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8 Common Sleep Apnea & DOT Compliance Questions Answered

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💡 Key Takeaways

  • Federal Regulations and Sleep Apnea: While there’s no federal law requiring sleep apnea testing for commercial drivers, the FMCSA states that any medical condition affecting safe driving can disqualify you. Successful treatment for sleep apnea can reinstate your “medically-qualified-to-drive” status.
  • Diagnosis Consequences: If diagnosed with moderate to severe sleep apnea, you will lose your Commercial Driver’s License (CDL). However, treatment and approval from a medical examiner can allow you to reapply.
  • CPAP Compliance: To maintain your CDL, you must show CPAP compliance, defined as using the therapy for an average of four hours each night for at least 70% of the nights.
  • Risk Factors: A Body Mass Index (BMI) of 35 or higher, along with other factors like age and family history, increases your risk for sleep apnea. Being proactive about testing can prevent delays in certification.
  • Be Proactive in Treatment: Stay informed about sleep apnea and your treatment options. Always bring a copy of your CPAP compliance report to your DOT medical exam.

The National Highway Traffic Safety Administration attributes 2.2% of all traffic accident fatalities to drowsy driving. People who drive tired, a symptom of sleep apnea, may not realize how much their lack of sleep affects their driving, which is why undiagnosed sleep apnea is a major concern for the Federal Motor Carrier Safety Administration (FMCSA).

Currently, federal law does not require testing, but testing and treatment for sleep apnea can improve productivity and save lives. If you suspect you have sleep apnea or are you ready to renew your Commercial Drivers license (CDL), keep reading to learn more about the Department of Transportation (DOT) and CPAP compliance requirements.

1. Does sleep apnea disqualify you from CDL?

While FMCSA regulations do not currently address sleep apnea specifically, the FMCSA does state an individual with a clinical diagnosis or medical history of any condition that could interfere with their safe driving ability can’t be medically qualified to operate a commercial motor vehicle (CMV) in interstate commerce.

However, once they receive successful treatment, they can then qualify for “medically-qualified-to-drive” status. It’s important to know most sleep apnea cases can be successfully treated. 

2. Does DOT or FMCSA require sleep apnea testing?

There are currently no laws requiring a Department of Transportation (DOT) physical for sleep apnea. However, DOT does require a medical examination for truck drivers to receive and maintain a CDL license as well as obtain DOT medical cards.

During the examination, a medical practitioner will determine if you require sleep apnea testing. DOT states it’s up to the medical practitioner to determine whether or not your health condition can interfere with your driving. 

Visit our home sleep apnea test for more details!

3. Can I lose my license if I test positive for sleep apnea?

FMCSA has concluded that moderate to severe sleep apnea levels (per sleep study diagnosis) interfere with safe driving. If you are diagnosed with moderate to severe sleep apnea, you’re considered unsafe for driving a CMV and will lose your CDL. Once you begin treatment and are approved by your medical examiner, you will be able to reapply for your CDL.

Apnea-Hypopnea Index (AHI)

If the results of your sleep study indicate moderate to severe (Apnea-Hypopnea Index (AHI) greater than 20), then you will need to show adequate compliance with your recommended therapy, according to the FMSCA, and report your sleep apnea is being effectively treated.

Drivers who have recently been diagnosed with sleep apnea may continue to drive conditionally for one month while simultaneously beginning CPAP therapy. At the end of that month, drivers can be certified conditionally for three months if there is documented CPAP compliance in the previous two weeks. Drivers should be reevaluated at three months, and if they are compliant with their CPAP therapy, they can be certified for one year

4. What are the symptoms of sleep apnea?

Symptoms medical examiners can take as suggestive of sleep apnea include:

  • Daytime sleepiness
  • Loudly snoring on a chronic basis
  • Witnessed pauses in breathing or apneas

Take our free online sleep apnea quiz to find your risk level.

Think You May Have Sleep Apnea? Take Our FREE Sleep Apnea Quiz!

