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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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Does anyone know what the requirements are for a retest for sleep apnea? I had a new study done showing negative and now my company’s compliance department tells me that they will not accept it because I did not stop using my machine 48 hours before the new study. Has anyone else had this issue?
Hello I have sleep apnea and can’t use a cpap can I use the oral instrument instead to make me compliant.
@ Jerry T
For DOT/FMCSA class A cdl, you are going to need to provide significant medical documentation to support having your condition under control. But it is possible. For lesser class license, you fall under the states guidelines and regulations.
I never had a problem passing the physical, however, my primary doctor no longer does physicals. I was at a pharmacy picking up a prescription and noticed that they did walk in physicals. I took the physical, the nurse practitioner stated that due to being a male over 50 along with my weight and a history of high blood pressure, even though it is under control while taking medication, she said that I have to go for a sleep apnea test and was limited as to timing or would have to take another complete physical. I explained that there is no family history for sleep apnea, as well as answered a questionnaire online which resulted in not having a sleep apnea issue. She claimed that her insistence for me taking the test is mandatory based on changes to the requirements. I’m unsure about where to go for a second opinion, as well as the timing and cost of having to go through another complete physical in which may bear the same results. I haven’t driven a truck for many years but do not want to give up my license which I’ve had since inception.
@ Dan B
Sorry you went to a ‘doc in a box’, there is no such regulation in the DOT/FMCSA for a mandatory sleep study, unless there are a multitude of signs and symptoms. Go to a CME that understands the guidelines and regulations and get a second opinion.
I had same thing happen to me.I have 0 symptoms 6ft 6 270 lbs 18 Inch neck. Rude doctor would not listen. I understand that there a lot of doctors with this false belief. It’s wrong. Needs to stop.test is expensive if I deductible I pay to prove . Got a 2nd opinion
@ Bill F
It is unfortunate that some doctors and the facilities they work for have a conflict of interest with sleep study groups. FMCSA is pretty clear on their side of the requirements and regulations, but some examiners are not looking to be driver friendly, but looking for any reason to be non-driver friendly.
I was diagnosed with sleep apnea a few years ago and use a cpap machine to keep my cdl. Since then I have lost alot of weight and am trying to get off the machine. I recently retested and AHI is at 5.8(mild). Willni still be required to use cpap or is it only required for moderate to severe apnea?
@ Ruben
You will need a note from your doctor indicating you are off the cpap and are doing fine. Supporting medical documentation and a medical release form from your doctor will aid in the CME’s decision making process.
Hi, I’m in Ny state and I need to know what the class b Cdl requirement is for a 1 year medical card renewal with a cpap machine. 30 days or 90 day cpap compliance?
@ Darryl H
Your class B is state, not federal, and will be best answered from your local driver license department.
Went for a first ever DOT physical in order to take the CDL class A permit test in Florida. Medical Examiner measured my neck and my height and weight and said “per DOT, My BMI indicates i need a sleep study”, which I did and I have been diagnosed with sleep apnea. The Medical Examiner says I have to be on the CPAP machine for 30 days before she can grant me my medical card and I Cannot take the permit test until that is complete and certified.
My question is, Is what I’m being told legitimate? I’ve spoken to a friend who is going through the same thing and has also been told his BMI requires a sleep study but he was given his 3 month card to start his licensing process. He went to a different Medical Examiner.
Also- I am a bit confused because i read in this guide that there are currently NO BMI-regulation as per DOT.
Thank you
@ Brian
Neck measurements, BMI and weight are a very small portion of a preliminary diagnosis and the DOT/FMCSA states that there should be many significant findings on top of those three. There are no specific DOT/FMCSA regulations for BMI, neck measurements, that would warrant a sleep study all by themselves. A 3 month medical card for an individual just starting a cpap is not a normal issuance. DOT/FMCSA for a class A driver would be 90 days, with a readout for the last thirty days, showing good compliance.
I have a diagnosis of EDS from a sleep practitioner after having 2 separate sleep studies and ruling out sleep apnea. Correct me if I’m wrong, but would taking Ritalin (methylphenidate) cause an immediate fail of the DOT physical? If I’m stable on Provigil, would that be considered okay, or also bar me from driving?
@ Sarah S
Your condition and medication use will cause questions with the CME. The examiner will request additional information from your prescribing doctors, but neither of your meds are immediate disqualification from DOT/FMCSA. You will need to be on any new medications for a period of 30 to 90 days before a medical card would be issued.
I am a Sleep apnea patient. I am SO glad my doctor recognized it and have been using CPAP for 4 years now. I can tell any driver that without a doubt, I am better off for having been diagnosed.
That said, here’s my question/gripe (How do you make a driver gripe? Give him a job!). To get my 1year medical certificate, the CME needs a report from the Neurologists office that I am indeed using CPAP. To get the report, I must schedule an appointment which can take weeks/months depending on your location. Once obtaining the report, I then go see a CME to get my certificate. Then report it to the state all in time to prevent disqualification.
So, In planning ahead to clear the hurdles, I end up making appointments (and paying for them) weeks/months in advance. This then actually gives me an 11-month certificate since I have to stay ahead of it rather than be disqualified. As I see it, I should get a free year after a decade! (yeah, right)
Now to the question- How long is the report valid from the neurologist to the CME? If I can hold out to the last available days and get my certification within a week of disqualification, maximizing my 1-year ‘value’.
@ Chip W
The CME needs to see a recent 30 day readout. Questions, does your machine not provide a readout report or must you go to the neurologist for the report? If you have to go to the neurologist, then see if he will give you a 90 day readout. That will cover your bases right up to the last minute so you can get your one year for one year.