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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 was diagnosed more than 8 years ago with severe OSA. I tried a CPAP and it didn’t work well for me, so instead I had two surgeries on my sinuses. After that was finished I had another sleep study that showed I no longer had severe OSA. This was a few years ago, and I haven’t needed a DOT physical card recently. I’m about to apply for one again, only Class B intrastate driving if that matters. Since my last sleep study showed my OSA was corrected I am no longer regularly seeing a sleep doctor, only my regular physician. What chance do I have to getting a DOT card if I pass the physical? Would it be for 1 year or 2?
@ John
You should not have any issues. Make sure you have some documentation to support the success of the surgeries.
I took sleep apnea test for DOT exam passed no problems. When will I have to retest any guidelines or regulations on this thxs
@ Steve
If you passed with no issues, then keep a copy for future reference and you should not be ask to do it again.
I have been driving non cdl commercial box trucks for 5-6 years. Was asked to get a dot physical and which the doctor referred me for a sleep study. The day of the test i worked 22 hours, drove 4 hrs without stopping. 3p-7p. Went in for the test. Just got my results back and it says i have narcolepsy. I really feel that its misdiagnosed since ive been driving ans never fell asleep at the wheel. I also train as a bodybuilder 4-5 days of the week. So definitely no loss control of my muscles. How do i go about getting a second opinion. Because of thid diagnosis my company that ive been driving for took me out of my truck and i was preparring to get my cdl’s. Please help, i feel that the test wasnt done under right circumstances, and i was given a prescription for somethin that i feel i dont have. Please help
@ Brad
You fall under your states regulations and not FMCSA, so the sleep study may not have been necessary. Check with your local drivers license department for the states guidelines of non-commercial drivers and then get your medical certificate done with the states guidelines and not FMCSA guidelines. Your CME should know the difference.
I’ve held a CDL for almost 10 years without incident. Worked a regular 40hr shift to full capacity. Due to the conditions of the job (emergency call outs, winter storm outages, MVA’s and etc) on any given night or day, you can assume a 24hr night or consecutive nights. I’ve complained of minor exhaustion but NEVER a drop off in the middle of any event. I’ve been recently diagnosed with CHRONIC NARCOLEPSY from a sleep study. Even never showing any symptoms, except minor fatigue from the lack of sleep, I am able to maintain wakefulness for several days on less than minimal sleep. More like insomnia tendencies than narcoleptic. Question #1-has this been heard of? #2-Can this be a misdiagnosed condition if one is able aware for 48hrs after a2 to 3hr rest? #3-Is such conditions determined by one test or a series of tests to confirm of clarify a positive or negative diagnosis? #4- Is there any such thing as controllable narcolepsy? I’m a lineman. I’ve worked multiple 75 to 80 plus hours for a straight 3 months and never dosed off behind a wheel.
Looking for answers as I’m about to lose my home, my freedom to drive and my rights I’ve earned to live as a normal person. I understand narcolepsy. I understand apnea. I can sleep for 45mins and Work for 2 days or more But if I’m narcoleptic…I would not be able to. What are tests taken to give a definitive diagnosis? Help!!!
@ David
It sounds like the sleep study has been mis-read and you should request a second opinion based on your work. And unless you are a class A OTR driver, you fall under the states guidelines and not FMCSA’s guidelines. Go get a second opinion, if you need and check with your local drivers license department for your states guidelines.
I’m scheduled for a second opinion plus additional tests. Had a sleep study before @25years ago because I thought I was having apnea attacks, not being able to breathe, which tests were negative. But narcolepsy tests were positive. I achieved REM Levels in 2 to 3 minuets when falling asleep but only laying in bed. I’ve had another test just within last 6 months that shown the very same. Not understanding if and why I’ve not displayed symptoms. So far the doctors I’ve come across say that they’ve never heard of anyone having this issue. I can’t be the only one. I’ve been said to have controllable narcolepsy?!?! And at the same time I’m considered a danger. I’m up against a wall and having my life stripped from me. Are there any doctors who have had any abnormal situations such as this? I’m pushing for a HLA Test to check my DNA, if covered. Also, I’m wearing a monitor so my sleep patterns are recorded. I’m lost soul in this realm. Need help.