Discover your risk for sleep apnea with just a few clicks! Our FREE Quiz is super simple and easy to use. You’ll receive a personalized score that will tell you how likely you are to have this sleep disorder and the next steps you can take for diagnosis and treatment.

5. What are the risk factors for sleep apnea?

Here are seven risk factors that may indicate sleep apnea:

  1. BMI greater than or equal to 28.
  2. Small jaw
  3. Advancing age
  4. Family history of sleep apnea
  5. Small airway
  6. Neck size greater than or equal to 17 in males
  7. Neck size greater than or equal to 15 in females

The medical expert panel for the FMCSA states that drivers with a BMI greater than or equal to 33 may be conditionally certified to drive depending on a sleep study. 

If you have diabetes, high blood pressure or previously suffered a stroke; You should consider talking with your doctor about a sleep study before your DOT physical exam.  By being proactive, you’ll eliminate any unnecessary delays in your certification.

If you have a BMI of 35 or higher, it may be time to consider bringing up sleep apnea with your doctor. 

If you have a BMI of 35 or greater, you should be proactive and get yourself tested.

Not sure what your BMI is? Find out with the National Heart, Lung, and Blood Institute’s free BMI calculator

6. If I have moderate to severe sleep apnea, how can I prepare for my DOT medical exam?

If you have a current sleep apnea diagnosis, make sure you stay compliant with your treatment by meeting the FMCSA’s compliance standards. Be sure to print a copy of your CPAP compliance report to bring with you to your exam. If you have more than one machine and mask, you’ll need to bring a copy of each compliance report.

7. What does CPAP compliance mean?

CPAP compliance is the measurement of how many hours and nights you’re using your therapy, and if you’re using it enough for treatment to be effective. When you’re noncompliant, it means you don’t use your CPAP device as often as you should be or you’re not using it long enough while sleeping.

The FMCSA describes compliance as therapy usage for an average of four hours each night for a minimum of 70 percent of the nights.

Devices today can determine if you actually wear your mask or simply turn the machine on but don’t wear your mask. This measurement helps with assessing compliance and is usually a factor insurance providers measure for purposes of coverage. DOT may also use your CPAP compliance report to prove you’re treatment is successful.

8. What are some tips on getting started with CPAP therapy?

If you think you may have sleep apnea, we recommend speaking with your doctor first. Below are a few steps you can take in order to advocate for yourself to ensure you get the care you need : 

  • Get a sleep study. The first step to CPAP therapy is to receive your official diagnosis from the doctor. To do this, you’ll need to undergo a sleep study. This is also known as polysomnography and is the gold standard for diagnosing various sleep disorders, including sleep apnea.
  • Undergo a titration study if indication. If your sleep study results indicate you have sleep apnea, you’ll need a “titration study” next for the doctor to decide on the accurate pressure level you require for maintaining your airway while you sleep. You may have the titration study the same night you have your sleep study, or the doctor may schedule it for a later date. While in your titration study, a sleep technician will monitor you while you’re sleeping and gradually increase your CPAP machine’s air pressure until you can sleep with few or no sleep events (hypopneas and apneas). Throughout the night, your pressure requirements will vary; therefore, an overnight sleep study is needed so the doctor can prescribe the proper pressure to you.
  • Get a prescription. You will need a prescription to start CPAP therapy and purchase a CPAP mask, humidifier, or mask. This is because these machines are FDA classified as Class II Medical Devices, and they can’t be sold legally without a valid prescription.

Be Proactive With Your CPAP Treatment

You need to stay proactive in your treatment. Learn all you can about sleep apnea and your treatment options. If you experience problems or side effects, seek out solutions the minute they become a problem. Get an understanding of the way the equipment works and what your part is in the process and what you should expect.

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  • David Repasky

    David Repasky has been using CPAP treatment since 2017 and has first-hand experience with what it's like to live with Sleep Apnea. He brings the patient's perspective to the CPAP.com blog and has received formal training in CPAP machines, masks, and equipment.

Need Help With Sleep Apnea?

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26 Responses

    1. Hi Steve, in some cases you are able to print your data. Which machine do you have? In order to print the data from some machines, you are required to have software downloaded which is specific to your machine.

