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See our BLOG Category on Sleep Apnea for articles and more information.
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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Hi I have a California class c drivers license. my dot examiner is making me take a sleep test am a local delivery driver to local supermarkets. Its a 10 minute drive fron my warehouse to my first stop and after that its 5 minute drives going supermarket to supermarket i drive a regular bread similar to a catering truck…ive been doing this for 12 years no problem. Do i have to be taking this test ir the dot examiner thinks i drive a class a trailer? Thanks
@Raul
You just need to inform the examiner that you are a class C driver of a bread truck and that all you need is a medical card to operate an in-state only vehicle.
And since there were no new rulings on sleep apnea, you may want to go somewhere else for a second opinion.
Hello, and thank you for your input!
My spouse is a class B, local delivery driver. He has been on a 1 year card dt controlled hypertension for a few years. Last year however after a particularly awful round of bronchitis he quit smoking and gained some weight. The clinic that his company subsidizes his Dot physical through immediately pegged him for OSA, which is fine. They made him pay for a “home sleep study” ($350 out of pocket). Which declared that he has severe OSA. Now we’re trying to wrangle these doctors to order the cpap machine so that he can wear it and get back on his 1 year card. However, in a effort to have something explained to him he made another appointment with this same clinic (different provider) who did not perform a physical in anyway, but who after looking at the sleep test printout told him that she was going to revoke his medical card immediately.
My questions are:
*Is she allowed to do that if a 3 month card has already been issued?
*What is the significance of a second opinion? As in which one does the government go by?
*if so would it be in our best interest to go to his family doctor and give him all the information and ask if he will reinstate his card – if that’s possible- for 3 months until we can get this worked out.
* if his medical card was actually revoked, what happens to his license status, does he have to retest for his CDL entirely?
Again, thank you so much for your input we are completely lost in this process and appreciate all the help and information we can get!
Ema
@Ema
If the last provider did not do any examination, then she/he can not make a change on the FMCSA data base.
Since there is no change on the data base, then a true second opinion would be worthwhile and the second opinion, then placed on the FMCSA data base, becomes the new medical certificate.
Unless your primary doctor is on the national registry with the FMCSA, he can’t do anything that will change the medical card. He can provide a medical release form explaining his findings, but that information will be used by the CME on the national registry.
And if a medical certificate is revoked or disqualified, it does not directly influence the CDL until the issuing state for the CDL becomes aware that there is no valid medical certificate. Then it becomes a state issue which most likely will downgrade the license.
I had been a bus driver for 8 yrs took a break for 2 years. I have sleep apnea and since i wasn’t driving wasn’t faithful to wear it . So now want to go back to driving and so now I don’t have 3 months of data on machine . I have used it everynight since found out school had opening. Is there a way I can drive like on a probationary period until I get 3 months under my belt on cpap?
@Janita
You should be OK with a 30 day compliance report and they may do a short card until you do have a 90 readout.
Thank you so much.
@Janita
You are welcome. Please tell others about our website, and support our driver friendly(TM) doctors if you have one in a convenient location.
I’ve been required to submit proof of CPAP compliance since I was diagnosed with Sleep Apnea several years ago. I’ve lost over 40 pounds no longer need any sleep appliance. My wife tells me I hardly snore at all and I’ve even recorded myself while sleeping – practically zero snoring, not to mention I feel better and more rested than I ever did using a CPAP.
How do I get the “OSA” designation removed from my DOT Medical report? Is a sleep test required? If so, where do I go to get one?
@Alex
Start with your primary doctor and have a medical release form from him stating that the CPAP is no longer needed. If that does not get the job done,then check with your local doctor as to who does sleep tests and go from there.
DOT doctor said I needed to get sleep study done and gave me a 3 month card. I did sleep study and was diagnosed with sleep apnea. They put me on a cpap machine and I could not tolerate it . I went a little over a month with little or no sleep just to get compliance. After going back to the doctor to get recertified he only gave me another 3 month card and said I have to do it all over again. I cannot handle or tolerate a cpap machine I just can’t sleep with it. I am working with my sleep clinic to try and find an alternative, one being the oral appliance that I cannot afford(about $2000-3000). What options do I have to keep my job of 17 years with the same company.what does the dot allow . please help
@Scott
Try getting a second opinion from another CME. Someone who has sleep apnea and truly needs the unit, won’t leave home without it. So try for a low profile mask if they feel that you truly need the unit.
