- Phone 614-766-0773
- Location Dublin, Ohio
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DOT Evaluation
Commercial motor vehicle drivers are required to have a commercial drivers license (CDL) and undergo yearly Department of Transportation (DOT) physical evaluations. Any medical disorder that may potentially impair the driver should be identified during DOT physicals. These evaluations are meant to determine the eligibility of the driver to obtain a CDL and to ensure that any potentially dangerous medical condition is properly treated.
Why should commercial drivers undergo yearly DOT physical evaluations?
Yearly DOT evaluations help ensure that commercial drivers are fit to handle the challenges they face and to maximize public safety. Because of the high prevalence of sleep disorders in the commercial driver population, screening for sleep disorders is an essential component in DOT evaluations. Obstructive sleep apnea is found in approximately 15% of all middle-aged men, but present in 30% of all truck drivers. Long-haul truckers in particular tend to have a very sedentary lifestyle and eat fast food or have unhealthy nutrition leading to obesity, a known risk factor of obstructive sleep apnea.
Commercial motor vehicle operators are held to a higher standard than the general population regarding driving privileges. Not only do these drivers tend to have long hours behind the wheel, but they also tend to operate larger vehicles which may contain hazardous chemicals or they may transport large numbers of passengers. Moreover, commercial drivers often have economic incentives to drive farther without stopping or under unsafe driving conditions such as bad weather.
Your Health
What happens during a DOT Sleep Evaluation?
You will undergo a comprehensive visit with our provider. We will obtain a thorough history and screen for any potential underlying sleep disorders that may place you at risk for a motor vehicle accident, such as obstructive sleep apnea.
You may undergo an overnight sleep study to monitor your sleep and breathing. This objective testing procedure provides a comprehensive assessment regarding the severity, if any, of obstructive breathing in sleep or the presence of other sleep disorders.
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If you are found to have obstructive sleep apnea, you will be required to return for a second night in our sleep laboratory for a nasal CPAP titration. CPAP stands for Continuous Positive Airway Pressure and involves a small mask placed over the nose which is connected to a blower unit. It applies a low level of air pressure to the keep the airway open during sleep. To be successful with CPAP, it is essential to identify the ideal pressure that is specific to your needs which is why a second night in the sleep lab is required. If the pressure is too low, obstructive breathing events will persist. However, if the pressure is too high you may have difficulty adjusting to the pressure. Nasal CPAP is typically well tolerated if the appropriate pressure, mask type and patient education are pursued.
Once nasal CPAP is initiated, you may be asked to return for a Maintenance of Wakefulness Test (MWT) to evaluate your ability to stay awake in a standardized testing procedure. This procedure involves four testing sessions on a single day performed at two-hour intervals. During each of these 40-minute testing sessions, you will sit in a dimly lit room and be asked to maintain wakefulness throughout each session. The MWT provides an objective measure of your ability to maintain wakefulness in a very boring or soporific situation.
Compliance with therapy and ability to drive
Commercial motor vehicle drivers are generally cleared to drive as long as they adhere to the prescribed medical therapy. CPAP units provide objective data regarding adherence or compliance. We recommend a follow-up visit after the first month of therapy and at least one on a yearly basis. We will monitor compliance with the prescribed therapy and evaluate interim changes in the health status. As long as commercial drivers with obstructive sleep apnea are compliant with their medical regimen and use their CPAP whenever sleeping, there is no legal or medical necessity to restrict their activities above that of any other commercial driver. On the other hand, a commercial driver who has an accident and is not adhering to CPAP therapy may carry an increased level of personal liability and the likelihood for future driving restrictions.
Commercial drivers should always remember to maximize their total sleep time to avoid any unintentional self-imposed sleep deprivation. This recommendation should be followed by all drivers, irrespective of their medical status, to minimize fatigue and sleepiness when operating motor vehicles or heavy machinery. All drivers have a risk of nodding off behind the wheel if they are sleep-deprived, even if they do not have an underlying sleep disorder.