- Part 1 – Can A DOT Medical Examiner Refuse You A Medical Card Unless You Have A Sleep Study Done?
- Part 2 – DOT Physical And Sleep Apnea Testing: Are Medical Examiners Caught Between A Rock And A Hard Place?
- Part 3 – Commercial Driver Awareness About The Sleep Apnea Issue
- Part 4 [You Are HERE] – OSA: How To Know If You Have It
- Part 5 – Commercial Drivers Can Manage Sleep Apnea And Maintain Their CDL
Long-haul drivers can suffer from obstructive sleep apnea for years and not know that they have it.
Commercial drivers do whatever it takes to stay on the job. As a professional driver, you may have gotten used to masking symptoms by using stimulants such as sugar and caffeine.
If you’ve had symptoms for some time you may have become conditioned to feelings of fatigue and not realize that they’re associated with sleep apnea.
If you think about it, though it’s not a thought any driver wants to entertain: If you experience restless sleep and feel sleepy during daytime hours, you may suspect yourself of having sleep apnea.
The question then, is …
What is obstructive sleep apnea?
How can you know if you have it?
Start With These Signs For Obstructive Sleep Apnea
The following are possible indicators of sleep apnea.
- Snoring
- Deep, gasping breaths while sleeping
- Pauses in breathing while sleeping
However, these factors alone cannot diagnose obstructive sleep apnea. Even the loudest of snorers may not have breathing obstruction.
Check with someone you trust! A sleeping partner can check to see if you experience breathing interruptions while you’re sleeping.
This is what to check for:
In adults, a pause in breathing must last 10 seconds to be scored as apnea.
Clinically significant levels of obstructive sleep apnea are defined as five or more of these 10-second episodes per hour.
- 5 – 15 episodes indicate mild sleep apnea
- 15 – 30 episodes indicate moderate sleep apnea
- More than 30 episodes indicate severe sleep apnea
Investigate Further. What Else To Check For…
If you have sleep apnea (even undiagnosed), here are some of the symptoms you may have been noticing:
- Excessive snoring or snorting
- Restless or interrupted sleep
- Frequent headaches or waking up with headaches
- Feeling more tired when you wake up than when you went to bed
- Daytime drowsiness
- Excessive nighttime urination
- Erectile dysfunction
- Family history of sleep apnea
A number of health issues potentially head you toward sleep apnea. These factors are even more likely to indicate sleep apnea if there is a combination of two or more.
- Obesity (indicated by weight, neck size, BMI)
- Small upper airway (check throat area by sticking tongue out, whilst in a seated position)
- Age increases potential risk
- High stress levels
- Other diagnosed medical conditions, such as:
- High blood pressure
- Diabetes
- Hypothyroidism
- Arrhythmia
- Cardiovascular disease
The work stresses and challenging lifestyle of long-haul commercial drivers has led to a higher inclination for these adverse conditions, which contribute to obstructive sleep apnea. This is not your fault, but it is the reality that you must deal with.
It is a combination of these conditions that a medical examiner will be looking at, to assess your overall risk of sleep apnea.
How Can You Be Sure You Have Sleep Apnea?
An overnight sleep test called a polysomnogram, or a “sleep study” is the most accurate way to diagnose, or rule out, many types of sleep disorders.
As the word ‘poly’ suggests – ‘many’ factors are scored in this test. A polysomnogram records your brain waves, the oxygen level in your blood, your heart rate and breathing, as well as eye and leg movements during the study.
A sleep physician interprets the data in conjunction with your medical history, a complete list of drugs you are taking, and any other relevant information that might impact the study. A report is sent to your referring physician, usually with specific recommendations based on the test results.
Undiagnosed Obstructive Sleep Apnea (OSA).
Where Are You Headed?
OSA can be life threatening. OSA is not only harmful in itself, but is correlated with many serious and potentially fatal illnesses and complications.
Obstructive sleep apnea is associated with increasing the risk of cardiovascular disease, stroke, high blood pressure, arrhythmias, diabetes, and sleep-deprived driving accidents. The most serious complication of OSA is a severe form of congestive heart failure. Sleep apnea sufferers also have a significantly higher risk of heart attack or premature death than those unaffected.
If you think you have OSA, you should not ignore the signs.
If you have been diagnosed with obstructive sleep apnea, you livelihood doesn’t have to be threatened. There are ways to manage this condition and still drive commercially.
Put In A Nutshell
- A combination of symptoms, health issues, and previously diagnosed medical conditions point to the need for a sleep study test to diagnose OSA.
- People with a combination of conditions have a much higher likelihood of sleep apnea.
- If a Medical Examiner thinks you are at reasonable risk, your DOT medical certificate may be temporarily disqualified while you get a sleep study done for proper diagnosis. If you have to start CPAP treatment, then you will have a conditional period of 30 days, before your next evaluation for a medical card.
If you have reasonable suspicion that you have sleep apnea, it’s recommended that you investigate it further, before you end up in a situation where your medical certificate is put on hold. See your primary doctor and do a sleep test if necessary — BEFORE it becomes an issue for your medical card.
Remember – You can manage sleep apnea and maintain your CDL!

You can find Dr. Seals at Chiro Stop in Salt Lake City, UT.
My husband is 56, and has his Class B CDL in Kentucky. He went in for his physical, and was told that because his neck size is 17, he has to have a sleep apnea test. He does have heart disease, so he complied, but he only has a mild AHI score, which from what I read, that is not treated with cpap machines. His doctor at Concentra is requiring him to get a cpap machine before he will renew his medical card. Does he have any options, as he really doesn’t want to have to mess with a cpap machine when it doesn’t appear to be needed?
@ Kallie B
Class B cdl’s are not under the federal DOT/FMCSA guidelines. He falls under the states guidelines and variances. The medical examiner at the facility you are using is holding your husband to a class A cdl standard, which he is not. Go get a second opinion from a CME that knows the difference between state and federal guidelines.