Sleep Apnea & DOT Physical
Ready to get your Medical Card updated? Feeling healthy, and you cruised through your last exam? What’s to worry about? Plenty.
If your neck is bigger than 17 inches (16 for woman), or your BMI is 35 or greater, there might be a medical “out of service” in your future. So, let’s see how this can happen, what you need to worry about, and then in conclusion, what you can do to prevent an out of service. Remember over 40% of drivers will meet one of these “criteria”.
WHO CARES ABOUT MY NECK SIZE?
The DOT does, and through regulations being promulgated by the FMCSA, DOT is going to have your neck size and body mass measured. Turns out there is a statistical correlation between your neck size and / or your body mass index, and the likelihood of sleep apnea.
According to the National Institute of Health;
Sleep apnea (AP-ne-ah) 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 then starts again, sometimes with a loud snort or choking sound.
Sleep apnea usually is a chronic (ongoing) condition that disrupts your sleep. When your breathing pauses or becomes shallow, you’ll often move out of deep sleep and into light sleep.
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.
Sleep apnea often goes undiagnosed. Doctors usually can’t detect the condition during routine office visits. Also, no blood test can help diagnose the condition.
So, drivers need to be proactive. If your BMI is 35 or greater or your neck is over 17 inches (16 for woman), you should get a sleep study at least three months before your Medical re-certification is required. Because if you test positive for sleep apnea you will have time to get treatment and prove the treatment was effective at the time of re-certification.
Unfortunately, this is the new reality of regulation in truck driving. CDL drivers need to be vigilant, both when they drive and when they negotiate the maze of regulations inherent to the industry. Make sure you pass this information along to fellow drivers, as a medical out of service can break most people’s finances. They’ll be sure to thank you.
Home Obstructive Sleep Apnea testing is offered through vendors like Apnea Med and kits can be purchased online www.apneamed.org or iSleep www.isleephst.com
ADDITIONAL RISK FACTORS FOR SLEEP APNEA
- Hypertension (treated or untreated);
- Type 2 diabetes (treated or untreated);
- History of stroke, coronary artery disease, or arrhythmias;
- Micrognathia or retrognathia;
- Loud snoring;
- Witnessed apneas;
- Small airway (Mallampati Classification of Class III or IV – see Figure 1 photos of Mallampati Classification below);
- Neck size > 17 inches (male), > 15.5 inches (female);
- Hypothyroidism (untreated);
- Age 42 and above; or
- Male or post-menopausal female
Mallampati Classification Classes I through IV of the throat:
- Mallampati Class I: If the bottom of the uvula is visualized the, it’s scored as Mallampati Class I since the airway is very open.
- Mallampati Class II: If the tongue is covering part of the uvula, then it’s scored as Mallampati Class II since the airway is mostly open.
- Mallampati Class III: If the tongue is covering most, but not all of the uvula then it’s scored as Mallampati Class III since the airway is mostly closed.
- Mallampati Class IV: If the tongue is covering all of the uvulae, then it’s scored as Mallampati Class IV since the airway is very closed.
Anatomy of the Mouth
Anatomy of the Throat
Anatomy of the throat. The throat is a hollow, muscular tube inside the neck that acts as a passageway for air to enter the lungs and for food and liquid to enter the esophagus. It contains many structures, including the adenoids, tonsils, pharynx (the nasopharynx, oropharynx, and hypopharynx), larynx, esophagus, and trachea.
Sleep Apnea & Snoring
Sleep Apnea is a condition in which your breathing stops periodically during sleep as many as 20-30 times per hour. Each time you stop breathing in your sleep, the resulting lack of oxygen alerts your brain, which temporarily wakes you up to restart proper breathing.
Wouldn’t I know if I had Sleep Apnea? The time spent awake is so extremely brief that most people with sleep apnea don’t remember it, and many believe they are getting a good night’s sleep when, in fact, they are not. The constant wake-sleep, wake-sleep cycle prevents those with sleep apnea from achieving deep sleep that can result in an intermittent or constant drowsy feeling during the day depending on the severity.
Snoring
Snoring may be more than just a nuisance. When you are awake the tissues in the throat and upper airway are open and allow air to flow to the lungs smoothly, but when a person falls asleep the soft tissues relax and can partially block the airway. The sound you hear from a snore is a vibration caused by an obstruction of the airway. The snoring sound comes from the uvula, the back of the tongue, or the other soft tissues of the throat flapping as air passes over them when you breathe during sleep. It can be associated with several types of sleep disorders; the most common is Obstructive Sleep Apnea (OSA) and Upper Airway Resistance Syndrome (UARS). All of these have one thing in common – you are not breathing normally while you sleep, and you need to consult a health care provider to receive the help you need to get a better night’s sleep.
Can I do a Sleep Apnea Test at Home?
Home Obstructive Sleep Apnea Testing is offered through vendors like Apnea Med and kits can be purchased online www.apneamed.org or iSleep www.isleephst.com
Does Insurance Pay for Sleep Apnea Test?
Yes, Medical insurance typically covers Sleep Apnea Testing when the test is ordered by a doctor. Medical insurance patients normally have a copay or coinsurance that typically ranging from $20-$70 depending on the insurance plan. This amount varies by insurance company. Check with your insurance company to determine your specific benefits and actual cost.
Does Insurance Pay for CPAP Machine?
CPAP machine is the most common form of sleep apnea treatment of therapy, it’s generally covered by most insurance policies. The CPAP machine is considered to be durable medical equipment by insurance plans.
CPAP machine supplies are covered separately and the amount of coverage for CPAP machine supplies varies by state.
Does insurance cover sleep apnea therapy? Chances are good that, if you’ve been diagnosed with a form of sleep apnea that your condition is considered medically necessary enough to be covered. Chances are also good that your doctor will only recommend the therapy that your insurance provider will cover. Every situation is different, so the only way to find out for sure is to call your insurance provider and ask.
You will need a doctor to order your sleep apnea test for insurance to cover it. You should have a prescription from a doctor to obtain the home sleep apnea test. First, you need to schedule an appointment with your primary care physician or a sleep specialist, who will ask you about your symptoms and pre-screen you for obstructive sleep apnea. There are also doctors available online that can order your sleep apnea test through telemedicine (always check with your insurance carrier to see if the telemedicine provider is covered).
How to get a Sleep Apnea Test with No Insurance?
Home Obstructive Sleep Apnea testing is offered through vendors like Apnea Med and kits can be purchased online www.apneamed.org or iSleep www.isleephst.com
DOT Physicals for $59
National Registry #: 5724319540
Certification Test Expiration: 05/23/2024
Medical Examination Report for Commercial Driver Fitness Determination
- Form MCSA-5875 Medical Examination Form
