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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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Need new DOT physical. I am switching to a new CPAP device from my older model. Still have my usage history from the older model. Do I need to have 30 days before the physical on the new CPAP machine? thanks
@ Vance G
It would work to your advantage, if it is at all possible, to be on the new unit for thirty days prior to your medical examination.
I have a driver who we have recently taken off the road as he has fallen asleep at the wheel twice. The company is paying for him to have a sleep study and he’s been advised to visit his PCP for a check up. His DOT physical does not expire until 10/19. Will he need to get this repeated sooner once all his testing has been done even if the test proves negative for OSA.
Thanks!
@ AJ
Yes he would need to have a new DOT medical certification examination done, even if he tested negative for OSA
I was diagnosed with moderate OSA roughly 10 years ago. I tried for several months to use a CPAP without success (multiple style masks were tried.) I finally gave up the idea of using the CPAP and went back to sleeping as usual, complete with loud snoring. I am trying to renew my DOT physical and the doctor wants me to repeat the sleep test. Is there any alternative to the CPAP that is DOT approved for OSA? Specifically, is the Inspire treatment system acceptable? I have heard good things about it, but has DOT accepted it yet?
@ Rick C
The Inspire system would be acceptable, once you are fully recovered and been on the system for a period of time, without incidence.
I was recently told to get a sleep study done. went to the in house sleep center had a panic attack was unable to complete. can I take a home test will that be accepted by the doctor. I also was told nothing about this 30 day comp thing will she be able to issue me another 90 day card or will I just lose my job
@ jerry j
Not sure that the DOT has fully approved any home sleep study packages. If you don’t experience day time sleepiness, regularly, then you may not be a candidate for a sleep study. Check on getting a second opinion.
My husband has been told by the DOT CME that he needs a sleep study because his BMI is 39 and his neck is 18 and to have his primary physician to write the prescription for the sleep study. However his primary DR, said the he does not need a sleep study. So now how does my husband get his CDL for longer than the 3 months the CME gave it to him for.
@ Linda W
He needs to get a second opinion at another facility, when his 3 months is nearly over. FMCSA does not have regulations on this issue, only guidelines for the CME’s.
I am going through the exact same thing. Got a 6 month card in Jan. I’m 35 yrs old and my bmi is high and neck is 18 inches which wasn’t even measures properly. Been this way for 15 years never any issues as I don’t have any symptoms of sleep apnea. Before the CME even did my physical he walked in and said I had to have a mandatory sleep test. Here’s my question. I told him I was going to get a second opinion. He told me that he was sending my info into a data base with fmcsa. He said even if you get a 2 year somewhere else your in a data base and if the fmcsa doesn’t get results for the sleep test In the 6 months that fmcsa would suspend my license. Is this true or can I go to a new Dr and get a second opinion and a 2 year card? I don’t want to be in a weight station 10 months down the road and them tell me I don’t have a liscence.
@ Nate F
That is complete ‘Bull Nuggets’. You are welcome to get a second opinion anytime, for any reason.
If you pass on a second opinion, then the new FMCSA entry is the medical card on file and valid.
I went to get medical card deiny because I didn’t do a sleep study on a ninety day card in Jan to April of 2018 however I did not use this card did not did not take the job went to addiffer job use a different dot clinic pass no problem jot a one-year card company now uses same dot clinic because didn’t do study won’t issue 90 day card can they do that company shut me down till I get one does it get reported to the state company safety said it did however second clinic had no issues never used it
@ Gerald b
You have the right to get a second opinion.
Just got a DOT physical and received only a 3 month card, CME wants me to get a sleep study done. How much time do I have to get a second opinion? Have to still get referral for study from my primary doctor. My BMI was 33 neck size 17.5 6’4″ 266. Just 4 yrs ago same CME while I was 295 lbs BMI 36 NECK 18.5 gave me a 1 yr no problem. How can the be?
@ Steve B
You can request a second opinion within the 90 day period, before your current medical card expires.
Follow up question. If I already handed in the long form with osa evaluation written on it to mvd. Will the second opinion supercede that one if it clears me for a year?
@ Steve S
Yes.
My husband wants to go get his cdl license. He has sleep apna and is already using a cpap machine. He is also on medication for high blood pressure. He uses his cpap and takes his medications as directed. Will he have a problem getting his license? Should he continue to pursue this career? We live in New Hampshire.
@ Joanna
State CDL may require a medical certificate. If so, take your latest test result from your cpap with you and a medical release form from your cardiologist or primary prescribing doctor.