osa infograph commercial drivers

Commercial Drivers and Sleep Apnea

Did you know that truck drivers, and other commercial drivers, are a risk on US roadways when they do not adhere to obstructive sleep apnea treatment?

This article discusses DOT regulations, how sleep apnea affects drivers and driving, some risk factors, and symptoms. Lastly, you can review some F.A.Q.’s.

“An American Transportation Research Institute (ATRI) survey of more than 800 commercial drivers previously reported that about 85% tested for OSA were diagnosed with the condition.”

osa infograph commercial drivers

DOT Regulations for Sleep Apnea

A Commercial Driver’s License (CDL) does not require obstructive sleep apnea testing. However, a medical examination is required. The Department of Transportation had begun to implement mandatory sleep testing, but the mandate fizzled out in early 2017.

The intent of the initiative was to give drivers, employers, and medical examiners clear criteria to look for prior to being sent to get sleep tests. Instead, the onus is on the medical examiners to determine if drivers have medical conditions that inhibit their ability to perform the necessary duties.

How Sleep Apnea Affects Drivers

Sleep apnea affects your ability to get a full night’s sleep. Therefore, it hinders your daytime alertness and performance in quick-thinking activities like driving. Untreated sleep apnea makes it difficult for you to stay awake, focus your eyes, and react quickly while driving.

Furthermore, you do not have to fall asleep to be in an accident. All it takes is a split second…

Sleep Apnea Risk Factors for Commercial Drivers

Due to the nature of the career, the lifestyles of commercial drivers are sedentary. They spend long hours driving, and usually get little to no exercise while on duty. Consequently, many of them are overweight or obese. Risk factors for sleep apnea in general include:

  • Overweight/Obesity
  • High blood pressure
  • Family history of sleep apnea
  • Male in middle or older age
  • Large neck circumference (17” or more for men, 16” or more for women)
  • Have a recessed chin, small jaw, or a large overbite
  • Smoking and alcohol use

Symptoms of Sleep Apnea Drivers Should be Aware of

  • Loud/excessive snoring
  • Waking up in the night gasping, coughing or choking
  • Pauses in breathing during sleep (observed by others)
  • Insomnia
  • Morning headaches
  • Difficulty with concentration
  • Loss of memory
  • Decreased libido
  • Irritability and mood changes
  • Vivid dreams followed by waking out of breathe
  • Felling drowsy during minimal activity (such as driving)

*NOTE: Like any condition, you are experiencing one or more of these symptoms that does not mean they have OSA. However, do not ignore the signs of sleep apnea! Seek a medical opinion if the symptoms become prevalent!

Learn more about Home Sleep Tests!

sleep apnea and commercial drivers

F.A.Q.’s for Drivers and Employers

Can You still drive commercially with Obstructive Sleep Apnea?

  • Yes, you can! You will receive your “medically-cleared-to-drive” status once you maintain successful treatment!

What happens when you find out you have OSA?

  • You and your physician will get you the treatment that you need to continue your career.

What severity of sleep apnea (mild, moderate, severe) disqualifies a CMV driver?

  • Moderate to severe sleep apnea interferes with safe driving. A diagnosis of moderate to severe sleep apnea will lead to further evaluation for you.

What are the obligations of an employer regarding employees with OSA?

  • An employer may not require or permit you to operate a commercial vehicle if you have OSA. It is crucial that you use the treatment provided by your doctor.
  • As a result, being effectively treated and complying with that treatment offers you the best hope to secure your career.

