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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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Is a surgical implant known as, inspire sleep, done as an out patient be an alternative to the cpap machine
@Mike
Only if it fully corrects the OSA. You may need to retest following the surgery to confirm.
Hi my husband was just told he has mild sleep apnea. He was at 93% the whole night he took the test at home . His doctor did not write him a passing letter and is considering cpap
Anyone else go through this?
Oh Yea, This is a big liberal government take over policy to punish the people who work that pay for the people who don’t. Get ready commercial drivers.. This ones on us.. Anyone that has a commercial drivers license and who is going to vote for Hillary Clinton should reconsider quickly. Do you really want more of what the last 8 years have given us ?
So true!
I didn’t meet the 30 day requirement to be recertified, Sleep Doctor said I need to take another Sleep Study and Awake Test to obtain Compliance Letter. Are both test required by DOT ?
@Jeff
This sounds like something that the sleep doctor wants to be sure that you are OK, before he signs off on the sleep test results. FMCSA wants to see a 70% compliance if the diagnosis confirms a sleep disorder.
Per company CDL doctor my husband was told he had to have a sleep apnea test done. He has no symptoms, no snoring, no stop breathing etc. I sleep next to him every night he sleeps like a rock. He is never tired during the day or takes naps. He gets 7-8 hours of sleep every night.
He was told he had 60 days to see a Dr and get the test done. Needless to say it is peak allergy season and he has severe spring allergies, can barely breath, stuffy nose, sneezing and everything else. He had to take the sleep test while suffering with his allergies, He flunked of course, they told him he stopped breathing 29.5 times in an hour. The first night on the machine he scored a 99 out of 100. with a stopped breathing of .5 per hour. He has noticed no difference in how he feels, since he always got a good nights sleep. My question? Should the sleep test be given to sever allergy sufferers in allergy season? or should it be given after the allergies go away.
@Carol
Ideally it would be given after allergy season. And if he did not demonstrate any signs or symptoms of sleep apnea he does not need to subject himself to a sleep test. There were no new rules regarding sleep apnea testing from FMCSA.
The company physical is every March, no way to change it, during allergy season and he was given 60 days to see a Dr and get tested. No one seemed to care if he has allergies, we got the paperwork/results from his test today and nowhere does it state he was suffering from allergies during the test, or taking numerous medicines for his allergies. Even sadder is they made him do the test on a work night, He works for the electric company and they were doing 13 hr days, he barely got any sleep at the test (less then 4 hrs, do to not being able to sleep on his back, pulling the wires off every time he rolled over etc. he is a stomach sleeper) They then sent him off to work a 13 hr day when he was so tired from lack of sleep, he actually had to take a nap to make it through the day. So unsafe on there part.
He has been using the machine and now wakes up feeling tired, instead of rested. He told me today he has never felt so tired during the day. We go online every morning to his sleep results and he gets a 100% every night, with less then 1 stop breathing every night. Sad part is there is no one to talk to about it, they just do the test, tell you your results, give you a machine and send you home. The rest is up to you. You are then told you have to use this machine for as long as you continue to be a lineman. Makes him think about becoming a dispatcher.. so sad when he loves his job.
He was made to take the test because he has a very large neck, 19″ always has, even when he was young and in great shape, he is overweight, but doesn’t snore or wake from not breathing. I have slept next to him for over 26 yrs, the only one to snore in our bed is the dog!
on another note.. are you required to use this stupid machine when you are on vacation?
@Carol
You really need to find a new CME and get a second opinion.
Vacation, if he is on the unit it needs to show a 70% compliance over a thirty day period.
Also what class license is your hubby? There is no reason for a lineman to be tested at the level of an OTR driver, and it sounds like that’s what’s happening to him.
He has a class A, even though the truck he drives is only 18,000 lbs. (he is a troubleman so he drives the smaller truck), but he has to be licensed to drive the 45,000lb trucks even though he doesn’t.
