I went for my DOT physical the other day, and the doctor magically confirmed that I have SA. I checked out fine on everything, BP, sugar, vision etc... Pretty basic physical, nothing complicated, very very basic, like if you are breathing you will pass, and yes I could touch my toes.
What has changed in the past two years since my last DOT physical... My weight is up due to a thyroid issue that I am under care for, and I told the doctor this. She ignored that fact, stated my neck was 18 inches... My neck has been 18 inches since I was in High School... This is the criteria... My Neck circumference, BMI (Body Mass Index), weight, along with age, over 42...
She looks at me with a straight face and tells me I have sleep apnea, and will be required to have a sleep study and more than likely purchase a CPAP machine if I wish to continue to drive, or in my case, WORK. She was kind enough to give the information on where I can have my study completed and which medical supply outfit to purchase my "approved" CPAP machine from. How kind of her.
Now you folks tell me with a straight face that this SA syndrome or disease, which I am not buying, is not a racket? I sleep like a log, have for years unless I have been drinking. I normally work 18 hours a day and have lived on 5 to 6 hours of sleep for years. I have been driving safely for 30 years, I have a $1000 mattress in the truck, AC, fans, stereo and some very nice Calvin Klein down pillows. My truck is so comfortable, I prefer sleeping in it compared to my own bed at the house.
I am not buying any of this nonsense I was just fed. How can you look at a 55 yo man and diagnose him without doing a test? And then tell him, if he does not take the test from their approved sleep study clinics, only two by the way in the Detroit area, that I will have my Commercial Driver License suspended and will not be allowed to work.
I have medical issues, with my THYROID, not my ability to sleep. And I find it rather striking that the SA issues are darn near identical to my Thyroid symptoms. I wonder if some of you folks have underlying conditions that you are not being tested for? Not saying that there is not real SA cases out there, I am not that ignorant, but when you see what I just went through, one has to seriously consider that this new medical industry is nothing more than snake oil, a multi BILLION DOLLAR a year industry, that even Forbes Magazine described as a "Racket". I believe it is.
On a side note, I have yet to meet a driver that has ever passed a sleep study test, the test itself is designed for the patient to fail. Do some research on the subject before you judge me. And follow the money.
And here is another thing, my blood pressure test... They used one of those $50 units that you can purchase on Amazon, I know the unit because I own one. I just pulled it out of the box to check... That unit is junk, it always reads high, and I told the nurse that and she agreed. I told her to use a real BP cuff and a stethoscope. I magically went from 160 over 90 to 134 over 78. Blood pressure is where they get us truck drivers too, just saying. Tell me again how any of this does not qualify as a racket? The clinic was Concentra, and I have 90 days to shell out untold hundreds, if not thousands of dollars to continue to work and support my family. I am self employed by the way, I cannot afford insurance, just as most truck drivers, even those employed as drivers. Time to get out of this insanely over regulated industry before the stress kills me.
I am a dentist working in dental sleep medicine. On one level I can sympathize with how you feel. When someone messes with a person's livelihood, it is, indeed, a serious matter. I have been working with sleep apnea patients for about 13 years and I have seen the condition get people fired from great jobs, lose their marriages, alienate their children, and die in their sleep. Please take it seriously. The condition affects 20 million or more people in this country and keeps growing as people get more obese. With greater awareness, doctors(and dentists) are screening people more carefully for the condition and you need to expect that. Many people do not suspect that they have the condition because they don't feel symptomatic. We now have a pretty good idea of the profile of potential victims, and from what you say, you are in there. Where I definitely DO fault the doctor is when she made the statement that you have sleep apnea based on the profile. That was unnecessarily upsetting to you. Nobody can be sure that a person has sleep apnea without appropriate testing and there is a significant chance that you DON'T have it. Screening is no big deal. They now have home sleep tests that are easy, fast, and cheap. So just get it done quickly and have peace of mind. Even if you do have it, not everybody gets CPAP. There are oral sleep apnea appliances, surgical options, and an Inspire pacemaker, too. Good luck to you. It will work out. Arthur B. Luisi, Jr.,D.M.D.