I was diagnosed with narcolepsy at 14. I went to a sleep doctor because of my “insomnia”. I had trouble falling asleep because I was entering rem sleep while I was awake and it was disrupting my sleep patterns. If you had sleep apnea hours of sleep wouldn’t hold you over. Deep level rem is what makes you feel well rested and takes most people hours to achieve. With narcolepsy you can achieve it in minutes and it’s why you can function off of few hours of sleep. That being said it’s extremely disruptive to sleep cycles. You need to have an extremely structured sleep schedule. One of the biggest misconceptions about narcolepsy is falling asleep at random. This is narcolepsy with cataplexy. Cataplexy is only diagnosed in about 35-40% of narcolepsy patients and is defined as sudden and involuntary loss of muscle control or tension often brought on by extreme emotions or stress.
This compliance issue is causing more health problems & sleepiness nights then it resolves.
My DOT doctor ordered the sleep study when it was a medication causing my drowsiness, which when stopping the medication, completely stopped the drowsiness
I wear the the CPAP 30 days, some months compliant, some fall short.
I still have no drowsiness during waking hours, but move around in my sleep causing mask to leak.
This nightmare is causing me financial problems being out of work for more than a year. It is the financial worries making everyone’s health worsen.
How do I get a medical release from this nightmare?
@ Mario
Have you been retested for any sleep disorders? If not, have your doctor complete a medical release form stating that you do not suffer from OSA and take the form in to the examiner. If you need the mask, then you have OSA, if you don’t have OSA then you don’t need the mask. Just get it confirmed one way or the other.
I’ve been Diagnosed with mild sleep apnea by my family doctor. What are the ramifications of not disclosing this to the medical examiner? Does the medical examiner have the power to check your family doctor files? Is that a regular practice they do with patients? Or do they just take your word for it if you tell you you don’t have it?
I was diagnosed with severe sleep apnoea Based on nothing more than the home sleep study I have never been to a sleep lab. I have no problem staying awake during the day I just feel tired in general. and I cannot tolerate cpap .if I downgrade my CDL to intrastate driver only can i just lose weight to treat the apnea.? I live in Pennsylvania and I am a local driver I only drive During daylight hours and rarely work more than 8 hours A day.
I was forced to take a sleep study three years ago by dot dr. My ahi was 14. They still wanted compliance to get my year card. Am I required to use the machine even though my ahi is in the mild category.
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If you were issued a 3 month card for suspected sleep apnea and then was determined to have mild sleep apnea (new diagnosis), received your CPAP and have been compliant for 30 days (over 70%) can you get a 12 month card or do you have to wait 90 days. On the letter at the Medical Examiner’s office it stated if new diagnosis 30 days if compliant for a 12 month card. They stated that was for the suspected not the confirmed diagnosis on the letter, which did not specify that and will not give me a 12 month card. I am compliant and passed everything else. My job requires a 12 month card is there anything I can do? Class B license – Delaware
I ve been on my sleep apnea machine for almost 2 years. This year I have struggled with it just the same as last year. I ve tried all the masks. And my sleep is worse then ever. I wake up in 4 hours and take it off. So I stopped using it. I found a nose pillows mask i think they are called. And i like it. Mu question is ill have 4 months on it everynight. Will i pass of fail the compliance. Please help
They only need last 90 day report. And have to be 70% compliant
We are in Washington State and our drivers are intrastate. The medical examiner we send our DOT drivers to is requiring almost all of our drivers do the sleep apnea test. 99% of them come back stating they have sleep apnea, when they may or may not have it. I think they are doing it for the $$$. Is there a way a CDL driver can renew their medical certificate without being required to wear the sleep apnea mask? A lot of the guys say it keeps them awake at night; rather them help them, so they really don’t need to wear the mask. The problem is the medical examiner can run a test on the machine while doing their physical, and if they see the driver isn’t wearing the mask, they can deny their renewal for their medical certificate. I’m just wondering if their is some type of waiver the medical examiner could sign indicating the driver isn’t required to wear the mask, or how we can get around having these guys do the expensive sleep test and have to wear the mask every night. Any information would be very helpful.
Why not change the DOT facility that you send your drivers to if you think this one is acting unreasonably? Are the drivers having their reports explained to them?
I am an Illinois school bus driver, class B license. Our bus driving physical form does not address sleep apnea in any form. However when I went to get my physical the doctor stated due to some standard measurements he suggested I go and get a sleep apnea test done and said I could drive for three months. School bus drivers do not have a three month card option in the state. My question is since I technically passed every part of the physical required by the state, is this doctor allowed to require this. I think he is wrong since this is only a class B license. Thanks for the information
If you have sleep apnea and it’s moderate does dot still want you or its required to still use the cpap device
@Edward
Yes, cpap compliance is required for moderate sleep apnea.