I tryed several masks and could never get comfortable with any of them. What I really need to know is does the dot approve use of an oral appliance or if I have surgery or the inspire implant. I am just a local truck driver not otr do the same rules apply. There is just limited info on the web and everyone I talk to tells me something different. Even my dot doctor did not know what to tell me. I have been going to the same clinic through my work forever.
@Scott
If you fall in the local driver intra-state only category, then you should not be required to do the sleep study, unless all of the other OSA criteria are met. So check with your local drivers license department and ask them. FMCSA will accept the surgery, but if you are state wide only, it’s not an issue for you. Just inform the CME that you are in-state only and fall under the state variances.
CAN A DRIVER BE DENIED A DOT CARD ON BMI ONLY
@John
No.
Question I also got my neck over 17 inches and a 37 on bmi, yhe doctor sent me for a home sleep study, after thats takrn care of whats next? Ig I have OSA or Regular sleep apnea will I be disqulified? Please help. Tks Ivan
@Ivan
If you were diagnosed with OSA and were put on a cpap unit, then you need to be on it for at least thirty days with a 70% or better compliance before you go for your next DOT medical certificate. Take your latest report with you and you should be good.
Last year inhad a sleep study done and it showed I didn’t have sleep apnea and was issued at 1 year medical card. My question is how long are my test results good for? Am I going to be asked to have a sleep study done ever year? Thanks
I found the answer to my question.
@Alex
Negative results should be good for years on end, unless other conditions develop and indicators show that there needs to be a new test. Not just neck measurements and BMI.
I work for an auto parts company and am a delivery driver. I do not go out of state and have just a class C license. My company makes us drivers get a DOT card every 2 years. Last year I was diagnost with slight sleep apnea and did the cpap machine for a month just to get a 1 year card. Today I went into the dr’s office to renew and she asked for my cpap readout. No one ever explained to me that I needed one. Now my DOT card expires at the end of month and by the time I finish another month of cpap use, I may not have a job to go back to. Any help would be most appreciated.
@Gene
All you need is a readout from your unit. You can get that anytime from the cpap prescriber. Check with them and have them help you out here.
I was diagnosed with mild sleep apnea 2 years ago. AHI of 7. Since then I have had 3 DOT physicals and got certified with no problem. Today I went for a DOT physical and presented the DOT Certified Nurse Practitioner with the sleep test results and was denied a card. The (Doc) said that because I was diagnosed with sleep apnea that I had to do treatment to be certified. The FMCSA recommendation clearly states that AHI > or equal to 15 is moderate to severe obstructive sleep apnea and requires treatment. It says under 15 with no excessive daytime sleepiness should be certified.
What can I do about this.
The Nurse Practitioner says that not only do I not know what I’m talking about, but the clinic that did the sleep test and analyzed it doesn’t know what they are doing or talking about and surely are not DOT certified. The company that did the test is contracted to some of the biggest commercial trucking companies in the USA and does all of the sleep tests for them.
@Joe
Go get a second opinion elsewhere.
I’m having the same issue! My AHI is only 5 and have no daytime sleepiness or snoring. I am being forced to use a cpap. I can not tolerate the machine and was told at my physical last week that if I don’t show compliance in 90 days I will not be certified. Everyone has said I and they have to do what the sleep doctor says. He is having me do an at home sleep study now to see if it will show no apnea at all but I feel like they are just trying to get more money. Should I get a second opinion from another sleep doctor or family doctor? This is wrecking my life.
@Jacob
Best bet is to get a second opinion. Most drivers that actually need the CPAP won’t leave home without it. If you do not truly need the unit, then you fight with it all the time. Second opinion is the direction to go.
Tested positive for sleep apnea,how long will I need to be on treatment before going back to dmv to show improvement dealing with sleep apnea
@Alvin
At least thirty days with a minimum of 70% compliance for at least 4 hours a day.
