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You are here: Home / Driver Questions… And Answers / Sleep Disorders

Sleep Disorders

sleep disorder med

403dPlease read through the Q&A before posting a question. This will help everyone to not have duplicate questions. Thank you!

If you still can’t find a related answer, then you are welcome to ask your question in the comments section below.

See our BLOG Category on Sleep Apnea for articles and more information.

 

Q&A

Is sleep apnea a disqualifier?

Is narcolepsy 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.

Is narcolepsy a disqualifier?

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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Comments

  1. Anglis H says

    January 26, 2023 at 1:51 pm

    I was diagnosed with sleep apnea in 2019 it is 2023. I was cleared and returned back to work in 2019 for a over the road driving.Did I supposed to continue this program and get readings each month? Is there a time Limit that you have once you pass before getting reevaluate ibecause it’s on your record?

    Reply
    • Trucker Docs™ says

      January 27, 2023 at 8:38 am

      @ Anglis H
      For class A, if you are still using a c-pap, then you need a monthly reading of 70% compliance. If you are no longer using a c-pap, then you need a release form from your sleep specialist.

      Reply
  2. Jay G says

    December 16, 2022 at 5:16 pm

    I’ve been diagnosed with Narcolepsy since 2016. I’ve had my dot medical card for almost 3 years. Just went to a new doctor to get it renewed he told me people with Narcolepsy cannot get a dot medical card and told me to go back to the doctor i got it from for the last 3 years. I stated I have never caused and accident my entire life (I’m 30 yrs old) my sleep doctor is well aware of my job and okays me to do my job. It is well controlled with my medication I have no EDS and no cataplexy anymore with my medication. After reading more on it, I have not found anyone else with Narcolepsy having their dot medical card, it seems the FMCSA is grouping all people with Narcolepsy into one. I feel with any medical diagnosis things should be decided on a case by case basis due to different severities of the same diagnosis. Its like saying almost all people with cancer are the same despite being in stage 1, 2, 3 or 4
    One thing I noticed is they state: People with Narcolepsy are unable to receive a dot medical card. Then when you read the reason is because of EDS.
    Then under EDS it says you can submit a medical opinion letter from your sleep doctor. So does that mean if your EDS is controlled you have a chance to receive it? As long as the doctor who does your Dot physical signs off on your medical card ?
    Do you have any input on my situation?
    I have already scheduled an appointment with the doctor that I usually get my card from.

    Reply
    • Trucker Docs™ says

      December 17, 2022 at 7:50 pm

      @ Jay G
      You are on the right track. Get your card from someone who understands that these examinations are to be treated on a case by case basis, not grouped together via a single diagnosis.

      Reply
  3. George says

    October 29, 2022 at 11:01 pm

    I’ve had my cdl license since 2008 Ive never been in an accident. But I’ve been diagnosed with sleep apnea for the past 2 years. I’ve been excercisng and trying my best to lose weight so that I could contest my sleep apnea. Is it possible to retake the sleep apnea test.

    Reply
    • Trucker Docs™ says

      October 30, 2022 at 8:35 am

      @ George
      You should be able to be re-tested.

      Reply
  4. Chris says

    October 1, 2022 at 3:08 pm

    Had a sleep study done in 2015 AH-I was 6 Never had an issue getting dot certified Last dot physical it showed up in my charts was given 3 months and told it could be extended again if needed to get new sleep test done DOT card is up next week Have new sleep study next month Different Dr at same place just told me they couldn’t pass me Explained I was complying with everything they asked but might take 3-6 months to get it done She would not give me an extension therefore I could be out of a job What are my options

    Reply
    • Trucker Docs™ says

      October 3, 2022 at 6:48 am

      @ Chris
      Go elsewhere for a second opinion.

