DOT Physicals and Sleep Apnea

DOT Physicals: Can I Pass With Sleep Apnea?

DOT Physicals and Sleep Apnea. What you need to know to pass your DOT physical. If you want to drive large commercial vehicles for a living, you will need a CDL (commercial driver’s license) and a valid Department of Transportation (DOT) medical card. This card can only be obtained once you have successfully passed a DOT physical, which you’ll need to have annually for the duration of your career.

Researchers from the American Transportation Research Institute of the American Trucking Associations found that almost 28 percent of commercial truck drivers suffer from Obstructive Sleep Apnea (OSA). Sleep Apnea is a health issue for many, but truck drivers are becoming increasingly concerned that a Sleep Apnea diagnosis will prevent them from doing their job.

Can Sleep Apnea prevent you from receiving a commercial driver’s license (CDL)?

Is Sleep Apnea testing a part of the DOT Physical?

People who experience symptoms of sleep apnea may not realize how much their driving is affected, which is why undiagnosed sleep apnea is a huge concern for the Federal Motor Carrier Safety Administration (FMCSA).

The FMCSA does not have requirements in place that mandate a commercial truck driver to complete a Sleep Apnea test during a DOT physical; however, the FMCSA does have a regulation called the Pulmonary Standard that grants a medical provider the discretion to determine whether testing for a respiratory disorder like Sleep Apnea is necessary for a driver to be medically certified to operate a commercial motor vehicle (CMV).

Once you are diagnosed with Sleep Apnea, you can seek treatment for OSA and qualify for “medically-qualified-to-drive” status and resume regular driving. If you are diagnosed with Sleep Apnea and refuse treatment, you will not be cleared to resume regular truck driving. It is important to note that plenty of truck drivers can perform their jobs even with Sleep Apnea as long as it is successfully treated, and you remain compliant with your treatment

What is Sleep Apnea?

Obstructive Sleep Apnea is a potentially life-threatening condition that affects approximately 20% of adults in the US and about 90% of whom are currently undiagnosed.

Obstructive Sleep Apnea (OSA) involves a decrease or complete halt in airflow despite the body’s ongoing effort to breathe while sleeping. These interruptions can last 10 seconds or longer and can take place hundreds of times throughout the night. It leads to an increase in blood pressure and is a major contributor to heart disease – a condition that likewise can hinder a driver’s ability to safely operate a CMV.  As a result of the OSA, sleep is disrupted by not allowing the individual to get quality sleep. This can lead to excessive daytime sleepiness, drowsy driving, fatigue, performance problems and lack of concentration, all of which can affect your ability to drive. It can also put you at risk for future medical conditions, such as heart attack, heart failure, stroke, type 2 diabetes, obesity, and high blood pressure.

Signs and symptoms of obstructive sleep apnea include:

  • Excessive daytime sleepiness
  • Loud snoring
  • Observed episodes of stopped breathing during sleep
  • Abrupt awakenings accompanied by gasping or choking
  • Awakening with a dry mouth or sore throat
  • Morning headache
  • Difficulty concentrating during the day
  • Mood changes, such as depression or irritability
  • High blood pressure
  • Decreased libido

While determining risk for CMV drivers during a DOT physical, medical providers look for certain risk factors. These can be predictors of sleep apnea and could prompt provider to order a sleep test.

Risk factors include, but are not limited to:

  • Being Overweight. Many, but not all people with obstructive sleep apnea, are overweight.
  • Snoring – Most people with sleep apnea snore, but it is not always a sign of sleep apnea.
  • Neck circumference (>17 inches for men, >15.5 inches for women)
  • Older age. The risk increases as you age
  • Receding chin or narrow airway
  • High blood pressure
  • Diabetes
  • Chronic nasal congestion
  • Smoking habits
  • Alcohol consumption at bedtime
  • Being male
  • Post-menopausal (for women)
  • History of stroke, coronary artery disease, heart arrhythmias
  • Micrognathia or retrognathia
  • Witnessed sleep apneas

Obstructive Sleep Apnea (OSA) Testing

Comprehensive Sleep Care Center can assist drivers in testing and treatment for their OSA. After a consultation is performed by one of our Sleep Medicine Specialists, a sleep study may be ordered. This test can be performed in any of our 10 sleep lab locations or with an at-home testing kit.

 How is Sleep Apnea Treated?

The FMSCA states that Positive Airway Pressure (PAP) therapy is their preferred treatment for OSA. Like CPAP or BiPAP therapy, it is also the gold standard of treatment recommended by the American Academy of Sleep Medicine. Using a PAP therapy machine will help you get more quality sleep.  Most drivers who use their PAP machines report having an incredible quality of sleep and an all-around improved quality of life!

 What are the CPAP Requirements for the DOT Physical?

Do You Need a CPAP Report for a DOT Physical?

If you are diagnosed with sleep apnea and have a PAP machine, you will need to ensure you are managing your OSA properly during your annual DOT physical. This requires that you bring documentation of usage of at least 4 hours a night showing at least 70% usage compliance. This compliance data must not be more than 30 days old and should be for a minimum of 90 days (some medical providers may require a year of data if available). The DOT wants to monitor your condition closely to ensure you are managing it well.

If you feel you may have a sleep problem. Call our office and make an appointment with one of our sleep medicine professionals. Let us help you to Say Hello to Sleep Again.

Comprehensive Sleep Care Center has 10 locations in Virginia and Maryland (AlexandriaArlingtonBethesdaChantillyDumfries, Fredericksburg, GermantownLansdowneManassasWoodbridge).

Stay safe out there.