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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 have been on cpap for 22 years. I couple of years ago I had to buy a new machine that would record use. I thought you had to use it for a minimum of 4 hours 70% of the time. My doc says different. I cannot find any time requirement for this. Where might I be able to see it and print it out?
@Greg
See info at this link http://dotphysicaldoctor.com/commercial-drivers-manage-sleep-apnea-maintain-cdl/
There is no written rule by FMCSA.
The Medical Expert (to FMCSA) Panel’s minimum recommended compliance is: 4 hours of CPAP sleep per day, 70% or more days.
Your company/carrier is allowed to impose stricter standards than those recommended by the Medical Review Board.
Some companies are requiring at least 6 hours of CPAP use, 80% of days.
The most effective treatment is 7 or more hours of CPAP use during sleep.
I have an employee who can’t get his medical card. Due to the fact instead of a cpap machine he got dental implants that where recommended by his dr. DOT dr said he needs a cpap machine is this correct
@ Paul
No, it is not correct. Proper documentation may be needed, but a dental implant is acceptable by FMCSA with documentation from his doctor. Get a second opinion from someone who understands the FMCSA guidelines.
I train new drivers. And they often wake me up to ask questions or get my help multiple days students waking me up causes me to not use it every “day” for 4 hours. Somedays I register 3 and the next I register 12, because of the per “day” understanding. But I use it 6-8 hours each “night” or more exactly each time I go to sleep. Also with each of us having a 14 hour clock we have a 28 hour “day” fairly often. Where can I find the dot regulations on cpap usage? If I take my logs and usage report showing I’m in compliance with the spirit of the law, which is to use it 4 hours each time I go to sleep, 70% of the times I got to sleep. Or do I really have to get a new job to be in compliance with the “letter of the law”?
@ Jordan B
FMCSA issues guidelines in this case and your situation should be considered by the guidelines , not regulations.
I was told due to an 18 inch neck o needed to due an at home sleep apnea test. I took it and was told I have moderate sleep apnea. Noe I am being told I must purchase a cpac machine that my insurance will not cover for hundreds of dollars or I won’t get my medical card signed. I read here that it’s only in severe cases that a cpac machine is required. I live and work in California and I deliver gasoline. Can you clarify what my requirements are. What are my options?
Thank you.
@ George
1. 18 inch neck is not grounds for a sleep study. 2. Home sleep studies are not acceptable for a DOT medical card.
If you are driving within the state and not traveling interstate on a routine basis, then we would recommend you go get a second opinion.
where is it stated that Home sleep studies are not acceptable for a DOT medical card? there is no mention of that any where, plus most companies that require a sleep study st you up with a Home sleep study !
@ Dave
Check on the FMCSA website. The guidelines that the CME’s have to follow are, or were, available there.
Typical they are lying to you and requiring a CPAP. Get a second opinion. Apnea and CPAP are a huge game of corruption and making dirty money! ALWAYS QUESTION ANY DOC THAT ORDERS A SLEEP STUDY! CPAP can kill you!
if the federal gov. has NO laws for sleep apnea how are these doctors threating our license??the DOT has no regulations about sleep apnea.
I was diagnosed more than 8 years ago with severe OSA. I tried a CPAP and it didn’t work well for me, so instead I had two surgeries on my sinuses. After that was finished I had another sleep study that showed I no longer had severe OSA. This was a few years ago, and I haven’t needed a DOT physical card recently. I’m about to apply for one again, only Class B intrastate driving if that matters. Since my last sleep study showed my OSA was corrected I am no longer regularly seeing a sleep doctor, only my regular physician. What chance do I have to getting a DOT card if I pass the physical? Would it be for 1 year or 2?
@ John
You should not have any issues. Make sure you have some documentation to support the success of the surgeries.
I took sleep apnea test for DOT exam passed no problems. When will I have to retest any guidelines or regulations on this thxs
@ Steve
If you passed with no issues, then keep a copy for future reference and you should not be ask to do it again.