      Reply
  5. Christopher says

    September 11, 2022 at 7:00 pm

    I came forward in regards to my previous sleep apnea diagnosis during my last DOT PHYSICAL. New rules seem to apply as I was originally told I would have to have a cardio pulmonary test and would only be given a 90 day certification. With my disclosure of sleep apnea I have added insult to injury. I passed the Cardio Pulmonary test but wasn’t able to get a new Cpap machine (the machine I was using was old and didn’t carry Bluetooth or SIM card capabilities) until 4 days too late. I need to provide proof of twenty one days of usage for at least 4 hours a night. As I said, I am four days behind the eight ball on this. Can a medical examiner provide me with an extension to compensate for these 4 days. I had to jump through hoops just to get my new machine so quickly!!

    Reply
    • Trucker Docs™ says

      September 12, 2022 at 3:57 pm

      @ Christopher
      DOT/FMCSA has extended your grace period to the middle of October. Just get it done and get the results into the examiners office.

      Reply
  6. Heather says

    September 9, 2022 at 3:42 pm

    At what AHI does the dot rrquire you to use and be compliant with the cpap regulations. I read somewhere your AHI had to be atheist 20. And another said if you were moderate, which is 15-30.

    Reply
    • Trucker Docs™ says

      September 11, 2022 at 7:15 am

      @ Heather
      There are a multitude of signs and symptoms that the CME is looking for. 15-30 is an indication of moderate OSA and would present with a series of moderate symptoms. DOT/FMCSA does not require a specific AHI. That is left to the sleep specialist to maximize those numbers.

      Reply
  7. Michael E H Jr says

    July 10, 2022 at 9:57 am

    My cpap machine only has a sd card to get the compliance report since 3G is out the door. If I download a report from The Oscar program, will the DOT doctor accept it?

    Reply
    • Trucker Docs™ says

      July 10, 2022 at 6:23 pm

      @ Michael E H jr
      He should, if it shows good compliance for your sleep patterns.

      Reply
  8. Michael T says

    June 20, 2022 at 10:43 am

    I have a cdl and sleep apnea which requires a 30 day report with 70% compliance. Problem is my cpap machine was recalled and has been for about a year!! I just got it back a few weeks ago. My Medical card expires in less than 30 days. My Dr. wont give me a new Medical card because I don’t have a 30 day report. I coudn’t use the machined because of the recall. I am using it now but the medical card will expire before I have the 30 day report. How is this fair to me I could not comply because of the Phillips respironics recall

    Reply
    • Trucker Docs™ says

      June 22, 2022 at 6:42 am

      @ Michael T
      DOT/FMCSA has extended your grace period to the end os August. You have time to get it done.

      Reply
  9. Jessica D says

    May 4, 2022 at 11:21 am

    I have a patient with sleep apnea. what is the compliance requirements for CPAP to be certified?

    Reply
    • Trucker Docs™ says

      May 5, 2022 at 6:59 am

      @ Jessica D
      30 to 90 days readout indicating 70% compliance.

      Reply
  10. Jerry says

    May 3, 2022 at 9:16 am

    Is a Herbst Oral Appliance with a monitor chip an acceptable device for sleep apena?

    Reply
    • Trucker Docs™ says

      May 4, 2022 at 6:31 am

      @ Jerry
      As long as you can provide some type of readout/information indicating a 70% compliance, you may be OK.

      Reply
  11. Charles B says

    April 2, 2022 at 1:30 pm

    What if I use “Inspire” for my sleep apnea? What type of documentation will be required by the certifying doctor?

    Reply
    • Trucker Docs™ says

      April 2, 2022 at 4:05 pm

      @ Charles B
      Most likely the CME will need some documentation from your doctor indicating a successful correction of your OSA. If you have had great success with this, tell others that may need such a device.