Incidentally, I have seen plenty of patients take sleep tests and find out that they don't have it. The tests are pretty objective. Electric leads are put on your body to monitor things. There is no human input. As they say, leads don't lie. Don't get me wrong, mistakes are made. Sometimes the leads are put on wrong or fall off and other things happen. There are false positives and negatives, but, over-all, I have a pretty high level of confidence in the results.
Thank you for the well thought out reply, and yes, having my employment threatened is beyond disturbing, along with the cost of tests and a possible CPAP machine purchase, I have no insurance as I am self employed, Obama took care of that, and was also the one that signed this SA nonsense into law after the congress passed it regarding my industry.
I have already had several friends tell me they will donate their own CPAP machines to me, as they simply played the game to keep working, they have never even taken them out of the box as they feel they do not need them. They were in the same boat as myself, go in for a DOT physical and find out you will be denied making a legitimate living due to your neck circumference, weight or BMI.
And I know I have an issue, it is my Thyroid, and the reason for my sudden weight gain. I have had ultrasounds and biopsies, it is a real issue, as I said prior, but does not affect my sleep. What is criminal to me is that I am being held hostage in regards to my work.
The federal government also mandated that I have a device in my truck, an ELD (Electronic Logging Device), it is a clock, it starts when I wake up, and then it is a race towards the end of the day not to surpass the time it allots me to work. Same thing, I cannot function under this gun. And then I get hit with this SA nonsense?
There is much more to this story and my frustrations, and stress. 30 years out here, ad they are killing the entire industry with regulations.
And as I stated earlier, I know there are real cases of SA, and it is great that there is a treatment, but don't shove it down my throat and then threaten my livelihood to feed an industry that in my opinion is selling snake oil.
Believe me, I am more sympathetic to your plight than you know. I have felt the heavy hand of government regulation, too. Where will it end? Who knows? It really doesn't seem fair that you are held hostage in this way. But remember, this forum is made up of concerned people who want to help you. The most important thing to us is your health. Check it out for yourself, for your family. They need you to be healthy as the breadwinner. Good luck to you. We will be here if you need us.
That is what really angers me, I am being forced to do this. I have enough issues in my life right now, changing carriers at the moment and I am strapped financially to the point it is getting very very ugly. And now to be hit with this right out of the blue, and again threatened at having my license pulled if I do not comply. The only thing stable in my life right now is the cost of diesel fuel, LOL!
I hear your frustration. I think they have only given you the simple screening test that is done to justify doing the sleep study. It is not a given that you will fail the actual sleep test. Here are my thoughts:
First, if you are paying it may be worthwhile to look around to find a sleep clinic that will do a home study instead of an in lab study. Much less expensive, and the results are valid for normal uncomplicated apnea. And if you fail the sleep test, some clinics will insist on an additional titration study to determine what pressure your CPAP should be set at. If you have basic obstructive apnea that is really not necessary. It is better to just buy an automatic APAP machine which is less than $100 more, and it will determine the pressure you need.
Sleep clinics can charge outrageous amounts for a machine. On line a get started package is around $800-900 for the automatic APAP machine, hose, and mask. But, if you can buy a "used" or little used unit, or be given one, that is better still.
If you end up needing a CPAP, I normally recommend a ResMed machine. However, if you are going to use it in a truck and I expect run it on 12 volts, the Respironics Dreamstation machines are nearly as good, and they run on 12 volts. ResMed machines want 24 volts and they charge $130 or so for a 12 volts to 24 volts converter.
Hope that helps some, Any questions, just ask...
I'm looking into the $100 at home services, I cannot afford a $1000 in house study, and even if I could, I would not comply. I am being forced to do this, so finding the least expensive route is my only option. As far as the machines, most of my buddies have them, still in the box. I have had several fellow truck drivers already tell me I can have theirs.
And that is the kicker, they force us drivers to do all of this, and few if any drivers actually use these devices they were forced to purchase. Most trucks do not have the required inverter to power these units, so they stay in the box and are never used, and there is no medical follow up, they simply ask if you have your machine! Again, tell me this is not a racket?
