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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 sleep apnea and it’s moderate does dot still want you or its required to still use the cpap device
@Edward
Yes, cpap compliance is required for moderate sleep apnea.
I was diagnosed with mild sleep apnea in 2010. I have had the same doctor over the time period to now. I had a home sleep study done in 2014 and it showed positive changes in my OSA. The dr encouraged me to continue cpap therapy but didnt give me a definite yes or no answer. Up until October 5, 2017 I have not used cpap since November of 2014. I went to orientation with another trucking company earlier this month and was told I needed to show 85% compliance over 90 days. I have also read 70% over 30 days is suffecicent. My medical card expires November 2, 2017 and I am currently unemployed at the moment because of it. Which time frame will I have to follow?
@Justin
70% over 30 days, unless there’s a company policy in place that requires stricter compliance.
I have a question in regards to cpap compliance. I was diagnosed with mild sleep apnea just over a year ago. I have not been using the machine for the past 3 1/2 months. I went yesterday to renew my dot medical card and was told to get a compliance report, well that’s where the problem is, my doc can’t generate a report because I haven’t use the machine. So, can I simply go to another physician and not disclose I use a cpap, and get a medical card? I only had less than 5 episodes per hour when diagnosed. Does the results of dot physicals get reported directly to the dot? I have been given a 45 day temp card in order to get the compliance report. In other words will the dot know if I simply find another doctor who will give me a physical and issue me another card even though I saw another doc who is telling me I have to get the report.
Quick question, I got my medcard for only 3 months because the Dr recommended a sleep study due to neck size and bmi. My question is, if I go to another DR will the result be the same? Will they recommend the sleep study based on the previous examination?
@Roman
Neck size and BMI are not conditions on their own to necessitate sleep apnea screening.
Read these articles to understand sleep apnea screening issues.
Go for a second opinion.
I only see questions and answers pertaining to Obstructive Sleep Apnea. Can a person being successfully treated for Central Sleep Apnea get a DOT Medical Card?
@Alan
Yes.
Has the DOT changed requirement for sleep apnea testing for medical card
@George
No. And because there has been so much misunderstanding about it the DOT has withdrawn the proposed rule to set sleep apnea screening criteria for truckers.
The medical examiner is still responsible to make a decision to refer drivers for apnea testing if they “believe the driver’s respiratory condition is in any way likely to interfere with the driver’s ability to safely control and drive a commercial motor vehicle.”
Is this documented any where? Went to get my recert. Dr. Would not recert until test was done per new law.
If a driver is diagnosed with sleep apnea and requires a Cpap machine, what are the ramifications if they don’t use the machine at night, but sit in a chair during the day and use it, then turn in that data to the doctor?
Can I get a 2 year renewal on a DOT physical if I am diagnosed with CPAP and using it correctly?
@Curt
No. With everything else being fine FMCSA still wants you checked once a year.
I am about to go to school and get my CDL and start a trucking career. I am worried that the DOT physical I need before I start school will tell me need a sleep apnea test as my neck is 18 or 18.5″. I am 5.9 1/2″ weigh 2215, BMI maybe 31? I think I might really have sleep apnea. If it is proven I have sleep apnea, how will that affect me going to trucking school and my first job. The school already set me up with a company . Will it delay school? Will it delay me starting with this company. I need to start ASAP. I need the work. I am also doing this with my spouse . They will pass with flying colors. The new job is with us a a team . Trained as a team so I don’t want any delays on my part.
@Steve
If you think you have sleep apnea, you probably do. You need to get this checked out before you go any further.
If you are required to use CPAP to manage your apnea, you can still drive as long as you meet the CPAP 70% compliance.
What about after today 8/9/2017? Now that the trump administration scrapped the sleep apnea regulations from the federal government. What is that going to do to the people already dealing with cpap compliance?
The regulations are for determining the criteria for sending the patient out for a sleep study. Whether those regulations change or not has no bearing on the condition of sleep apnea itself. If a CME suspects that a driver is at high risk of sleep apnea, it is the CME’s responsibility to send the patient out for a sleep study, regardless. Sleep apnea is a respiratory condition that can affect safe driving and ignoring it would be like ignoring diabetes, high blood pressure, or any other condition that can affect a patient’s ability to drive safely.
Ruling out sleep apnea is still an important part of the DOT exam.