They really need to set different standards for over the road truck drivers and those that use them as their daily work trucks.
He has no choice of company Dr, they come to his work to do the physical every March. I just wish there was someone to talk to about it. It is- go to this Dr. get tested, here’s a machine, we’ll see you in a year.
If this is such a big thing you would think there would be follow up visits to explain the results, if there is any way to get retested after allergy season, and if you can do something to not need this machine.
If you have a commercial drivers license but only do classroom and yard teaching, an instructor, and never drive on the road, is there any type of waiver to be able to keep your license even with a medical problem as long as you only teach in classroom and not go on the road?
@Carol
You need to check with your local drivers license department for the best answer. Most states require a valid medical certificate to maintain a valid class A license, but check with your state DLD first.
Question is it true that if you use a Cpap machine you can only get a one you med card? And if so can you get a waiver for two year card with high usage from download from Capp machine?
@J
FMCSA has made its position clear, that they want a re-examination done once a year if you use a CPAP, even with 70% or better compliance.
I have a question…my husband has been a truck driver (local) for a long time and has weighed the same for years (actually has lost 20 now) but he has NEVER EVER been required to do a sleep study by a DOT doctor for just saying he has a 17″ neck and is overweight. Now in checking into this, our insurance will not pay for any of the sleep study and he is almost at the end of the 3 month temporary card they gave him. Should he go somewhere else? He has never had any daytime sleepiness, is an excellent driver with no accidents or tickets. This has never come up before and there is another driver at his work that is bigger than him and he wasn’t required to do this study. This is just an opinion by some flunkie DOT doctor by looking at my husband. What should we do? He will be out of a job soon if we don’t get this resolved!
@ Ms. Moon
Go elsewhere for a second opinion.
I went for my dot test today and was rejected based on the fact I snore along with my anti depressant medication which has drowsiness listed as a side effect. These doctors that we are required to go to now are ridiculous.
My regular dr. Has to write a statement stating that I’ve had no side effects such as drowsiness from my medication. Now call me an idiot, but what is the difference between me telling my doctor or me telling the DOT doctor that I don’t get drowsy? Oh, and how many medications of there list drowsiness as a side effect?
I’ve never fallen asleep at the wheel never been tired during the day besides a nap on Sundays once in awhile. I only drive locally in a landscape truck with materials. However because our possible WEIGHT can go over 10000 pounds I need a medical card.
I understand the philosophy behind everybody having some type of physical to be issued a medical card however some of this is completely ridiculous and quite honestly a waste of the working man’s money, when we have to pay for the unnecessary sleep apnea test. And how come they can issue a temporary Dot card based on having to get a sleep test if it’s really that much of a hazard? It’s rather contradictory?!
Hello I was wondering if any one could tell be if you have sleep apnea an have had a Cpap for years is it true you only get a one year dot medical card? I have had a Cpap for years use it every day I’m otherwise a healthy man in my late 30’s this time I went in to redue my dot medical card an the dr lady said that cause I have sleep apnea I can only get a 1 year card. That cause the apnea the DOT only allows one year card.
I also was told by her that I could not get a second opinion. Witch seemed odd to me? Is that true what ever they say is it no second opinions?
@Seth
Second opinion is not going to help here.
@Seth
One year according to the FMCSA guidelines is all any CME is going to provide you with.
Why would you ever choose a female doctor, can’t understand that one.
I have Sleep Apnea. I use a CPAP machine. I made the mistake (I believe) of using an over the counter nasal spray (phenylephrine) to open up my sinuses, making use of the machine possible.
I’ve read some things that this medication could/would show a false positive for Amphetamines.
My MedCert is up for renewal….anyone else have some experience with this? Have you had a false positive? I’m kind of backed into a corner here….
@Mike
If it is an over the counter medication, simply keep the medication packaging do you can support the MRO’s questions if it does come back positive. The MRO can re-test the split sample and confirm that is the medication in the sample and you may be able turn a positive test to a negative test result.