I had neck of 19 1/2″ and BMI of 32 and was sent to get sleep study before I could get longer than a 6 month card. Did home sleep test (worst I’ve ever slept if you can call it that, slept 2 hours maybe) and they said results show I now need to do lab test. I told them to get screwed. I don’t believe their results have been submitted to DOT because they are separate from my med examiner who did physical. I have a co-worker who is just as big as me and got cleared no problem. Can I get second opinion or will I get in trouble even though I’ve already done home study?
@Alex
Yes you can get a second opinion.
No one is going to accept the home study results. They are too inconsistent for any CME to accept for DOT.
So do I need to get lab study or am I clear to just see another ME for physical? After initial visit when I was told to get study, I received 6 month card until I came back with study results.
@Alex
Get second opinion first and go from there.
Just went for 2nd opinion and this doctor cleared me. Thanks for your help
Long story short….Last year I got flagged for sleep apnea during my DOT physical. I went & had the sleep test & my ahi was 11. The sleep Doctor set me up with a cpap machine. I’ve used it 100% the whole year. I went today for my yearly DOT physical & the doctor made the comment while looking at my sleep report that my ahi is low & that my use is optional. However he only recertified me for one year because of sleep apnea! I am so confused! So do I HAVE to continue using CPAP? It definitely hasn’t helped at all, it’s made my sleep worse to the point I feel drunk when I wake up. I’ve been prescribed Nuvigil to help with this.
What do I do to be able to quit using CPAP?
@Leslie
Check with your sleep study facility and ask them if you truly need the unit. If it is just a mask thing, then see what options they have.
As long as you use the CPAP your DOT medical card will only be good for one year at the time. If the sleep facility says that you do not need to use the unit, make sure you have them put it in writing so you can take it off your medical examination findings.
Will do! Thanks ????
Okay finally got with my sleep doc & because I’ve been diagnosed with sleep apnea even though it’s just an ahi of 11 he will not sign off stating I’m clear to NOT use cpap to maintain my certification. So I’m stuck using cpap even though it’s made my sleep worse & I’m having to take Nuvagil just to function everyday! ????
I’m from Iowa and wondering about sleep apnea test guidelines. My neck was larger than the guidelines so I took the sleep apnea test and it came back 19.8 events per hour. I was told this is borderline for my CDL. Are more tests required? I can’t get an answer from the dr. He thinks I need more tests..What are the guidelines for Iowa..I’ve been driving school bus for 19 yrs.
@Dale
If all you are driving is a school bus, then you should not need any additional testing. You should not be being held to a class A interstate drivers standard, so check with your local drivers license department and see what they have to say. Since there were no new regulations regarding OSA and you drive locally and are home each day, you should only check with the sleep study group and see what they have to offer.
My husband had a TIA 1 1/2 years ago. The Neurologist (who also ran and owned a sleep study center) required he go through a sleep test. His employer required him to complete the doctors request and receive a clean bill of health before he could return to work. It just so happened that my husband had very slight sleep apnea. Strapped with a cpap he went on with life in order to keep his job. This year he had an at home study done and was told by his PCP that he didn’t need a cpap and took him off of it. His employer released him from any further requirements. Now he is trying to get his medical card renewed. The doc. at Concerta will NOT accept at home test results. He is requiring him to either show him an in clinic study results or 70% cpap usage. Do we have to comply? His employer will ONLY use Concerta.
@P S
The CME is going to question the at home studies because there is no verification printout to go along with the study. So they will require a new study be done, with readouts to support the no need for the cpap. Also a medical release form from your primary doctor will be helpful in this situation too.
Husband had his DOT physical Monday. Was disqualified due to his eyes. Had an eye exam got his glasses. Called to make his f/u appt. and was told by the examiner since his BMI, Age and because he is male she is now asking for a Sleep Apnea test. Nothing is on the form but to see an eye doctor. What should we do?
@Linda
Go somewhere else for a second opinion. No FMCSA guidelines on age or BMI, so second opinion time.
My son was told He needs a sleep apnea test because of his neck size and being overweight. Does he have to take the test or should he try elsewhere. If he does go elsewhere does he have to tell the second Doctor that the first one suggested the sleep apnea test.