And that is another thing, sleeping hard in a truck is really not in ones best interest. With the new logging devices we are now required to use, I find myself taking sleeping pills and or NyQuil to force myself to sleep to stay compliant with our new government mandated duty cycle. The government states we need more rest, so we pop pills and or drink lots of NyQuil. You think that is healthy? LOL! I don't, and try not too, but many times I have too. I wake up feeling like the bottom of your shoe, if anything happens I sleep right through it, like a fire or accident, or God forbid someone tries to break into my truck, which is very common in more than a few locations around the country. Trust me, truck stop parking lots are not the safest place to park, but it is all we got.
Meanwhile, I am changing carriers, I own my truck, and will be going to work with a local outfit. They have a run that may just allow me to hit the gym on a daily basis, now that is something I have been trying to do for over a year now. with zero success.
I don't work a 9 to 5 job, so staying healthy out here is darn near impossible, with the new driving regulations and the egg timer on our dash, I can no longer just go to the store or gym, I am held captive in my truck. I cannot even move across the parking lot to a better parking space. Prior to these regulations it was much easier to at least have a choice, now I get whatever I happen to land in. And by that I mean available parking.
And then staying healthy with the food available out here is darn near impossible unless you have a refrigerator in the truck. The food our here is pretty much crap, Mcdonalds and the like, and lack of real restaurants out here like we used to have, restaurants with locals in the back cooking up some really good stuff. That is all gone now, Subway is the healthy choice, unless you can find a grocery store, but that is getting to be more difficult as many businesses ban our trucks from entering their property.
I'm going to retire soon, have to, as this industry is going down the tubes very quickly, too quickly and the stress of the government regulations has MY stress levels through the roof. I have to leave sooner than later, because my body is telling me if I continue in this racket I will be at room temp within a few years, and it won't be from SA, but government regulations.
Many of us older drivers are fleeing the industry, 30 years of safe driving out here, and millions of miles under my belt. Getting to the point it is no longer worth it. Just informed my truck insurance rates are going up yet again. Truck accidents are through the roof, due to the electronic logs and inflexible hours that we can actually work. No more fudging and taking our time, now it is hammer down and to heck with everything and everyone else. Not how I was trained, and you will see it out where you are if you drive the interstate, trucks speeding, cutting off cars, switching lanes, etc... Sad
Thank you for the reply.
If you end up on the CPAP try to find somebody that will give you a DreamStation machine. They are the easiest to hook up to a 12 volt cigarette lighter socket. See this link.
Hi AmusingBarracuda,
I also was shocked when I first became aware of the nature and extent of the sleep industry.
I am in Australia and we are perhaps a bit behind the American version but stupid enough to be gradually embracing the whole convoluted package.
I think perhaps a lot of the blame rests with your health industry and the insurance companies.
It astonishes me how much power and influence the sleep industry has accrued and how few standards and controls are in place for the industry itself.
I am also extremely skeptical about the key claims and statistics that the industry makes and promotes in order to justify their misappropriated authority. (see previous ramblings of mine)
Unfortunately the whole construction is too entrenched and too lucrative to be easily challenged.
I think the greatest harm it does for me is the way it reflects on humanities greed, ignorance and gullibility.
Not the most diplomatic statements for me to be making in a sleep apnea forum. :(
None of that was helpful sorry.
I might not be the best one to be offering advice here.
I refuse to learn all the correct terms and labels and have only general impressions to work with.
I believe that anybody who does a sleep study will be diagnosed with Apnea.
The numbers are rigged so there really is no other possible outcome.
Even so I would suggest that you do the at home study if possible.
Don't take any extra meds or alcohol in the days prior to the study.
Don't do anything excessive with exercise or diet etc.
Arrange your bed so you are comfy but cannot sleep on your back.
If you have a partner get them to stay up for 5 or 6 hours and make sure that you do not roll onto your back.
Don't persist. If you can't get to sleep quickly take the gear off and try again later.
If you have slept fairly well for even 3 or 4 hours just take the gear off and pack it away to return.
Insist on getting ALL the results including the raw data they used to generate the reports.
Yep, my plan exactly, really prepare for the test. As I stated earlier, I know of no one that has ever passed this sleep test, at least in my industry. And after all of the monies are spent on testing and gear, there are no follow ups. As I stated, most of the drivers I know have no way to even operate the machines they were forced to purchase in their trucks. Still new in their boxes, never opened.
None of this passes my 55yo smell test. None of it. I believe we are on the same page.
