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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 told by my employer that I was only 59 % compliant and that they were going to monitor my machine closely and when I got to 70% they would set me. a co up for work. How long would it take for me to get that 11%????
@David
Compliance is at 70% for 30 days straight. That’s it!
So what if i was out of work for a week or two and wasn’t driving a commercial vehicle or didn’t have my machine for a week or two…was i still required to wear it?.. Even if i wasn’t driving?!?
I drive a school bus in Michigan. I made the mistake of going to a DOT physical exam a few months back in between my morning and afternoon run. This means that I had a full breakfast and half a pot of coffee which raised my BP beyond its normal reading but still under the 140/90. I’m a big guy so my bmi is not very flattering. They looked at that and my neck and that was all it took for them to want a sleep study done and only issue a 3 month card. I have always had two year cards prior to this. The examining doctor gave me a form to take to my doctor which if he signed off on it would’ve waived the sleep study. My own doctor threw me under the bus and wouldn’t sign it. Instead he gave me a referral to a sleep study specialist. I didn’t do anything about it because there was a “Driver friendly” doctor near me when i checked your site at that time. Now its not showing any in the entire state of Michigan. My 3 month card expires August 9th. What are my options? Help!
@Awesome
Go get a second opinion at any medical examiner that understands the type of driving you do, and that you should not be held to the conditions of a class A driver.
If that examiner thinks you need a sleep study then you do, if not, then you’ll have a new medical card.
My husband had his DOT physical yesterday, Passed everything. THEN the doc told him since he is on CPAP he has to get a letter from his doctor stating he is compliant and CPAP is effective. He hasn’t seen pulmonary Doc in years. CPAP is fine, no problems. Also, there is currently no ruling by FMCSA for sleep apnea!! The doctor refused to renew his medical card which expires today. Can he go to another DOT doc and explain this and possibly get card renewed? If not, as of today he will no longer be a truck driver!!!
@Susan
If his CPAP unit will give a readout that demonstrates 70% compliance that is all he needs. If his unit does not provide a readout then the CME is simply looking for supporting documentation.
He finally got a letter of compliance from pulmonary doc which is what DOT doc asked for. When he went back to DOT doc he said it doesn’t have the results of the test on it so will not accept it. This was not stated on the form the DOT doc gave him. Just a letter of compliance from pulmonary doc, signed by pulmonary doc!!! He is back on his way over to pulmonary to get results. It seems like the DOT doctor is deliberately being difficult!! Very frustrating.
If I get diagnosed with severe sleep apnea, and get the testing/machine. I know I’d be disqualified from getting my cdl. I didn’t start showing symptoms until my weight gain though. So if I lost weight after getting the machine, could I be retested and be able to get my cdl then of my apnea went away or at least calmed down quite a bit?
@Pokie
You’ll need to get a new sleep study to make that determination.
I was given a 90 day card at my last exam. I was told I have to do a sleep study because my bmi is too high. I wasn’t happy, but I went to see my doc to get the process started. He referred me to a sleep center. Problem is, my 90 day card expires this month (July) and the sleep center can’t get me in until the end of August. Can I get another card to get me through to my appointment with the sleep people? If so, should I go back to the same examiner? Or should I try someone else? The whole thing is stressing me out. Any guidance you can offer would be appreciated.
@Bob
Recommend that you get a second opinion from a different medical examiner.
I’m a School Bus Driver. I’ve had my CDL since 1999. My company sends all their drivers (over 500) to the same Work Clinic for our DOT exams. A lot of drivers are failing the exam for the same reason-Sleep Study. I took my Physical in January- 2017. I have always received a 2 year card. Blood Presure- 120/69, Eyesight-20/30 etc. Everything is good. At the end of the exam, I only qualified for a 6 month card- yup, Sleep Study. I went to my Doctor. He set me up with a Sleep Clinic. Unfortunately, my medical insurance had to okay the Sleep Study. That took 2 months. It was almost 3 months before I received the CPAP and learned how to use it. I had a follow up with my Sleep Study Doctor on 6/23/17. I did my required 30 days (42 days) and passed. Yesterday, 6/26, I went to the Work Clinic to get my DOT card. I gave them all my paperwork. They said since it’s been almost 6 months (my card ex. 7/6/17), I have to take the DOT Physical again. Why? This doesn’t make sense. Shouldn’t the DOT go by the date for my Sleep Study? Not the date of my original Physical?
@Jo
Yes, you are required to have a new DOT physical. And the new FMCSA medical forms require the CME to complete a whole new medical certification.
First, thank you for providing this service. I am a Class A, Interstate CDL holder. I have TennCare (Medicaid). I need advise on initiating a sleep apnea test or not. I am overweight, hereditary high blood psi and I might have sleep apnea. I lost enough weight before my last DOT physical to get my BMI “under the limit”. My dilemma is do I continue to lose weight right before the physical to avoid any sleep apnea testing or go ahead and have the testing done while I have coverage that might pay for all of the costs? If I were eventually tested and didn’t have the coverage I have read the cost can be very high. On the other hand do I avoid having the “scarlet letter” of sleep apnea attached to my personal medical file for the rest of my life? Your advice would be greatly appreciated. Understand in no way am I asking for medical advice or diagnosis, simply broad general opinion of the matter.
@Zak
If you feel that you may have any OSA symptoms then go get the test.
I went for my physical today and I have used a cpap machine for the last 26 years I have a machine that does not have a chip in it because it is older I do not know how I am supposed to get a record like they are asking me for what do I do I have had this license since I was 19 years old so basically 50 years
@Danny
If you can, get a medical release form from your doctor explaining that you are fully compliant with your unit and have no issues. Then when you go for your medical card examination take the release and explain to the examiner that your unit is older, but still functional. Drivers who need the units will not leave home without it.
Otherwise you may need to update your unit to a newer one.