You must provide your medical examiner with the following information:
• Date onset of Sleep Apnea / Sleep Disturbance, if known.
• Name and location of treating health care professional.
• What interventions have been done.
• Medications you are taking.
• Treatment plan.
• Side effects of medication.
• Report: Any history of chest pain, shortness of breath, swelling of ankles, dizziness or fatigue, excessive sleepiness during normal wake period, accident from falling asleep
Report: Is sleep apnea treated? If so, with what and how often? Last visit to doctor? If on CPAP, what is the compliance from the download? Any co-morbidities: CAD, MI, CVA, diabetes?
Drivers at risk for sleep apnea will be identified using clinical predictive model (STOP BANG or similar). Your medical examiner will assess: BMI, neck circumference, Malampatti class, subjective sleepiness (Epworth / Berlin), comorbid conditions, age, gender.
A sleep study will be reqiured for any examinee with a BMI ≥35 or any examinee with a STOP-BANG score indicating the examinee is at high risk for a sleep disorder in conjunction with with a BMI ≥ 30.
Testing: Drivers identified as significant risk for sleep apnea will be referred for testing.
Driver without sleep apnea: Certify up to two years
Driver with risk of sleep apnea: Certify limited time; 1-3 months recommended depending on availability of testing and treatment in the driver’s area.
Driver with sleep apnea and stable on CPAP: May certify up to one year
Do Not Certify:
Driver with very high risk: Driver has been in an accident because they fell asleep, admits to excessive sleepiness during major wake period
Driver is not compliant: Driver with sleep apnea not compliant with PAP treatment
CPAP Compliance: Minimum of 4 hours use per night on 70% of nights
Driver with sleep apnea and states compliant but does not have documentation: May consider a limited certification card depending on examiner’s knowledge of driver. Maximum of 30 day certification
Driver with sleep study showing significant sleep apnea but has not yet received CPAP machine: Do not certify.