A Physician is treating me for a medical condition. Can I obtain a medical certificate, still? (FAQ’s, FMCSA)

  • The Medical Examiner has the final say. Therefore, the examiner can request information about the commercial driver’s condition from their treating doctor.
  • Certification is permitted if the driver does not have a condition, use medication or receive treatment that impairs safe driving. (FAQ’s, FMCSA)

“My medical certificate is still valid. Am I prohibited from operating a CMV if I have a medical condition that developed after my last medical certificate was issued?” (FAQ’s, FMCSA)

  • FMCSA regulations prohibit commercial drivers from beginning or continuing to drive if their ability and/or alertness is impaired by: fatigue, illness, or any cause that makes it unsafe to begin (continue) to drive a commercial vehicle.
  • The driver is prohibited from driving a CMV with any medical condition that would be disqualifying or may interfere with the safe operation of a CMV.
  • Lastly, a driver is responsible for obtaining re-certification from a Medical Examiner. 391.45 (FAQ’s, FMCSA)

I’ve been prescribed Provigil (Modafinil), can I still be qualified to be a CMV driver? (FAQ’s, FMCSA)

  • “Provigil (Modafinil) is used to treat excessive sleepiness caused by sleep disorders. These sleep disorders are narcolepsy, obstructive sleep apnea/hypopnea syndrome and shift work sleep disorders.
  • Provigil has severalconcerning side effects such as chest pain, dizziness, difficulty breathing, heart palpitations, irregular and/or fast heartbeat, increased blood pressure, tremors or shaking movements, anxiety, nervousness, rapidly changing mood, problems with memory, blurred vision or other vision changes to name a few.
  • Many drugs interact with Provigil which include over-the-counter medications, prescription medications, nutritional supplements, herbal products, alcohol containing beverages and caffeine. Above all, the use of Provigil needs careful supervision.” (FAQ’s, FMCSA)

Are there CPAP machines that are better for commercial drivers?

  • Yes! Travel CPAP machines have recently come into focus over the last few years. They are lightweight and compact, making them much easier to transport than traditional sized CPAP machines. Here are a few examples:
    • ResMed AirMini™ (available in CPAP & APAP)
    • Phillips Respironics Dreamstation Go (available in CPAP & APAP)
    • Transcend Mini (available in CPAP & APAP)
    • HDM Z1 (available in CPAP & APAP)



  • Allen, Matthew. “What About the New Law on DOT Physicals for Sleep Apnea?” Trucking Podcast, 9 May 2018, www.truckingpodcast.com/what-about-the-new-law-on-dot-physicals-for-sleep-apnea/.
  • “American Academy of Sleep Medicine (AASM).” Federal Motor Carrier Safety Administration, American Academy of Sleep Medicine – Association for Sleep Clinicians and Researchers, 2016, www.fmcsa.dot.gov/advisory-committees/mrb/infographic-undiagnosed-sleep-apnea.
  • “Driving When You Have Sleep Apnea.” Federal Motor Carrier Safety Administration, United States Department of Transportation, 19 Feb. 2014, www.fmcsa.dot.gov/driver-safety/sleep-apnea/driving-when-you-have-sleep-apnea.
  • Kunzmann, Kevin. “The Sleep Apnea Problem for Truck Drivers.” MD Magazine, 30 Oct. 2017, www.mdmag.com/conference-coverage/chest-2017/the-sleep-apnea-problem-for-truck-drivers.
  • Royalty Truck Insurance. “Screening Truckers for Sleep Apnea Disorder.” royaltytruckinsurance.com, 8 Jul. 2016
  • Sleep Medicine, American Academy of. “Crash Risk Soars among Truck Drivers Who Fail to Adhere to Sleep Apnea Treatment.” ScienceDaily, ScienceDaily, 21 Mar. 2016, www.sciencedaily.com/releases/2016/03/160321081224.htm.
  • “United States Federal Motor Carrier Safety Administration.” Federal Motor Carrier Safety Administration, United States Department of Transportation, 2018, www.fmcsa.dot.gov/faq/Medical-Requirements.

About the Author


Jason Smith is recognized by the board of polysomnographic technologists (BRPT) as a registered polysomnographic technologist (RPSGT) since 2003. He is also Director of Clinical Operations for 6 multi-state sleep diagnostic facilities including the nation’s largest 20 bed sleep disorder testing center. Jason has also been a Co-Author with two research publications featured in Journal of Clinical Sleep Medicine.