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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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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.
I have been a CDL-B driver since 2018. At the time of my first medical I was ordered to get a sleep study and I was diagnosed with sleep apnea and put on a CPAP. Over the past year, I have lost approximately 80 lbs and have gone from 255 lbs to 168. My neck is 16 3/4″ now (formerly 22″). I have been waiting for months to see the doctor so I can be scheduled for a new sleep study so my machine can be adjusted appropriately or done away with. Am I now exempt from having to comply with the 70% rule? Do I even need to go thru a new sleep study to satisfy the DOT because my neck is now under 17″?
@ Steven
As a class B cdl holder, you are not held to federal DOT/FMCSA standards, but to your states guidelines and variances. Your state may not require any information regarding your OSA. Confirm this with your local DLD.
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?
@ 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.
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.
@ 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.
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.
@ George
You should be able to be re-tested.
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
@ Chris
Go elsewhere for a second opinion.
I tried that route. My safety office told me that I’m not allowed to get a second opinion and they would not accept it if from another facility. So I just have to accept the fact that one doctor is the end all be all to my career basically?
@ Nichole
You can always request a second opinion. Your safety officer is saying they won’t accept it, that is a company decision not DOT/FMCSA. Might look for another company. Drivers are needed everywhere.
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!!
@ 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.
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.
@ 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.
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?
@ Michael E H jr
He should, if it shows good compliance for your sleep patterns.
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
@ Michael T
DOT/FMCSA has extended your grace period to the end os August. You have time to get it done.
I have a patient with sleep apnea. what is the compliance requirements for CPAP to be certified?
@ Jessica D
30 to 90 days readout indicating 70% compliance.
Is a Herbst Oral Appliance with a monitor chip an acceptable device for sleep apena?
@ Jerry
As long as you can provide some type of readout/information indicating a 70% compliance, you may be OK.
What if I use “Inspire” for my sleep apnea? What type of documentation will be required by the certifying doctor?
@ 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.
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
@ 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.
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
@ 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.
If you are on a c pap machine does the dr. Report it to the fmcsa?
@ Darin
Class A cdl holder are reported to the FMCSA, but not for specific conditions. Lesser class cdl holders are not reported to FMCSA.
Who reports to fmsca the examiner or a pulmonary dr
@ Paul
The medical examiner reports to the FMCSA.
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 …
@ 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.
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.