      Reply
  12. Lance z says

    March 30, 2022 at 3:27 pm

    I drive a 18 wheeler it is tagged a farm truck I don’t drive over 70 miles one way home every night im not required to have a CDLs I went to get a medical card and the doc went back about 12 years on my medical record I went to have a sleep study done right at 12 years ago I weighted about 360 lbs it was the worst night of my life I couldn’t sleep at all so the test came back inconclusive I now weight 240 lbs but they will not give me a medical card until I go have another sleep study done so I could loss my job and my house because it’s part of my pay can they go back that far

    Reply
    • Trucker Docs™ says

      March 31, 2022 at 7:09 am

      @ Lance Z
      If you are not required to have a cdl to operate your farm equipment, then the CME does not understand the differences between federal requirements and state variances. You fall under your states guidelines and variances, not federal DOT/FMCSA. Go elsewhere for a second opinion, and make sure the examiner understands you do not carry a cdl.

      Reply
  13. Taye W says

    March 28, 2022 at 5:22 pm

    Of you are overweight they WILL make you do a sleep apnea test. It doesn’t matter if you don’t have any accidents or a history of issues/concerns with your sleep. Simply being fat is enough smh.. So DUMB

    Reply
    • Trucker Docs™ says

      March 29, 2022 at 6:55 am

      @ Taye W
      This is not totally correct. A sleep apnea test should only be requested by an examiner if the driver presents with a multitude of symptoms, weight is a small indicator. Unfortunately, there are facilities which have a serious conflict of interest and request a sleep study. If you do not have symptoms of sleep apnea, then go else where for a second opinion.

      Reply
  14. Darin says

    February 22, 2022 at 7:07 pm

    If you are on a c pap machine does the dr. Report it to the fmcsa?

    Reply
    • Trucker Docs™ says

      February 23, 2022 at 6:51 am

      @ Darin
      Class A cdl holder are reported to the FMCSA, but not for specific conditions. Lesser class cdl holders are not reported to FMCSA.

      Reply
      • Paul says

        December 1, 2022 at 2:14 pm

        Who reports to fmsca the examiner or a pulmonary dr

        Reply
        • Trucker Docs™ says

          December 2, 2022 at 2:29 pm

          @ Paul
          The medical examiner reports to the FMCSA.

          Reply
  15. James H says

    February 13, 2022 at 3:15 pm

    Hello, I have been issued a 90 day Medical Card by a DOT Certified Physician in the National Registry. The reason I was given a 90 day window is, because of my sleeping issues and possible sleep apnea and due to this possibility, I need a sleep study. Where I am confused is, if I do have possible sleep apnea, wouldn’t the sleep study need to be conducted first so the issue can be diagnosed before I am cleared to drive a CMV? If the 90 days is for a sleep study to be conducted, a lot could go wrong on the road if i have sleep apnea before then and when the 90 days are up? I don’t understand why I would be cleared to drive …

    Reply
    • Trucker Docs™ says

      February 14, 2022 at 7:19 am

      @ James H

      The medical examiner is giving you 90 days to get the study done, trying not to put you out of work whilst you wait. Your statement is correct and if you feel that you are a risk to yourself and others, then do not drive until you have the test done. Once you have a diagnosis you will need to be on a C-pap machine for 30 to 90 days to demonstrate compliance, before you will be given your final medical card.

      Reply
    • Mike says

      March 26, 2022 at 11:54 am

      There is no DOT history regarding sleep apnea recordable involved accidents in America to back sleep studies. You don’t have to have sleep apnea to fall asleep in a truck driving long hours all day. You can have sleep deprivation from an unsteady sleep pattern driving odd hours. Sleep apnea is bogus, it’s a “pretext” for racial and age discrimination for trucking companies that want to keep out minorities or age discrimination. Doctors simply can practice discrimination in medical because of your nationality Asian, black, Indian, or Mexican, they can disqualify you on “discretion”. Sleep apnea is used for discrimination in trucking by carriers that contract with certain doctors in clinics like “Concentra” Did you sign the medical card? Do not sign the medical card if you disagree with a (3) month certification. If the doctor files it after your disagreement, sue the doctor for fraud. No more forcing bogus sleep apnea test on drivers to injury our health and practice unlawful employment discrimination. We are going to take our health back in charge and stop unlawful discrimination against Title 5 and civil rights.

      Reply
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