      Please feel free to contact us directly at: 1-800-356-5221, so that we may provide accurate information based upon the machine you are using.

      We hope to hear from you soon!

  1. If you can’t sleep with the cpap and decided to get an dental mouth guard, would that be ok what could i use to monitor myself to get an print out?

    1. Hi Que, a dental mouth guard may work if you have mild to moderate Sleep Apnea, but you must speak with your doctor to confirm if the mouth guard would be the best treatment for you. Also, if you are only using a mouth guard, there is no way to record your therapy data, which means there will be no way for you to receive any print out.

      For further questions, or concerns, please fee free to reach us at: 1-800-356-5221.

      Have a great week!

  2. I’ve decided to surrender my CDL at my renewal. I was diagnosed with SA. in 2017. My sleep went from bad to worse using the machine. I’ve gotten horribly sick twice with this this. Lost more sleep them I care to imagine. Keeping my CDL isn’t worth the headache…..

    1. Hi David, i’m very sorry to hear that your CPAP therapy hasn’t been working out for you. Perhaps, setting adjustments, or a change in masks would have benefit you. You may consider speaking with your doctor to see if a new sleep test is warranted for a possible pressure setting change.

      If you decide to give your therapy another try, we’d be more than happy to speak with you and give suggestions/tips on how you may be able to improve your sleep and keep your CDL!

      If you’d like to speak with us please feel free to reach us at: 1-800-356-5221.

      We wish you the best and hope to hear from you soon!

  3. Was diagnosed with mild to moderate Sleep Apnea, Test showed that it was only really bad when I was on my back. Sleep study also determined that the CPAP wasn’t a good fit for me. So, I was prescribed a BiPAP instead. After 3 months of trial use I got disqualified by my Insurance Carrier for non-compliance with their minimum 5 hours a night for 70% of the nights. A script of “Trazadone” pills didn’t help either. I couldn’t seem to be able to tolerate the breathing machine for much more than a hour or so per night at most.

    Doctor says the next step at this point would be the Dental Appliance to wear in the mouth at night.
    Or the “Inspire” sleep implant.

    Are either of these DOT medical approved?

    P.S. I’m also non-CDL.

    1. Hi G. Lee, i’m sorry to hear about the troubles you have had with your CPAP therapy. Unfortunately, I am not able to answer your question with certainty, this is because we don’t sell the Inspire, or the Dental Appliance therefore, we have very little information.

      I would suspect that the Dental Appliance would not be DOT approved, as there is no way to track/confirm your usage. I pulled some information on the Inspire, please see the link below for more information.


      We hope all works out for you, but if you think of any further questions, or concerns, please contact us at: 1-800-356-5221, or you may e-mail us at: cpap@cpap.com.

      Have a great day!

  4. I have severe sleep apnea and I have been told that all I need is 30 days on the machine to get back to my truck. But I have also been told that I need so many hours. I’m a CDL driver, so which is right?

    1. Hi Panda, my apologies for the delayed response. I would recommend you speaking with whomever is requiring you to have the therapy (doctor, employer) to confirm what percentage of use is considered in compliance. Usually it is 70% compliant and everyday use, not just 30 days.

      Keep in mind that once your diagnosed with Sleep Apnea, you should use your CPAP machine nightly, unless otherwise instructed by your doctor.

      For further questions, or concerns, please feel free to reach us at: 1-800-356-5221.

      We wish you the best!

  5. I was Diagnosed with a mild Case of sleep Apnea .When I went for A physical Doctor proscribed a Sleep Apnea test when I went back he ask to see my Diagnosis it showed I had a Mild Case so He told me I didn’t need The CPAP . Now I went to a Different Center to Get back to work after I’ve been off for almost six months .This new Doctor is Making me do it again . won’t let me back until it’s done He won’t Accept My past findings of Apnea . What I’m asking is At my age 62 Do u I need another test Its been Probably two years since the last one .

