am up against the end of my second (and presumably last) extention but still can’t manage to keep the mask on for at least 4 hours a night. Is it possible to get another extention, or should I be re-tested?
@Patrick
Getting another extension will be up to the examining CME. And retesting is not going to work since you have to show 70% compliance for a thirty day period. Have you checked into a low profile mask? Check with your sleep doctor to see what options you may have. Good Luck.
I went down to get my DOT medical exam on 2-4-17, I’ve kept up on my CDL license and Medical certificate every year since not driving a commercial truck since 2011. On the exam theirs a question that says : Has your USDOT/FMCSA medical certificate ever been denied or issued for less then 2 yrs? I said “yes” and the Doctor who was doing my exam put down “NO”. I even told her in front of my girlfriend that my CDL was suspended once for not having a up to date medical card on file. In the note section on the physical exam, the doctor put down in her notes after i had already sign the certificate,that and I quote” he later reported in front of his girlfriend,PO,BM, and myself that he had his CDL suspended and has had to get his license renewed every year. He is aware that I called our medical director DR.Poon and that his license is being revoked” end Quote. She disqualified me for having OSA and C-PAP. She says I misrepresented myself on a federal form. I didn’t, she didn’t hear me correctly. They also asked me if I had a sleep study done and I said “yes, back in Dec 23,2016. The doctor asked why I had it done and I said cause I felt I wasn’t sleeping well enough. She asked what the report said and I told her I have a mild case of sleep apnea. She asked if I had a CPAP machine and I said “no” coz i didn’t know I had to say anything about it. Then she left the room and came back with another person and that’s when I told her that I had a CPAP machine at home. I feel like the examiner had it out for me from the beginning. Can the doctor put notes down on my exam report that is sent to DOT after I had already signed it? What Options do I have now,if any at all? I already called my primary care doctor to get a second exam done and for him to fill out the medical release form opinion that shows my use of the CPAP machine as I”ve only had it Since Jan 2017. I’m lost in what direction can I go. Thank you.
@Ronald
Sounds like you and the CME are at odds. Best bet is to get a medical release form from your doctor explaining your need for the CPAP machine, along with your most recent compliance report. Then go and get a second opinion somewhere else. The new medical certificate will over-ride the last one. That should do the trick, good luck.
Having similar problem. Medical card came due Jan 26-17. Went on Jan 27. First time asked about cpap machine.Reluctantly admitting to having one but explaining not much data on it cause of mask problems and loosing more sleep.Doctor still required 30 day read out. finally got appt with VET hospital on March 2. Got read out and fitted different masked,but not enough data on readout.Started using cpap on march 3 finally averaging 6hrs/night.Knowing this doctor is going to fail me called other doctors explaining situation and need time to comply cause my 45 days is running out.Can not find doctor to work with me on this problem.This is my third year having my cdl and the first time i am being asked about cpap machine.What rights do i have if any or what can I do?
@Tim
The FMCSA is holding pretty strict on this and has the CME’s between a rock and a hard place. Best bet is to learn from this experience and have the documentation ready before you go for the examination. Now that you are in the FMCSA database as a CPAP user, you should only need a read out just prior to doing your medical certificate examination. Good luck.
I have mild OSA. Prior to renewing my CDL last May I purchased a Resmed S9 variable with a nasel pillow mask. Three months later my medical provider, Kaiser, provided me with a Phillips cpap. I keep one machine in my truck and the other one at home. We very quickly discovered that the AHI number on the Phillips consistently runs three time higher that the Resmed. So I purchased another Resmed S9 identical to my first machine. I am set at 5.6 pressure and my AHI runs from 0.6 to 5.0 with the average under 3. I am 95% compliant with 4 hours or more.
My dilemma is…only the combination of the two machines will show these numbers. Is that acceptable? Also, what exactly is the Fed DOT looking for? If they have the hours and the AHI number, are they looking for anything else?
My Kaiser doctor is giving me a hard time. I don’t fit his medical learning profile. He wants me to take another sleep study which will most likely show a higher pressure. I don’t tolerate pressure higher than 6.0 well. It suddenly involves mask leaking and difficulty breathing out. He refuses to accept the work I’ve done to minimize the pressure for minimal AHI numbers.
@Lee
You may want to get a second opinion from another CME. You numbers appear within normal limits and your usage/compliance are within the FMCSA requirements. Once those criteria are met, then the FMCSA is OK as long as everything else checks out satisfactory.
I was told by ME that because of my bmi I must take a sleep apnea test I have a pulmonary Dr that the Me sent me too for a pulmonary evaluation sign off and gave me an OK my primary doctor who I see 3 or 4 times a year signed off it but the ME still says because of my bmi I need the test.1 week left on my med card can I get a second opinion?
@Rochard
Go somewhere else for a second opinion. No new rules regarding BMI or neck size, so your best bet is to get a second opinion.
I am in a similar boat. I only have until the end of the month before my card runs out!
Original exam was told “too fat” and neck too big that I had to get sleep test done. Was told only to do that and bring results back within 90 days to centra care. Did that and saw a different doctor who lost his temper because even though I was never told to do so, said I should have already undergone treatment and been able to show compliance. He would only give me a 30 day extension. I takes 21-28 days just to make the device I’m seeking for treatment.
To that, I am claustrophobic and deathly afraid of cpap. There is an alternative called an Oral Devise but I am meeting with resistance to that. If centra care doesn’t agree to this treatment and my card runs out I will automatically lose my job on the 31st.
My company won’t let me go anywhere else to seek a second opinion.
What can I do? Do I have any options for some kind of appeal or anything? Doesn’t the ME have to help me if I’m seeking treatment l, even if it’s other than cpap?