I have been driving non cdl commercial box trucks for 5-6 years. Was asked to get a dot physical and which the doctor referred me for a sleep study. The day of the test i worked 22 hours, drove 4 hrs without stopping. 3p-7p. Went in for the test. Just got my results back and it says i have narcolepsy. I really feel that its misdiagnosed since ive been driving ans never fell asleep at the wheel. I also train as a bodybuilder 4-5 days of the week. So definitely no loss control of my muscles. How do i go about getting a second opinion. Because of thid diagnosis my company that ive been driving for took me out of my truck and i was preparring to get my cdl’s. Please help, i feel that the test wasnt done under right circumstances, and i was given a prescription for somethin that i feel i dont have. Please help
@ Brad
You fall under your states regulations and not FMCSA, so the sleep study may not have been necessary. Check with your local drivers license department for the states guidelines of non-commercial drivers and then get your medical certificate done with the states guidelines and not FMCSA guidelines. Your CME should know the difference.
I’ve held a CDL for almost 10 years without incident. Worked a regular 40hr shift to full capacity. Due to the conditions of the job (emergency call outs, winter storm outages, MVA’s and etc) on any given night or day, you can assume a 24hr night or consecutive nights. I’ve complained of minor exhaustion but NEVER a drop off in the middle of any event. I’ve been recently diagnosed with CHRONIC NARCOLEPSY from a sleep study. Even never showing any symptoms, except minor fatigue from the lack of sleep, I am able to maintain wakefulness for several days on less than minimal sleep. More like insomnia tendencies than narcoleptic. Question #1-has this been heard of? #2-Can this be a misdiagnosed condition if one is able aware for 48hrs after a2 to 3hr rest? #3-Is such conditions determined by one test or a series of tests to confirm of clarify a positive or negative diagnosis? #4- Is there any such thing as controllable narcolepsy? I’m a lineman. I’ve worked multiple 75 to 80 plus hours for a straight 3 months and never dosed off behind a wheel.
Looking for answers as I’m about to lose my home, my freedom to drive and my rights I’ve earned to live as a normal person. I understand narcolepsy. I understand apnea. I can sleep for 45mins and Work for 2 days or more But if I’m narcoleptic…I would not be able to. What are tests taken to give a definitive diagnosis? Help!!!
@ David
It sounds like the sleep study has been mis-read and you should request a second opinion based on your work. And unless you are a class A OTR driver, you fall under the states guidelines and not FMCSA’s guidelines. Go get a second opinion, if you need and check with your local drivers license department for your states guidelines.
I’m scheduled for a second opinion plus additional tests. Had a sleep study before @25years ago because I thought I was having apnea attacks, not being able to breathe, which tests were negative. But narcolepsy tests were positive. I achieved REM Levels in 2 to 3 minuets when falling asleep but only laying in bed. I’ve had another test just within last 6 months that shown the very same. Not understanding if and why I’ve not displayed symptoms. So far the doctors I’ve come across say that they’ve never heard of anyone having this issue. I can’t be the only one. I’ve been said to have controllable narcolepsy?!?! And at the same time I’m considered a danger. I’m up against a wall and having my life stripped from me. Are there any doctors who have had any abnormal situations such as this? I’m pushing for a HLA Test to check my DNA, if covered. Also, I’m wearing a monitor so my sleep patterns are recorded. I’m lost soul in this realm. Need help.
I was diagnosed with narcolepsy at 14. I went to a sleep doctor because of my “insomnia”. I had trouble falling asleep because I was entering rem sleep while I was awake and it was disrupting my sleep patterns. If you had sleep apnea hours of sleep wouldn’t hold you over. Deep level rem is what makes you feel well rested and takes most people hours to achieve. With narcolepsy you can achieve it in minutes and it’s why you can function off of few hours of sleep. That being said it’s extremely disruptive to sleep cycles. You need to have an extremely structured sleep schedule. One of the biggest misconceptions about narcolepsy is falling asleep at random. This is narcolepsy with cataplexy. Cataplexy is only diagnosed in about 35-40% of narcolepsy patients and is defined as sudden and involuntary loss of muscle control or tension often brought on by extreme emotions or stress.