Sleep Apnea, BMI & DOT Physicals

If you are concerned about needing a Sleep Apnea test when it comes to your DOT Physical, you’ll learn about it here.

Some drivers believe it’s unnecessary or some have even told me it’s a ‘Raquet’, or a means for providers to charge patients more money.  Well, that couldnt be further from the truth.

See, we have guidelines that we must follow as providers that tell us who needs a sleep apnea test and who does not.

Who Needs A Sleep Apnea Test? (this is what the FMCSA says).

Here are the 2 Types of People That Would Need A Sleep Apnea Test:

1. If your BMI is over 40 it is SUGESTED that you perform a sleep study.


2.  Your BMI Is over 30 and you suffer from Three (3) or more of the following:

  • 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)
  • Neck size 17 inches (male), 15.5 inches (female)
  • Hypothyroidism (untreated).
  • Post-menopausal female.

You can either go to a Sleep Lab or do it At-Home.
Most prefer the cost and convenience of doing it at home.

Why Did Primary Health (or insert any other doc in the box or urgent care) Make Me Get A Sleep Apnea Test This Time?

Major hospitals, Urgent Cares, Concentra’s etc… do not have any discretion when it comes to requiring sleep apnea testing.

This means the doctor (usually a nurse practioner) does not get to use their differential diagnosis skills to determine if this person truly needs a sleep apnea test.

It’s Black Or White, no in between. They only go by the chart above.

This means, if your BMI is over 40 they will require you to get a sleep apnea test (even if you don’t have problems sleeping).  Or if your BMI is over 30 and you have any of the conditions listed above, they will require you to get a sleep apnea test, or if your neck is over 17 inches they will also require you to get a test.

This Is Very Frustrating For Drivers!

Does This Mean I Never Recommend Sleep Apnea Tests?


I use my discretion for each and every case. I individually determine if this person truly needs a sleep apnea test…but I definitely don’t just go by the chart above. It’s individualized recommendations that I give based on that persons detailed history and exam.

Will I Fail My DOT Physical If I Need A Sleep Apnea Test?

No, you will not fail the test.

You will be given time to go and get a Sleep Apnea Test.

The test will determine if you indeed have sleep apnea.

If you have sleep apnea, you will be given the proper equipment to begin your therapy.  You must show compliance for 30 days and show 4 hours per night use on 70% of nights.

I Can't Get A Sleep Apnea Test For Several Months!

Yes, unfortunately this is a major problem.

Due to Covid, many clinics are behind and some drivers are being told they must wait 3 months or longer for a Sleep Study in a Clinic!

So I suggest you get an at home sleep apnea study kit.

Where Do I Get An At Home Sleep Apnea Test?

 If you’ve already been told you need a sleep apnea test we can send you a kit and show you how to use it, if you need an At Home Sleep Apnea Test.

Click here to get an At Home Sleep Test.

You can also reach out to your doctor and make an appointment for a Sleep Study in a Lab.