Nearly one-third of commercial drivers have obstructive sleep apnea (OSA).1 While it does not automatically disqualify you from driving, it will impact the DOT certification process. Depending on the severity of your symptoms, it could even affect the outcome because any condition that affects your ability to operate your vehicle safely is a potential problem.
Ultimately, the medical examiner decides whether or not you are medically fit to drive commercially. However, the Department of Transportation (DOT) provides guidelines to help providers determine whether your sleep apnea treatment is effective and whether the condition affects your ability to be alert and reactive behind the wheel.
What is Sleep Apnea?
Sleep apnea is a common but serious sleep disorder where a person repeatedly stops breathing for short periods during sleep. These pauses in breathing can happen dozens or even hundreds of times a night, often without the person even realizing it. The most common type, obstructive sleep apnea, occurs when the muscles in the throat relax too much, blocking the airway. The result is fragmented, poor-quality sleep that can leave you tired, irritable, and unfocused the next day.
Because it happens while you are sleeping, you may not realize it is happening. Many people associate sleep apnea with loud snoring, but not everyone with sleep apnea snores. Other signs include:
- Gasping for air during the night
- Waking up with a dry mouth or headache
- Frequent urination at night
- Feeling unusually tired despite getting a full night’s rest
- Pauses in breathing
You can have sleep apnea without experiencing all these symptoms. However, if you have one or more of these symptoms, and you drive for a living, talk to your doctor about ordering a sleep study. Treatments are very effective and it can help your overall health as well.
Can Sleep Apnea Affect Your Driving?
Sleep apnea doesn’t just interfere with your sleep. It also impacts how alert and focused you are during the day. When left untreated, it can make it harder for you to stay awake, keep your eyes focused, and react quickly behind the wheel. Even slight inattention or delayed reaction time can be enough to cause a crash. And when your sleep is disrupted night after night, you’re simply not as sharp or alert as you need to be on the road.
Can You Still Drive if You Have Sleep Apnea?
Yes, many drivers have sleep apnea and still qualify to drive commercially. To receive a DOT medical certificate you will need to meet specific criteria and demonstrate that you follow the prescribed treatment protocol, and that it is effective. Adhering to your treatment as prescribed is critical if you want to continue to drive.
For most drivers with OSA, the prescribed treatment consists of using a continuous positive airway pressure or CPAP device when they sleep. This machine blows air into your airway to keep it open throughout the night, helping you breathe better. To meet the DOT physical requirements, you must use your CPAP at least 70% of nights for at least four hours each night.
When you go in for your physical, the certified medical examiner will want at least a CPAP report showing you are using your assistive device as prescribed. For most drivers, this means bringing in a report for the last year. If you have only just started treatment, a report of the last 30 days is sufficient.
If you don’t have that data, they may give you a temporary certificate, allowing you more time to collect it. If your 30-day history shows consistent usage and you have no signs of daytime sleepiness, the examiner can certify you to drive for one year.
The key to driving commercially when you have sleep apnea is to remain compliant with your treatment. Drivers who refuse treatment or do not use a CPAP as prescribed may be disqualified.
Do I Need a Sleep Study as Part of My DOT Physical?
A sleep study is not a required part of the DOT physical exam. However, medical examiners may ask drivers who meet specific criteria to get a sleep study. For example, individuals who are overweight or have large necks are more likely to develop sleep apnea. So, if your BMI is over 40 or over 33 and you have other qualifying conditions, you may need a sleep study. You may also need a sleep study to pass your physical if your neck is larger than 17 inches for males and 15.5 inches for females.
If the medical examiner orders a sleep study, it will not automatically freeze your driving certification unless you are showing signs it may be affecting your ability to drive, such as falling asleep behind the wheel or excessive daytime sleepiness. They will likely also give you a temporary 90-day certificate to allow you to drive while you have the test done. You can continue with certification if the test does not reveal sleep apnea. If the test shows you have sleep apnea, you will need to begin treatment and show compliance with that treatment before receiving further certification.
Sometimes testing and receiving treatment for sleep apnea takes longer than 90-days. As long as you are earnestly working towards a diagnosis and treatment, the medical examiner may decide to extend your certification on a case-by-case basis.
How Can I Manage Sleep Apnea on the Job?
Managing sleep apnea on the road is not easy. You don’t have the luxury of crawling into the same bed each night and putting on your CPAP before you drift off. However, with your health and job on the line, following through on your prescribed treatment is vital.
Talk to your doctor about getting a portable CPAP machine. These devices are lightweight, compact, and perfect for travel. They often come with battery packs for off-grid use. You can also get adapters that allow you to plug in wherever your hauls take you.
It’s also helpful to adopt lifestyle changes that support better sleep, such as avoiding heavy meals before bed and reducing alcohol consumption. Reducing your BMI can also help lessen the severity of sleep apnea symptoms. Try to incorporate healthy foods and fit in exercise when you can. Small changes can make a big difference.
Just as important is staying on top of regular follow-up appointments with healthcare providers. Monitoring the effectiveness of treatment and making any necessary adjustments ensures continued compliance with DOT regulations and will help you maintain your driving privileges.
Conclusion
Sleep apnea doesn’t just affect your sleep. It directly impacts your ability to stay alert and focused while driving. For commercial drivers, untreated sleep apnea can be a roadblock to maintaining DOT certification, but with proper diagnosis and treatment, it doesn’t have to be. Managing the condition effectively through CPAP therapy and lifestyle changes can keep you healthy, compliant, and confident on the road. Taking sleep apnea seriously is a step toward keeping your certification and protecting yourself and others every time you get behind the wheel.
1https://rosap.ntl.bts.gov/view/dot/29191