The fact that nobody has passed the test must surely prove that the doctors are always right and that everybody in America over the age of 30 has Apnea. For those who don't get sarcasm it also proves the existence of the tooth fairy. :)
On a more technical note. If they set the bar at 5 and the average for the normal population is 5 then what other outcome is possible. If they have created a margin, say 7 or 8 then it seems to me that all they need to do is be more selective of which particular period of data they process to generate their preferred outcome.
I thought "they" required you to submit the CPAP machine periodically so they could retrieve the data which the machine would normally have been recording.
Nowadays they could have most CPAP machines online and monitored, effectively policed.
Perhaps the system is in place in theory but not the follow through on the ground.
We have license issues down here too which is one of the reasons I first came to this forum ten months back.
Wow! You really unloaded on us this time. I am one of the pioneers in dental sleep medicine. If you could have seen what a struggle it was to begin to find a way to treat people for OSA with little knowledge and no research and if you could have seen the hundreds of patients that I have given back their lives and their health, I hope that you would feel more kindly towards us. Doctors are human beings just like everyone else. I know some that truly care about their patients and go the extra mile. I know some that are pretty selfish and basically in it mostly just for the money. Just like people in every other profession. I know that people HATE to be diagnosed with OSA. Everyone just wants to be able to sleep in peace without masks and hoses and air pressure or appliances in their mouths, etc.. But you have to accept the hand that you are dealt and make the best of it. This is what this forum is all about. Dr. Luisi
I didn't mean to be critical of the doctors SleepDent and I apologise for my lack of tact. I was just depicting the world as I see it. BUG's world.
Most doctors I know are largely unwilling participants in this whole debacle and those that are willing are often zealots who believe in what they are doing.
What I see as the sleep industry is primarily driven by insurance companies who have become expert at manipulating our laws and policies.
They effectively dictate to the government and the health industry and largely control the flow of money in all these areas.
They function on the same principle as the casinos. The more money being spent the more they benefit.
It is in their interests to make every aspect of health as expensive as humanly possible.
The sleep industry in general (clinics and manufacturers) has thrived in this enriched environment.
So how did they accrue so much power?
An escalating scare campaign was an excellent opening strategy.
Lowering the bar to include a vast chunk of the population was a good secondary move.
But they really trumped the game when they were able to threaten peoples jobs and licences.
What's the next step?
Compulsory testing of everybody for normal drivers licenses?
Random workplace testing?
An Apnea free certificate required to stroll down the sidewalk?
Yes let's do it!
I love the fact that many places are legalizing marijuana yet you could lose your license and your job if you are caught snoring! :)
With some clever manipulation of numbers and careful omissions the whole industry has fabricated a false reality and accrued an unbelievable level of power and authority.
I am not questioning the reality of serious levels of Apnea nor the necessity to find treatments.
I have a CPAP machine that I use all the time.
I don't object to companies and industries making money, even insane amounts of money.
It is the misleading claims and abuse of power that I would question.
You do have some valid concerns. I would have to agree that compulsory testing, no matter how well intentioned, is a slippery slope. The safety concerns which are the basis for it make sense on the face of it. Nobody wants to be mowed down by a driver asleep at the wheel. However, after reading the story of the original poster here, how can I say that he has been treated justly. I can not. As you said, if you make licensing contingent on a raft of these things, you have a police state. People like the poster should not have to suffer in silence. We need a national (or international) dialogue on the subject. Let's face it. Life has its dangers and no one can be protected from them all. Who knows, maybe the doctrine should be "you break it, you own it". That is, if the government wants to jeopardize this poor guy's career by making apnea an issue, THEY need to pick up the tab for all of his testing and treatment. And if they ultimately want to pull him off the road, they owe him and his family substantial compensation for that. Just a thought. Dr. Luisi
Now I am watching an advertisement on a CPAP cleaning machine, because the bacteria growth in the CPAP is enough to kill you. And the machine is only $400 US... I feel like I am on a street corner with a gun in my ribs, give me your wallet.
CPAP "cleaning" machines like the SoClean are totally unnecessary. The manufacturers of the CPAP machines, like ResMed and Phillips, do not even recommend them. CPAP is a buyer beware business. Full strength vinegar to clean the humidifier reservoir, the mask, and the hose, once a week is all that is necessary.