I was diagnosed with mild sleep apnea in 2010. I have had the same doctor over the time period to now. I had a home sleep study done in 2014 and it showed positive changes in my OSA. The dr encouraged me to continue cpap therapy but didnt give me a definite yes or no answer. Up until October 5, 2017 I have not used cpap since November of 2014. I went to orientation with another trucking company earlier this month and was told I needed to show 85% compliance over 90 days. I have also read 70% over 30 days is suffecicent. My medical card expires November 2, 2017 and I am currently unemployed at the moment because of it. Which time frame will I have to follow?
@Justin
70% over 30 days, unless there’s a company policy in place that requires stricter compliance.
I have a question in regards to cpap compliance. I was diagnosed with mild sleep apnea just over a year ago. I have not been using the machine for the past 3 1/2 months. I went yesterday to renew my dot medical card and was told to get a compliance report, well that’s where the problem is, my doc can’t generate a report because I haven’t use the machine. So, can I simply go to another physician and not disclose I use a cpap, and get a medical card? I only had less than 5 episodes per hour when diagnosed. Does the results of dot physicals get reported directly to the dot? I have been given a 45 day temp card in order to get the compliance report. In other words will the dot know if I simply find another doctor who will give me a physical and issue me another card even though I saw another doc who is telling me I have to get the report.
Quick question, I got my medcard for only 3 months because the Dr recommended a sleep study due to neck size and bmi. My question is, if I go to another DR will the result be the same? Will they recommend the sleep study based on the previous examination?
@Roman
Neck size and BMI are not conditions on their own to necessitate sleep apnea screening.
Read these articles to understand sleep apnea screening issues.
Go for a second opinion.
I only see questions and answers pertaining to Obstructive Sleep Apnea. Can a person being successfully treated for Central Sleep Apnea get a DOT Medical Card?
@Alan
Yes.
Has the DOT changed requirement for sleep apnea testing for medical card
@George
No. And because there has been so much misunderstanding about it the DOT has withdrawn the proposed rule to set sleep apnea screening criteria for truckers.
The medical examiner is still responsible to make a decision to refer drivers for apnea testing if they “believe the driver’s respiratory condition is in any way likely to interfere with the driver’s ability to safely control and drive a commercial motor vehicle.”
Is this documented any where? Went to get my recert. Dr. Would not recert until test was done per new law.
If a driver is diagnosed with sleep apnea and requires a Cpap machine, what are the ramifications if they don’t use the machine at night, but sit in a chair during the day and use it, then turn in that data to the doctor?
Can I get a 2 year renewal on a DOT physical if I am diagnosed with CPAP and using it correctly?
@Curt
No. With everything else being fine FMCSA still wants you checked once a year.
I am about to go to school and get my CDL and start a trucking career. I am worried that the DOT physical I need before I start school will tell me need a sleep apnea test as my neck is 18 or 18.5″. I am 5.9 1/2″ weigh 2215, BMI maybe 31? I think I might really have sleep apnea. If it is proven I have sleep apnea, how will that affect me going to trucking school and my first job. The school already set me up with a company . Will it delay school? Will it delay me starting with this company. I need to start ASAP. I need the work. I am also doing this with my spouse . They will pass with flying colors. The new job is with us a a team . Trained as a team so I don’t want any delays on my part.
@Steve
If you think you have sleep apnea, you probably do. You need to get this checked out before you go any further.
If you are required to use CPAP to manage your apnea, you can still drive as long as you meet the CPAP 70% compliance.
What about after today 8/9/2017? Now that the trump administration scrapped the sleep apnea regulations from the federal government. What is that going to do to the people already dealing with cpap compliance?
The regulations are for determining the criteria for sending the patient out for a sleep study. Whether those regulations change or not has no bearing on the condition of sleep apnea itself. If a CME suspects that a driver is at high risk of sleep apnea, it is the CME’s responsibility to send the patient out for a sleep study, regardless. Sleep apnea is a respiratory condition that can affect safe driving and ignoring it would be like ignoring diabetes, high blood pressure, or any other condition that can affect a patient’s ability to drive safely.
Ruling out sleep apnea is still an important part of the DOT exam.