Do DOT Physicals Require a Sleep Apnea Test?

Drivers, who come into my office for a DOT physical exam often ask: “Why do I need a sleep study?  DOT doesn’t require it.”

So here is the information a driver needs to know regarding if you need a sleep study or not:

The FMCSA states that DOT medical examiners should follow “best practice” guidelines when evaluating a driver for sleep apnea and ordering a sleep study.  Here are the “best practice” guidelines that are recommended:

A driver with symptoms:

If the driver has one of the following 4 symptoms it is recommended that driver be tested for sleep apnea:

1. Driver complains of consistent daytime sleepiness or fatigue.

2. Driver has been involved in a sleep-related accident.

3. Driver states that someone has observed the driver stop breathing while sleeping.

4. The driver reports that he snores loudly (snoring is heard thru a wall or door).

A driver without symptoms:

If the driver has none of the above symptoms but they have multiple risk factors for sleep apnea, it is recommended that the driver be tested for sleep apnea. Here is a list of those risk factors:

BMI of 33 or greater.

1. Neck size of 17” or greater for a male.

2. Neck Size of 16” or greater for a female.

3. Driver has one or more of the following disease:

   • Driver has High Blood Pressure

   • Driver has Diabetes

   • Driver has Heart Disease

   • Driver has Hypothyroidism

   • Driver has history of Stroke

   • Male driver over the age of 50.

Best practice recommendations for drivers that have had a prior sleep study:

A second sleep study is recommended if the driver has developed additional risk factors since the first study was done, or the driver has had a 10% increase in weight.