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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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This compliance issue is causing more health problems & sleepiness nights then it resolves.
My DOT doctor ordered the sleep study when it was a medication causing my drowsiness, which when stopping the medication, completely stopped the drowsiness
I wear the the CPAP 30 days, some months compliant, some fall short.
I still have no drowsiness during waking hours, but move around in my sleep causing mask to leak.
This nightmare is causing me financial problems being out of work for more than a year. It is the financial worries making everyone’s health worsen.
How do I get a medical release from this nightmare?
@ Mario
Have you been retested for any sleep disorders? If not, have your doctor complete a medical release form stating that you do not suffer from OSA and take the form in to the examiner. If you need the mask, then you have OSA, if you don’t have OSA then you don’t need the mask. Just get it confirmed one way or the other.
I’ve been Diagnosed with mild sleep apnea by my family doctor. What are the ramifications of not disclosing this to the medical examiner? Does the medical examiner have the power to check your family doctor files? Is that a regular practice they do with patients? Or do they just take your word for it if you tell you you don’t have it?
I was diagnosed with severe sleep apnoea Based on nothing more than the home sleep study I have never been to a sleep lab. I have no problem staying awake during the day I just feel tired in general. and I cannot tolerate cpap .if I downgrade my CDL to intrastate driver only can i just lose weight to treat the apnea.? I live in Pennsylvania and I am a local driver I only drive During daylight hours and rarely work more than 8 hours A day.
I was forced to take a sleep study three years ago by dot dr. My ahi was 14. They still wanted compliance to get my year card. Am I required to use the machine even though my ahi is in the mild category.
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If you were issued a 3 month card for suspected sleep apnea and then was determined to have mild sleep apnea (new diagnosis), received your CPAP and have been compliant for 30 days (over 70%) can you get a 12 month card or do you have to wait 90 days. On the letter at the Medical Examiner’s office it stated if new diagnosis 30 days if compliant for a 12 month card. They stated that was for the suspected not the confirmed diagnosis on the letter, which did not specify that and will not give me a 12 month card. I am compliant and passed everything else. My job requires a 12 month card is there anything I can do? Class B license – Delaware
I ve been on my sleep apnea machine for almost 2 years. This year I have struggled with it just the same as last year. I ve tried all the masks. And my sleep is worse then ever. I wake up in 4 hours and take it off. So I stopped using it. I found a nose pillows mask i think they are called. And i like it. Mu question is ill have 4 months on it everynight. Will i pass of fail the compliance. Please help
They only need last 90 day report. And have to be 70% compliant
We are in Washington State and our drivers are intrastate. The medical examiner we send our DOT drivers to is requiring almost all of our drivers do the sleep apnea test. 99% of them come back stating they have sleep apnea, when they may or may not have it. I think they are doing it for the $$$. Is there a way a CDL driver can renew their medical certificate without being required to wear the sleep apnea mask? A lot of the guys say it keeps them awake at night; rather them help them, so they really don’t need to wear the mask. The problem is the medical examiner can run a test on the machine while doing their physical, and if they see the driver isn’t wearing the mask, they can deny their renewal for their medical certificate. I’m just wondering if their is some type of waiver the medical examiner could sign indicating the driver isn’t required to wear the mask, or how we can get around having these guys do the expensive sleep test and have to wear the mask every night. Any information would be very helpful.
Why not change the DOT facility that you send your drivers to if you think this one is acting unreasonably? Are the drivers having their reports explained to them?
I am an Illinois school bus driver, class B license. Our bus driving physical form does not address sleep apnea in any form. However when I went to get my physical the doctor stated due to some standard measurements he suggested I go and get a sleep apnea test done and said I could drive for three months. School bus drivers do not have a three month card option in the state. My question is since I technically passed every part of the physical required by the state, is this doctor allowed to require this. I think he is wrong since this is only a class B license. Thanks for the information