DOT Physicals and Sleep Apnea Testing
by Brad Bockey
Why has the DOT Physical become so complicated? Many of us once thought that Sleep Apnea was only a condition where a person uncontrollably fell asleep without warning. Not the case. Sleep Apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.
Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing starts again, sometimes with a loud snore or choking sound. Sleep Apnea usually is a chronic (on-going) condition that is disruptive to your sleep. When your breathing pauses or becomes shallow, you will often move out of deep sleep and into a light sleep, which is not as restful. As a result, the quality of your sleep is poor, which makes you tired during the day. Sleep Apnea is a leading cause of excessive daytime sleepiness. This is not a new condition; just a new manner of diagnosis, and these new diagnoses initially caught the transportation industry slightly off guard. As mentioned in a previous article, there are many questions asked throughout the DOT physical process that are utilized to warrant Sleep Apnea testing, but 2 are somewhat controllable by the driver. They are a Body Mass Index (BMI) exceeding 34 and/or a neck diameter in excess of 17 inches. There are online BMI calculators that can assist you in monitoring your number if you are border-line in this area. Neck size may reduce with weight loss, but others may just have a larger neck and can do nothing about it. If your medical examiner believes you may have a moderate to severe case, it is his/her judgment as to whether additional testing is to be conducted or monitored for the time-being. If testing is advised then the medical examiner will issue the driver a 3-month medical certification card that will give ample time for the testing to be conducted. Ensure that you know all options that are available to you. If your medical examiner gives you only one office to contact, ask if they accept other options. There are even athome testing packages that have everything needed to comply, but the medical examiner must agree to accept these tests. Even if the tests dictate treatment is required, the Continuous Positive Airway Pressure (CPAP) machine is not the only option. There are dental devices that, when inserted for sleep, gently pull your lower jaw forward slightly, which can assist with keeping an open airway. Again, ensure you ask questions. What if you finish the testing procedure and you are found to not require any further treatment. No further worries, right? Well, you will receive the balance of your 2-year medical certification minus the time that has elapsed from your initial exam. You will not receive any reimbursement for what you may determine as unnecessary testing. And, your Apnea testing results are only good for 5 years. If your trigger was a high BMI, then work on a healthier diet and exercise to eliminate future testing. But, if your trigger will be with you for life such as high blood pressure, diabetes, etc. you can expect to have the testing every 5 years. One thing to remember through this process is that you may not realize, or remember, what a good night’s sleep feels like. You may have a moderate to severe case of Sleep Apnea that must be treated to keep you safe and those around you. On the other hand, is Sleep Apnea being somewhat expanded with the expectation that any person is not supposed to feel tired when driving? Driving is a tiresome job. Long distance and route driving (same route) are the worst due to no real change in scenery and just being somewhat boring. It is my belief that driving is not for everyone. Truck drivers have always put in long hours to get from point A to point B. Drivers, Dispatchers and Managers must be able to understand each driver’s limitations and further understand that just because the DOT states that you can drive up to 11-hours, doesn’t mean you have to drive 11 hours.