5 Questions About Sleep Apnea and Your DOT Medical Card
The Federal Motor Carrier Safety Administration (FMCSA) reports that 28% of commercial truck drivers have sleep apnea. As a driver in the trucking industry, you are highly susceptible to obstructive sleep apnea (OSA) because of the demands of your job. You are sitting for long periods while driving with fewer healthy diet options available when you stop. Getting recommended daily exercise is challenging because of your long shifts and lack of accessible equipment or gyms while on the road.
Here are the top questions commercial drivers may have about sleep apnea and how it might affect their ability to obtain a DOT medical card:
1. What is Sleep Apnea?
You can be diagnosed with OSA when breathing becomes labored or even stops intermittently during sleep. This breathing change occurs when your throat muscles relax while sleeping. If you have it, you won’t get complete REM sleep cycles, the restorative sleep you need to function. Symptoms of sleep apnea can include noisy snoring, gasping for air during sleep, frequent nighttime wakings, or difficulty staying asleep. In the morning, you can have dry mouth and headaches, difficulty concentrating or retaining information, irritability, excessive daytime sleepiness, and need to nap.
Risk factors for OSA include:
- Increased body fat or overweight. Fat deposits around your upper airway can obstruct breathing. As you lose weight, your risk or OSA can resolve.
- Narrow airways. Thicker necks are associated with narrower airways. You can inherit a narrow airway, or your tonsils or adenoids can swell, blocking your airway.
- Nasal congestion. Whether you have an anatomical problem, like a deviated septum, or allergies, you are more likely to develop OSA if you have trouble breathing through your nose.
- Older or male. The older you get, the higher your risk is for OSA. Men are more likely to develop it, but if you are an older woman, who has gone through menopause, your risk also increases.
- Substance use. Alcohol, nicotine, sedatives, and tranquilizers, can either relax the muscles in your throat or increase inflammation and fluid retention.
- Other medical conditions. Asthma, congestive heart failure, diabetes, high blood pressure, polycystic ovary syndrome, and previous strokes can increase your risk.
2. Why is The DOT Concerned with Sleep Apnea?
According to the National Highway Traffic Safety Administration (NHTSA), driving drowsy causes more than 90,000 crashes, 50,000 injuries, and 500 to 1,000 deaths yearly. The DOT wants to eliminate avoidable accidents and ensure public safety. Since OSA causes daytime drowsiness, the DOT wants drivers to take preventative measures to ensure they are well-rested and alert on the job.
Beyond daytime drowsiness, OSA can lead to other medical conditions that are public safety issues for commercial drivers. Because of the frequent drops in blood oxygen levels, OSA can strain your cardiovascular system, increasing your risk of high blood pressure, heart attacks, irregular heart rhythms, and stroke. If you already have heart disease, OSA can cause sudden death from irregular heartbeats.
You are also at higher risk of developing diabetes or metabolic syndrome; this includes high cholesterol, blood sugar, and blood pressure. You can scar your liver and develop nonalcoholic fatty liver disease, leading to irregular liver function results.
3. How is Sleep Apnea Treated?
If you have a mild case or your sleep apnea is suspected to be due to modifiable factors, your doctor will recommend lifestyle changes. For example, if you have gained weight and suddenly developed sleep apnea, your doctor may suggest diet and exercise changes to bring your weight down to a level where your sleep problems won’t persist. There are oral appliances, airway pressure devices, and in extreme cases, surgeries to correct OSA.
4. Can I Lose My DOT Medical Certification If I Am Diagnosed With Sleep Apnea?
According to the FMCSA, it is up to the qualifying medical examiner to determine your fitness to operate a commercial motor vehicle. Sleep apnea is rated based on your AHI, the average number of episodes you experience every hour you sleep. It’s mild if your AHI is below 15, moderate between 15 and 30, and severe if greater than 30. If your sleep apnea is moderate to severe, it interferes with your driving ability.
The bottom line is that sleep apnea doesn’t automatically make you lose your clearance. If you are concerned that you have OSA, get checked out immediately. Early intervention will prevent the loss of your medical card and the development of any other health conditions that could exclude you from driving safely.
5. If I Already Have Sleep Apnea, Will it Disqualify Me?
Having sleep apnea will not stop you from getting your DOT Medical Certificate. Your ability to certify will depend on the severity of your sleep apnea, and whether you have preventative treatment. You will need to show the medical examiner that you are compliant with treatment to get your DOT card. You may also need annual physicals instead of every two years, but don’t let your OSA stop you from driving.
Early diagnosis and treatment are crucial for keeping your clearance to drive and maintain your health. You should not knowingly drive, especially commercially, with untreated sleep apnea, or you could lose your CDL. Once you can show that you are complying with an effective treatment, you can perform your job fully alert and safely for you and everyone else on the road around you.