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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 am a DOT medical examiner and my question is about Ambien. Are driver’s allowed to take Ambien nightly? I remember part of my review course mentioned taking sleep aids for no longer than 2 weeks.
Thanks
@ Dana
Due to the adverse side effects of Ambien, DOT/FMCSA recommended not to certify. And a driver starting this regime needs to be on these meds for at least 30 days before re-newing his/her medical card. The potential side effects are a high risk factor.
What Sleep study AHI am I disqualified from driving . Is it 15 or 20?
@ Terry W K
Neither, if the OSA is being treated with a C-pap. 15 is mild OSA and 30 is moderate.
If you have been diagnosed with sleep disorder in the past and have not been on a cpap for years and have had no issues since I had heart surgery do you still have to put that on your paper work?
@ Deb
Best to answer the questions truthfully and let the CME make the decision.
I live in NH and have my CDL-B for school bus. I couldn’t handle the cpap machine and mask, and the nose pillow was a hard no. Someone just told me about the mouth appliance type thing to help with sleep apnea. Does anyone know if this is an approved device for DOT/med card?
@ Jenn
Your cdl falls under your states guidelines and variances not federal DOT/FMCSA. Check with your local DLD and determine what is acceptable by your state.
What if you are a regular OTR driver?
@ Anne
And the question is ???
I live in Michigan and work for a School, so I am a bus driver. I have mild sleep apnea, (7.9) I have a CDL class C. My doctor said I have Mild case and do not need to use my sleep machine, but the examiner said the Doctor need to look this up and rewrite a letter. I am to use my machine for 30 day before the examiner will give me my license.
My School makes us get non-exempt inter State in case we need to cross state lines.
Bus Drivers only drive around 2hrs than break for 1-1/2 hrs then out again 2 hrs and break again. So why are we held to the same standard as a long haul driver?
Does anyone know the AHl number before you have to wear sleep machine?
@ Susan S
Your medical examiner is not using your states guidelines and regulations, but trying to hold you to a class A cdl standard. You fall under your states requirements, not federal DOT/FMCSA. Find an examiner that knows the difference and get a second opinion.
I had a multi car accident, my fault. I felt a pain in my chest and blacked out before hitting several cars. No one was seriously hurt, no one died, and I was not on drugs no dui etc.
I got checked out at the ER, they connected me to a machine etc and cleared me to drive. They were inconclusive as to what caused it.
I was told my another truck driver that my med card is automatically revoked.
@ Jason M
Medical card is revoked and will require a new medical certification examination. Be prepared, you are going to need supporting medical documentation and a full medical release.
What’s the best way to find out how far off you failed the Epworth sleep test? I’ve scored a 6, which is normal, but it’s considered excessive for my DoT exams. If I failed that’s fine, but sending me out to get retested and being told I failed more than once without know how I failed is frustrating. My oxygen levels never fell below 90% but I’m being made to take the 30-day test to improve my oxygen intake while I sleep (or so I was told). I’ve attempted to go to other physicians but they won’t see me because I have a score of 6 and a mild sleep apnea diagnosis at the moment. Is there anything I can do?
@ Alverta
What class cdl do you hold. A score of 6 is highly unlikely that you would have any issues, unless the facility that is doing your DOT/FMCSA medical certification examination is in bed with the sleep study group. Get a second opinion from another DOT medical exam testing physician.
I’ve been diagnosed with mild sleep apnea. Mild. Not moderate or severe. DOT doctor is denying me a medical card because I am not cpap compliant. Everything I’ve read or looked into mentions that mild sleep apnea does not require treatment in order to obtain and the level that disqualifies a driver is moderate or severe. The sleep study result does say cpap is the recommended treatment. Recommended is not the same as required. I feel like I am within the guidelines and regulations and not sure where to go from here. My company is looking into for it me. I’ve also had a second sleep study done and it also shows mild sleep apnea.
Same here, to clear the DOT physical even with mild sleep apnea(I barely have it as well), you need to comply with the CPAP for 21 days of at least 4 hours a night in a 30 day stretch. It is annoying but required, diagnosed is diagnosed unfortunately.