I’m in the exact same boat. Just got out of cdl school and never had a family Dr.
Went to get the i itial physical from the dr the cdl school referred me to, who gave me a 90 day card. The cme told me to have my family Dr get me a sleep test to get the full length med card.
Now found a family Dr, and he wants me to get the sleep test also, but the initial appointment with the sleep dr is 2 weeks after my 90 card expires! So now I dont know what to do, as I lose my cdl status if I dont have a valid med card. I’m hoping a dot physical fairy drops a card under my pillow as I’m sleeping….without apneas of course!
If only there were a dr like the old days with car inspections where you pay double, and they give you a card…lol
Seriously though, it’s absolutely outrageous .
I got my results back today from sleep clinic I see online that levels 20 or below of ahi dont require u to wear a cpap machine to Maintain my medical certificate card is that true my level is 12.5 does anyone have an answer for me
@Kyle
Your results indicate mild sleep apnea which most likely do not need a cpap.
The medical examiner should be looking at a combination of medical conditions to assess your overall risk of sleep apnea.
See these articles on our blog to better understand sleep apnea screening for the DOT medical qualification. http://dotphysicaldoctor.com/category/sleep-apnea/
Not sure what to do now. My son went for his physical at a place near the company he drives for and they gave him 3 month certificate based on him needing a sleep study because of his neck size and weight. They told him to go back to his primary doctor. He went in and talked to a sleep specialist who told him that he may not have sleep apnea but the only way is to test. Because of his deductible, it will cost him $1900 to have the split test.
After reading what was said on here and waiting 30 days, he went to a local DOT doctor for a physical and filled the form with the exact same information and was given a 2 year certificate as he has no problems with blood pressure, urine test or any of the other tests and is not on any medication. His employer’s safety department will not accept the new certificate because 2 different doctors have 2 different opinions. They want him to do sleep study and/or have the 2 doctors discuss it and come to an agreement. He told them that all he did was go for a 2nd opinion and disclosed the same information. They still refuse to accept the 2 year certificate.
I’m not sure how he needs to handle this because his other certificate expires at the end of July. He is talking about just going to another trucking company but do not know if this is going to be an issue once he turns in the 2 year certificate to the state (which his employer told him not to do). Any advice would be appreciated on how to handle this and what will happen if he uses the new certificate.
@Julie
The last DOT examination done will have been reported by the medical examiner to FMCSA and over-rides the previous one. That’s how the system works.
It is your son’s responsibility to get a copy of the last medical certificate to his local drivers license department, to be filed with his driver’s license.
Thank you. That is what I needed to know. So he should go ahead and send it to the DMV and it will override the other? It sounds like the argument is with the company on what they will accept which is why they told him not to file it with the state DMV. He has already been looking at some different companies that have more local routes than he does now. I just wanted to make sure that his new certificate will be valid if he leaves his company. I appreciate your advice. There are way too many competing interests in this whole sleep apnea/DOT physical problem.
I was told to do sleep test. So I took my referral back to my primary doctor and he told me I didn’t need the test. So he cleared me to wrk and I took it back to the clinic and they’re saying no no I need to have it done!! But there the ones telling me to get cleared by my primary Doctor which I did now they’re telling me I have to get it done. Is this true can they tell me to do it after being cleared by my doctor ? I really can’t afford this test or afford to lose my job???
@Matt
Go somewhere else for a second opinion.
No new rules on OSA according to the FMCSA. See articles on Sleep Apnea Screening.
I do not hold a CDL but am a contract driver for a RV delivery company in Indiana. They do not require a CDL to drive for them. Am I still required to do the Sleep study to get my DOT physical card?
@Monte
Your state drivers license department will have your answer. You should not be falling under FMCSA class A interstate regs. So explain to the CME what you do and since there were no new rules regarding sleep apnea test, then you should not be held to those guidelines.
what dot law gives a doc the right to force all of use drivers to get tested and hold us from making a living everything i have found states a guide no law and not requirement for fmcsa.
@Robert
There is no law. Read these articles to better understand Sleep Apnea Screening.