How many time a year do I have to have my C Pac machine read to be in compliance with DOT
@Brenda
As long as you demonstrate a 70% compliance for a minimum of thirty days, you should be OK. It is nice if you have a couple readings throughout the year, but it isn’t mandatory.
Ok .So I was diagnosed 10-12 years ago with sleep apnea. I get a cpap machine : (if anyone has snoring problems or they are tired all the time i recommend the cpap/sleep test or machine after getting used to the machine i would get out of the truck at bottom of grade and push it up the grade hahahahaha i sure felt like i could push the truck up the hill.) I use to sleep 10 hr a nite, after the cpap i couldn’t sleep more than 5 hours a nite if i wanted to. Sorry had to let it be known.
I had a heart attack almost two years ago. I went to renew my dot card and they told me I had to do a sleep study for sleep apnea, because my neck is 17″ and I take two blood pressure meds. One is 10 mg lisinophril and the other is 5 mg amlodipine. My doc did two, because the amlodippine is for spasms of the heart mainly. My question is, does taking these meds and my neck size warrant a sleep study? I’m not obese, but I am a fairly muscular and I’m tall (6’2″ 220 IBS). I need to know, because the owners of the company have strong ties with the company that does physicals and I want to see if they are making me jump through hoops for no reason.
@Will
If you do not demonstrate any other symptoms within the OSA protocols, then someone is overstepping their bounds with the FMCSA guidelines and you should go else where for a second opinion.
“@Will
If you do not demonstrate any other symptoms within the OSA protocols, then someone is overstepping their bounds with the FMCSA guidelines and you should go else where for a second opinion.”
Can I get a link to those OSA protocols?
Also I am looking for this study not the tech pamphlet: Pack AI, Dinges DF, & Maislin G. (2002) A Study of Prevalence of Sleep Apnea among Commercial Truck Drivers (Report No. DOT-RT-02-030). Washington, DC: U.S. Department of Transportation, FMCSA.
Thanks.
-john
Are the results of sleep studies automatically reported anywhere or is it up to the driver to honestly report potential conditions?
@Heather
It is reported to the FMCSA database and can be viewed if there are any questions.
And you need to bring a report or printout from your unit to demonstrate proper compliance usage.
I had a sleep study done in 2002. I had surgery to correct a mild sleep apnea and snoring, which was successful. Since 2002 I have lost 35lbs (from 225 down to 190) I began driving professionally in 2009 and have had 4 dot physicals clear me since then. I recently went for a dot physical and the doctor only cleared me for 90 days and required me to do a sleep study because of my diagnosis in 2002. Do I need to stay with this doctor or can I go somewhere else and get my med certificate?
@Rowdi
You can go for a second opinion with any NRCME you would like.
I’ve gone thru sleep study, found out I have sleep apnea , i have CPAP machine, adjusted to it well,
been on it one week, DOT Dr. refuses to give me a 30 day temp card,he says i need to show compliance for 30 days, I proved to him it was his judgment, not a LAW, so do I have to show 30 days or the 70% {21days} to get back to work. I live in Ohio
Thank You
@George
Guideline are guidelines and are left to the CME’s discretion as to how they want to use them.
FMCSA guidelines are 30 days with 70% compliance. He may be viewing this as a safety issue and may not budge from his stance.
The way the FMCSA has written this is that the risk falls on the examining doctor and any safety issue would hold him personally responsible.
