OT: DOT regs & sleeping pills/insomnia

My hubby is a local delivery driver for a major soft drink co & as such must have his CDL to work. Last Fri he had his physical & the company that does his physicals said his sleeping pill, the one he's been on 5 years to now disqualifying. Then yesterday they faxed info to his company that he could not work until his Dr. (he had appt for next Monday) sent a statement saying she would no longer prescribe the Temezapam & what she was switching it to. He got sent home from work until this gets straightened out.

He got an appt today. He got the Dr. to prescribe something else. The Drs. office faxed it after 5pm to the company that does physical's. My hubby went to get med card to work tomorrow & found out new Rx, Trazadone, is ALSO disqualyfing, so he can't work tomorrow. He did (finally) get a list of what is not acceptable, so we will take this to his Dr. in the morning.

Now truckers & truckers wives, do you know what is acceptable to treat insomnia that meets DOT regs? I've gotten on website & can find out what is UNacceptable, but there is no recommended substitute. I thought someone here might have run into this before & has an answer.

He is 100% compliant with his CPAP, A1c & others labs look great (at one time he was pre-diabetic, A1c now 5.5). He inherited the insomnia from his mom's family, so even CPAP hasn't fixed it. I monitor his data & on paper he looks great.

He is 8 years from retirement & doesn't want to start a new career that doesn't require a CDL, but was so discouraged before bed he was kinda pitiful. I thought maybe someone here had ideas.

I don't have a specific answer to your question, but I know some people who use melatonin for sleep. Maybe that would work for him instead of an RX drug... just a suggestion, in case he wants to try it.

A good sweaty shag seems to help, too.

@library lady:
He's tried it before having to go on sleeping pills. Didn't work for him, he has a family history of insomnia. I'm hoping his Dr. comes up with something today, or just the answer of nothing, so he can go back to work tomorrow.

@chunky frog:
Sounds good to me!

Well, to anyone who has someone in their life with a CDL in the US, the answer to my question is NOTHING. You cannot injest ANY medication that would induce sleep. Same as pilots. Not even Benadryl.

The upside is we will have safer highways (maybe???).

The downside is although my hubby can finally go back to work tomorrow, he is going to have to look for a job that does not require a CDL. Not many jobs pay like those that require a CDL. I am afraid the insomnia, if left untreated will ruin his health in the long run.

This sounds like a situation where insurance should cover behavioral therapy for insomnia.

I know that exercise helps with insomnia.

jencat824 wrote:Well, to anyone who has someone in their life with a CDL in the US, the answer to my question is NOTHING. You cannot injest ANY medication that would induce sleep. Same as pilots. Not even Benadryl.

The upside is we will have safer highways (maybe???).

The downside is although my hubby can finally go back to work tomorrow, he is going to have to look for a job that does not require a CDL. Not many jobs pay like those that require a CDL. I am afraid the insomnia, if left untreated will ruin his health in the long run.

Jen824,

That blows my mind. I understand the concern about safety but if your husband has a proven track record, common sense really needs to prevail.

And my guess is that meds that are approved can have just as many dangerous side effects that impact driver safety. But of course, no one wants to deal with that.

I am so sorry.

49er

Frog,
That's an excellent suggestion, one I would have expected the Dr. to think of. I'm going to pursue this.

49er,
He doesn't take any other meds, but my sister-in-law drives in under the recommended time frame after having seizures. I have a seizure disorder but didn't drive until the 1 year mark after my last seizure. She drives 20 minutes later. If I have a seizure tomorrow, I won't drive for a year.

So many other type drugs are OK, but not something to treat familial insomnia. I think having an untreated insomniac on the road is more dangerous than someone with a good nights sleep, even with sleeping pills. But what do I know?

With his CPAP therapy, he had hoped not to need sleeping pills, but that didn't work. I guess I work on finding a behavioral therapist for insomnia.

jencat824 wrote: I think having an untreated insomniac on the road is more dangerous than someone with a good nights sleep, even with sleeping pills.

My thoughts exactly jen.

I had a therapy client several years ago who was an airline pilot. He bought his antidepressant meds out of pocket in order to not jeopardize his employment. He also paid out of pocket for his therapy, for the same reason. I remember thinking: Would his employers rather have people with untreated clinical depression flying their planes? Similar strange policies as what you're up against. Sorry your hubby has such a crummy decision to have to make about his health and employment.

Ambien should be fine. It is approved for Air Force Pilots also.

guest-cdl holder wrote:Ambien should be fine. It is approved for Air Force Pilots also.

I would be a bit surprised if that is still true. The FDA recently changed dosages on the use of Z drugs by lowering them because of interference they have been shown to cause after taking them. In some cases, waiting 24 hours after taking the drugs is required.

Ref:
http://www.fda.gov/Drugs/DrugSafety/ucm352085.htm

FDA is also warning that patients who take the sleep medication zolpidem extended-release (Ambien CR)―either 6.25 mg or 12.5 mg―should not drive or engage in other activities that require complete mental alertness the day after taking the drug because zolpidem levels can remain high enough the next day to impair these activities.

guest-cdl holder wrote:Ambien should be fine. It is approved for Air Force Pilots also.

It is important to point out that aircrew members, that is anyone who flys not just pilots, are NOT permitted to "Self-medicate" which includes OTC meds.

That means all of their med choices must come from the Flight Surgeon and even if the FS were to prescribe Ambien for something it is not going to be a long term thing and I am resolutely certain the member would be grounded during that period.

I think it was VVV who yesterday posted a link to a article (about Robin Williams) by Dr Park titled "Chicken or the Egg: Depression or Sleep Apnea?" where he says

Here are 7 known facts about depression, insomnia and obstructive sleep apnea:

1. We know that depression and insomnia and other sleep problems tend to go hand in hand. People with insomnia are found to have a ten-fold increased risk of developing depression later in life.(1) Treating insomnia in patients with depression resulting in almost double the rate of depression remission.(2) Another study found that the presence of depression and insomnia predicted a higher rate of obstructive sleep apnea.(3)

The numbers in () above refer to references.

guest-cdl holder wrote:Ambien should be fine. It is approved for Air Force Pilots also.

According to the DOT Ambient is NOT fine. It is on the list of 'banned' drugs that will get your med-card revoked so fast you won't know what hit you.

My hubby has dealt with his insomnia several non-rx ways. First the book 'Sound Sleep, Sound Mind' that was recommended by a forum member, RobySue. Second he is taking several herbals, 5-HTP, GABA, Valerian Root & Kavinace. These are with the blessing of his sleep Dr & the DOT medical examiner. Its not been easy, he has had to work at this & try different approaches, but he is getting more sleep now than when the sleeping pill was first pulled. He could have tried to find another line of work, but chose not to since he is getting close to retirement & wanted to stick it out.

If you are holding a CDL & are on Ambien, you could have your med card pulled, so you should know you are playing with fire. If your medical examiner has OK'd the Ambient, then they haven't read the DOT handbook that gives specific guidelines. Even Benadryl is banned. Pretty much any OTC or RX that can have a sedative effect is on the list of meds that require a medical examiner to revoke a med card until the CDL holder is off the listed med. This includes drug testing to ensure the CDL holder is no longer taking that substance.

Don't know where you got your info, but forewarned is forearmed.

Jen

jencat824 wrote: According to the DOT Ambient is NOT fine. It is on the list of 'banned' drugs that will get your med-card revoked so fast you won't know what hit you.

Ambien is seriously addictive, unfortunately, and can lead to sleep walking. Wasn't it Ambien that got Tiger Woods in trouble?