I have had a lot of commercial drivers come into my office complaining that another certified medical examiner has told them that they have to have a sleep study to rule out obstructive sleep apnea (OSA) because of one or more of the following reasons:

-Their neck size was greater than 17 inches (for men) or greater than 16 inches (for women).

-They were older than 55 and a sleep study was needed.

-They were overweight with a body mass index (BMI) greater than 35.

-They smoked or used alcohol.

The fact of the matter is that none of these reasons in and of themselves requires a mandatory sleep study. In fact the FMCSA mentions nothing about sleep studies in their regulation. In order to get the full scoop  on what FMCSA expects from the regulations, you must look at the “guidance” the  agency issues on various regulations. The agency has established guidance for  chronic sleep disorders, including sleep apnea.

In that guidance, the agency lays out the minimum waiting period for certification or  recertification of an individual with a chronic sleep condition after starting  treatment. There is a minimum one-month waiting period after starting a  continuous positive airway pressure device (called a CPAP). Individuals with  surgical treatment are to wait a minimum of three months before certification  or recertification. Medical examiners are directed by the agency to certify the  driver for only one year."

If you look at the FMCSA regulation itself it states:

393.41(b) A person is  physically qualified to drive a commercial motor vehicle if that person (5) has  no established medical history or clinical diagnosis of a respiratory  dysfunction likely to interfere with his/her ability to control and drive a  commercial motor vehicle safely.

Some of the confusion started when the FMCSA posted some possible future guidance on their website in April of 2012.  It was taken down about a week later but it clearly showed that the FMCSA is looking at trying to implement regulation on OSA. There was actually a bill introduced in the House and passed in the Senate and signed into law by President Obama in 2013 that will force the FMCSA to go through the formal rule making process before implementing any new regulations. This would include several long term studies, cost of studies (billions) vs. benefits, and an open comment period for all involved to discuss the consequences of any new regulations.

The bottom line is that OSA is a serious and real problem in the trucking industry and should not be ignored or downplayed, but it is up to the medical examiner to determine if a sleep study is warranted based on his/her exam results and the drivers history, not on FMCSA regulation. Although some employers can require them. There are even simple questionnaire's that I can perform in our office that can help determine the risks for sleep apnea syndrome. So if a medical examiner tells you that the FMCSA requires a sleep study based on neck size or age or any other reasons you need to ask them to show you where in the FMCSA regulations it states that. They won't be able to.

If you have any questions regarding FMCSA regulations or if you need to schedule a CDL exam call Alexandria Chiropractic Center at 859-635-6666.
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