Many years ago I had a sleep study done on my own and was positive for sleep apnea. I used a CPAP but found I did not tolerate it as I would awake through out the night feeling like I was strangling. They tried adjusting my machine and different masks, all to no avail. In the end I just gave up. Fast forward to today. I have lost a significant amount of weight(+ quit smoking and drinking) and am driving a school bus part time. I have some health issues (type 2 diabetes, well controlled with metformin and hypertension well controlled with lisinopril) but based on this and my neck size (I am 6’2″ and 18.5″ neck) My DOT examiner ordered a sleep study. Fine. I went to the sleep clinic where I had been diagnosed years before for an overnight study. I completed the study but the analysis takes weeks (or more) to complete, so my personal physician ordered the raw data and My license is about to expire but here is the kicker, my physician says the data shows NO incidence of sleep apnea! (episodes of not breathing), Great, except that apparently it does indicate desat down to 87% at some point. So here is my question; Does the D.O.T. consider this “sleep apnea” ? and if they do would they consider ANY other treatment than a CPAP? (i.e. Inhaler, oxygen at night, ANYTHING other than the CPAP-which prevents me from getting any sleep at all now) Needless to say I am very anxious about what this means. I have been driving (with my C.D.L. “B”) for several years without an accident and no daytime sleepiness.
Thanks for your consideration,
@L.W.
Look into your states driving intra-state only rules. You are not driving interstate and the CME is holding you to interstate regs. So check with your local drivers license department and see what they have to say.
If there is no noted sleep disorders then the CME only needs a medical release form from your primary doctor stating so.
My husband’s company had a voluntary program where they went for a sleep study in a hotel setting. All volunteers, but 1, had sleep apnea. The company provided the machine and my husband was always in compliance. Recently my husband was let go and had to return the machine. He has no documentation of the results of his study. He is with another company now, should he go for a sleep study with another physician so he can possibly get this diagnosis removed? What is his best alternative?
@Carrie
If he was diagnosed with sleep apnea, then he should work on getting a new machine, if he did not have sleep apnea, then he will need to have a doctor documentation remove the diagnosis.
So it all really depends on how he is sleeping and whether he has sleep apnea or not. Based on how he is doing now will tell you the direction to go in next.
If my BMI is above 35 witch is the number they are using and I lower my BMI below that, should I still be required to do a sleep study?
@Kennard
Read these articles and you’ll know that BMI alone is not cause to require a sleep study.
That being said, if you are overweight, changing lifestyle habits, as best you can given the lifestyle challenges of professional drivers, would be a good thing to protect your health and your livelihood for the future.
If a person is required to have a sleep study, are they allowed to have a home-based study done instead of a facility-based study? Does Vermont have any DOT Physical Doctors?
@Linda
Best supporting results are coming from the facility based studies. The at home studies are on the questionable side.
in Oklahoma have a sleep study scheduled insurance will only pay for in home test will that work.
@Eugene
What class drivers license?
FMCSA class A interstate will probably not do. Home test is not reliable.
I have a diagnoses of sleep apnea (obstructive sleep apnea syndrome and excessive daytime fatigue). I am being treated successfully by my sleep clinic with CPAP and modafinil (Provigil). I have been under a doctors care for this for 5+ years and I am 97% compliant with my CPAP treatment.
I am applying for a vehicle maintenance job that will require a Class A CDL and a DOT pre employment physical (I currently hold a Class B CDL with no medical card).
Will I be required to retake a sleep study or will a medical release from my sleep clinic Dr. be sufficient to satisfy the requirement? Also should I get the release form filled out prior to the physical or wait to see what the DOT DR. says? (I have a current letter from my Dr but I don’t know if this will be good enough to meet the requirement).
@Christian
You should not be ask to redo a sleep study. Take a copy of your last readout from your machine (within the last thirty days) and a medical release form from your doctor and you should be good to go.
I hate to bother you but I went to get my physical done and the pa said I needed a sleep study. I went to my family doctor who has had me under for surgery twice and he said I did not have sleep apnea. He said if I did he would have seen it while I was under. There is no way I can afford the sleep study and there is no way I can afford to lose my CDL. CAN I go to another doctor to get my physical done over without the sleep study? Thank you.
@David
You have the right to a second opinion. The whole sleep study issue is completely out of hand. So go somewhere else for a second opinion, and choose your DOT doctor wisely!
Thank you so much for the response. Merry Christmas and Happy New Year.