I would encourage you to check out the following PDF located @ https://swhr.org/wp-content/uploads/2017/11/SWHR_Women-Sleep-Apnea.pdf to see if anything resonates with you. Sometimes, you could be experiencing symptoms that you are unaware are symptoms. Then sometimes, there are no symptoms. It would require a sleep study to diagnose. While this seems like a huge inconvenience right now and unfair, it could be a blessing in disguise if you can avoid some of the long term issues that come as a result of undiagnosed sleep apnea.
The federal government also mandated that I have a device in my truck, an ELD (Electronic Logging Device), it is a clock, it starts when I wake up, and then it is a race towards the end of the day not to surpass the time it allots me to work. Same thing, I cannot function under this gun. And then I get hit with this SA nonsense?
I'm not in the medical field, but I will that most doctors that measure the neck will say that anyone over 17" is at risk for sleep apnea simply by having that large sized neck. It doesn't mean that you have it necessarily. It just means that is a risk factor. There is no way that a doctor could logically look at you and simply by judging from neck size indicate that you have sleep apnea. A full overnight test is needed to determine that.
I'm back, here is what happened... I hope this comes out coherently... I am still a bit PO'd and have still not received my DOT Medical Card.
Let's start with the DOT regulations... SA is not there, and the only legal way to have a Commercial Truck Driver tested for such, is if the Carrier REQUESTS the Sleep Study! Only the carrier can request! Not the clown doing the DOT physical with the SA Testing Clinic Brochure and the SA Equipment I am required to purchase, from their select supplier pamphlets in hand. The physician has no say in the matter if the driver passes the prescribed DOT exam. No one else can "legally" make that call other than the carrier, that is the law, end of story.
OK... I called OOIDA, look it up... By DOT regulations I am allowed a second opinion. Well, I went and got one of those the other day...
Alright, the second opinion doc, he completed my physical, I passed with flying colors, and then he saw what the other doctor put in my FMSCA medical record... That record stated that I have SA... So, he stopped everything, as he was rightfully between a rock and a hard place, AND he was ready to sign the two year medical card... I told him what went down with the other "doctor" at that point... He told me to get a letter from my primary care physician stating that there is no reason to test me, as I do not have issues or symptoms related to SA, which I do not, and he would issue the two year card.
I called the VA in Ann Arbor MI, and my primary there wrote the letter, and nailed it right out of the park. It is the VA folks, if I have issues sleeping, or insomnia, they will take care of me, I have no such issues. But I do have thyroid issues, which is the reason for my weight gain, and the reason I am regularly going to the VA for testing to find the appropriate care. Neither here nor there, but anyways...
This second doctor was not going to even suggest that I have SA, he knew the law. But, because Concentra makes money off of this deal, here we are.
And there is the kicker, I called Concentra and explained my "issue", and they insisted that my carrier requested the test. Honey, I am the carrier! And I requested no such test!
I am going back on Thursday December 5th to the second DOT doctor, with my note from my primary care physician, stating that there is no reason to test me as there is no evidence of SA. I will report back when I get my DOT card.
When I am issued my 2 year card, I am calling an attorney.
Concentra is running one hell of a scam... Keep reading...
I went to the doctor this morning, I have my 2 year DOT medical card and can now work again! The letter from my VA doctor was all my 2nd opinion doctor needed to CYA and issue the card. It still cost me weeks of work, and an unneeded second physical.
I also called OOIDA, the trucker rights group I mentioned in my last post... I told them about the scam Concentra is running, they knew about it, which did not surprise me in the least. Like I stated in my original post, I have thyroid issues that lead to a sudden weight gain, I sleep fine. Anyways, what OOIDA did not know was the fact that I am the carrier, I am the trucking company, and being the carrier, only I, as the owner of the business, can request that a SA study be performed on a driver. That is the law, or rule in this case. When the gal at OOIDA heard that, the sirens went off... This is a scam folks.
If you are a SA doctor, and I do not doubt the condition exists, but to have a nationwide clinic pulling a scam like this against truck drivers, many of whom are scraping by, this is just down right criminal in my book, and a detriment to your business if this scam is allowed to continue. Truck drivers do have time on their hands, and they will spread the message, I know I will.
