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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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During my DOT physical i was told due to my body mass i will have to due a sleep study. They gave me a temporary certification. I completed the study, used my bipap machine for 30 days brought the results to the medical examiner. I was infomed i have to take another physical before i received my certification.
Is this correct? 2 physical by the same examiner within 2 months.
@ Samuel B
New DOT each time. FMCSA guidelines require a new examination each time.
I am a 51 year-old male, and am considering getting a Class A CDL for the first time. I am in good health, and have a BMI of 23.
A long time ago (I think it was in 1997), I had a sleep study and was diagnosed with moderate obstructive apnea and moderate central apnea. I was prescribed a Bi-PAP machine, which I was never able to tolerate.
Not long after, I was found to have a severely deviated septum and enlarged tonsils. I had the septum corrected, and then my tonsils and adenoids removed. It was life changing, and I’ve done fine ever since without using the Bi-PAP. About 10 years ago I had another sleep study, and the doctor told me that I don’t have sleep apnea.
I’m concerned about the impact this will have on the DOT physical, both initially and going forward. Do I need to even mention it? Will I need to get the records from that later sleep study, or have to have another one done? Thanks for the help.
@ Paul
If things have been corrected some 10 years ago, then go for the DOT examination. You should not have any issues regarding the sleep study, since you have had the issue corrected. Unless other issues require further investigation you should be fine without any additional sleep study testing.
My employer pays for employee CDL medical evaluations in accordance with California Labor Code Section 231 – “Any employer who requires, as a condition of employment, that an employee have a driver’s license shall pay the cost of any physical examination of the employee which may be required for issuance of such license, except where the physical examination was taken prior to the time the employee applied for such employment with the employer.” My Medical Examiner is now recommending a Sleep Apnea Test. Is my employer mandated to pay for all costs associated with this test, or am I out of pocket?
@ Stacey A
You will need to check with the human resources department, or legal department, on this issue
How many months back do I have to print out from my machine to prove I’m using my machine to take in for my physical
@ Scott
FMCSA wants 30 days, if you are new to a unit, the examiner may want to see 90 days.
Hello, quick question to piggy back to Scott’s question. I read that the sleep apnea law was never passed. How is the sleep apnea requirement being enforced?
@ Quintin D C
Just follow the money. The examiners that are pushing the issue are in a conflict of interest, or have done more homework and utilize additional test protocol to make their final decision.
Hello, there.
I recently had DOT physical exam for my courier delivery driver job. I have sleep apnea and had to have my doctor or my cpap supplies store send them a compliant report and passed but is only good for a year since I have OSA. My questions is: Would I ever have a 2 year medical card instead of 1 year? And I’m suring that I would have to present my compliance report each time I got to renew…
@ John
Unless you are a class A driver you fall under your states guidelines and variances, not DOT/FMCSA. These may be two completely different guidelines. By FMCSA guidelines for class A drivers, you will only receive a one year medical card and must supply a compliance report each time. But you state may be different than DOT/FMCSA for your class drivers license, check with your local DLD.
Is there a regulation or rule that a driver on a cpap can not get a two year medical card. I have been on a cpap for two years and have gotten a two year card by two different CMEs. Now my company wants me to go back to the doctor and get a one year card. Is this the law or just guidelines. Thanks for your time
@ Brian
DOT/FMCSA recommend a one year re-evaluation for drivers on a cpap.
Doctor wants a printout of useage. My cpap is 15 years old and doesn`t have any provision for an sd card or anything else. I see no reason to get a new machine when the old one works perfectly. Cpap has worked well for my sleep problems.
@ David H
How does your doctor get a readout from your machine. If he can have him provide you with the latest readout to show compliance.
Does the state of Texas have a minimum number of obstructive episodes on a sleep study before they will remove the requirement of wearing a CPAP device
@ Grady
You need to check with Texas on this issue.
I was told that you need to be using a cpap machine for a minimum of 30 days, after your diagnosis, before a re-certification will be issued. Is this true?
Hi Earl. I am in the same situation as you. I was told by my pulmonologist that I need a 30 day c pap reading in order to keep my medical card. I am devastated by this as I was diagnosed with mild sleep disorder and cannot get a reading off my machine. I have tried many masks and nasal pillows and still have no reading. I have been fighting for my medical card for 3 weeks now. I am praying with all I have that the DOT examiner will override this decision as I also have COPD which I believe is the cause of my hypopneas. I wish you all the best
@ Earl
FMCSA would like to see 90 days immediately following preliminary diagnosis. You may get a 90 card so the CME can do proper follow-up.
How far in advance of my physical may I take my CPAP test? For example if my anticipated date of hire is November 1 and I took the physical October 28 would my CPAP of August 1 be accepted. If not when is the earliest date that I could take my CPAP test to be accepted by Oregon DOT?
@ Sandy
Take your most recent reading as close as possible your examination date. Make sure it’s for the last thirty days and shows a 70% compliance.