    1. Hi Albert, i’m sorry that your being given contradicting information. Most insurance companies will pay for a new sleep study every 5-7 years, some doctors may require you to have a new study every 2-3 years. In honesty, there isn’t a required amount of time for you to have a new sleep study test. It really just depends on the doctor you’re seeing and your medical information.

      For further questions, or concerns, please feel free to reach us at: 1-800-356-5221, or you may e-mail us at: cpap@cpap.com.

      We wish you the best!

  6. I have an old CPAP machine that does not have a Sd card or a way to print out compliance. I have brought the machine to my supplier and they have no way of getting information out of the machine. I also called the manufacturer and they don’t have a way for a print out. The machine is 15 years old. If I cant get the information how do I get my CDL medical card?

    1. Hi John, i’m sorry that you’re having some problems with retrieving data from your machine. Most CPAP machines, have some option for retrieving, or viewing data. Please provide us with the name of your machine and we will be happy to confirm any options that may be available.

      You may reach us at: 1-800-356-5221, or e-mail at: cpap@cpap.com with and further questions, or concerns.

      We wish you the best!

  7. So the machine send a report at a certain time about your sleep. But being a CLD driver, and not having the same time to sleep every day sends a false report in. For example, if the report goes in at 1pm and I get to bed at 12 and sleep till 5pm I have used it for the required time, but the report only says 1 hour. How do we fix this? I have call the makers of the machine and they tell me that is how it works. This is a problem and needs to be looked at because drivers are being put out of work

    1. Hi Richard, i’m sorry that you are having an issue with the correct data being transmitted and we understand the importance of your data being accurate due to your CDL. What is the name of your machine?

      If you travel to an area where there is a timezone difference from what your machine is set to, this could be the issue. You must always adjust to the new time zone so that your machine is recording and transmitting your data accurately.

      For further questions, or concerns, please feel free to reach us at: 1-800-356-5221, or you may e-mail us at: cpap@cpap.com.

      Best Wishes!

  8. I need a Dot certified cpap I am looking for a portable unit that has printable information for the dot I have a home cpap but need one for being on the road what would you recommend thanks Gary Jones

  9. Have been on my CPAP since late October 2019. I use it nightly for 7.25 hours; I get all 70 points for hours of use. Since I started on October 28, 2019 I have missed less than ten nights. I do not feel my full-face mask at all. I went from 25-some events per hour in the September 2019 study down to just under 8 between October 28 and November 19, 2019. That’s just three weeks from Severe Obstructive Sleep Apnea (an APN disqualified me on July 1, 2019) to being cleared to drive again. Stay strong, drivers. There are solutions to this problem…

    1. Hey David, it sounds like your CPAP therapy, is working well for you! Thanks for sharing your experience with us and we wish you continued success with your therapy.

      If ever you have questions, or concerns, feel free to reach us at: 1-800-356-5221, or you may e-mail us at: cpap@cpap.com.

      Best Wishes!

  10. I have claustrophobia and bad anxiety I can not use the c-pap machine what can I do to keep my cdl

    1. Hi Renee,
      In most cases, either proving to not have Sleep Apnea, or remaining compliant with your CPAP therapy is the way you would keep your CDL. I would encourage you to speak with your doctor about other options that may be available for you.

      Also, CPAP.com does sell masks designed for claustrophobic patients that have very little face coverage. Also, all of our complete masks are sold with free 30 day returns, so if you purchase one, and find it will not work for you, simply return the mask for a different one, or a full refund (prescription required).

      For further questions, or concerns, please feel free to reach us at: 1-800-356-5221, or you may email us at: cpap@cpap.com.

      Have a great day!

  11. At less than 6 AHI in my sleep study , why are the sleep centers requiring a CPAP machine?? Isn’t the threshold 20 or more?

    1. Hi Scotty, having an AHI which is less than 5 is considered normal. Since your AHI, is 6, it’s considered mild sleep apnea.

      If you disagree on your need for a CPAP machine, please discuss your concerns with your doctor, or sleep therapist.

      For further questions, or concerns, please feel free to reach us at: 1-800-356-5221, or you may email us at: cpap@cpap.com.

      Have a great day!

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