When Do you disqualify a driver with Sleep Apnea?
Regarding screening for sleep apnea in DOT physicals. From my understanding, if I order a sleep study, the patient is temporarily disqualified until the study is complete. If they have obstructive sleep apnea found during testing, they must wait 1 month after CPAP treatment or 2 months after surgery.I have read other providers giving temporary DOT certification until testing is complete or between a patient having testing and having CPAP treatment. Is this allowed?
The DOT driver only needs to be disqualified for sleep apnea if s/he:
- Has been involved in a crash due to falling asleep
- Has excessive daytime sleepiness affecting the ability to safely operate a commercial motor vehicle
- Has sleep apnea and is non-compliant with treatment
In most cases the DOT driver can be given a “determination pending” or short term certification pending further evaluation. See below for full details and how you can learn about proper duration of treatment before certifying, certification duration/intervals, how to interpret compliance reports, and much more:
Learn More About Sleep Apnea in DOT Commercial Drivers Here!
Drivers, if you need a low cost sleep study, sign in here:
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I appreciate your information, Ive been dealing with my machine for 4 years now, not once can i say that Ive felt better, have lost weight, Ive had several sleep studies many different masks, I dont feel if your fighting with a machine night after night you are not getting proper rest Carol
Some people don’t do well with traditional CPAP. You may have tried this, but ask your sleep doctor, respiratory therapist or equipment vendor to try different types of masks, and if you don’t have it, switch to a machine that “auto-titrates” – delivers different pressure based on the amount of obstruction it detects.
There are also other oral/dental devices that may be effective instead of CPAP in some individuals. The problem here is being able to show compliance for DOT purposes.
I believe that there is some kind of a scam between doctors and insurance company’s over this sleep apnea. I have yet to meet a driver who can pass the test. Every driver I know has to go to the sleep study. This is getting out of control. The DOT needs to reevaluate this policy.
Don, I can appreciate your frustration with this issue. All the medical examiners I know and work with (hundreds or thousands) are diligent and want to do the right thing for public safety while being fair to drivers. Remember ME’s are not the driver’s treating physician – our responsibility is to assure drivers do not have medical conditions that would impair safety to the public.
It quite frankly has absolutely nothing to do with insurance companies.
The facts are that sleep apnea causes an increase in motor vehicle accidents due to fatigue, reduced attention, slowed reaction times and sometimes just plain falling asleep.
Commercial drivers have a much higher prevalence rate of sleep apnea than the general population – up to a third, vs. 2-4% in general.
The reason it seems that every driver you know has to get a test and can’t pass is due to a couple of factors.
1. You already have a population with a high prevalence of the condition.
2. When you have a population with a high prevalence of a disease, screening for that disease yields a very high probability that the disease will be present.
3. Sending a high probability group for testing is going to yield mostly “positives” for the test.
In fact it would be a shame if we were sending every driver indiscriminately for testing and many were coming back negative – that would be a waste of time and money.
The fact that they are all coming back positive means examiners are doing a good job of identifying those at risk for the condition.
On another note I just want to say having gone through this process with drivers for many years now – this is a condition that once treated, results in a driver who feels better, has more energy, loses weight, has a better sex life, less medical costs over the long run, is a more productive worker, etc, etc.
In other words, no one really loses here.
The only other point I will concede is we still need to see what effect this all has on actual driving performance, accident rates, injuries and death due to accidents in a going forward “prospective” manner. We just don’t have that data yet.
I would like to know what my weight and neck should be for someone that is 5 foot 11 1/2 to pass DOT test THANK YOU !!
Doug, there’s no absolute cutoff from FMCSA on weight or neck size, but BMI, neck size, age, other medical conditions together do form risk factors for certain other conditions like sleep apnea. Recent recommendations from the Medical Review Board state that any driver with a BMI of 40+ should be tested for sleep apnea. At 5’11 1/2″ that would be about 290 lbs. A BMI of 33 with other conditions like a neck size of 17″, age over 50 or high blood pressure may also be criteria used for ordering a sleep test. A BMI of 33 for you would be about 240 lbs.
So none of this means definite “pass” or “fail” but prompts the medical examiner to consider whether you have risk factors for sleep apnea or other conditions. Also, just because you are under these weights doesn’t mean you may have other risk factors or conditions that the medical examiner may still want other testing or treatment for.
great information.