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As with any ruling, it takes years for it to be cemented into law, and the obstructive sleep apnea (OAS) ruling is no different. But at last, two advisory boards have finally nailed down their suggestions for the final rulemaking.

Topping the list of recommendations as feared by many drivers are neck size, body mass index (BMI) and sleep testing. Drivers with a BMI of 35 or higher would need to be tested and if found to have obstructive sleep apnea (OAS) could be certified for 60 days provided they get treatment, followed by a conditional 90-day certification. Still compliant after 90 days they will receive a one-year certification, with certification dependent upon continued compliance. Compliance as it pertains to OAS means using a continuous positive airway pressure or CPAP machine at least 70 percent of the time and at least four hours a night with seven hours or more a night considered “optimal.”

Drivers would be immediately disqualified if they reported excessive daytime sleepiness while driving, had a crash associated with falling asleep or were found to be non-compliant with treatment.

It has been recommended that examiners judge a driver as “at risk” for sleep apnea not on just one factor, but a combination a factors including but not limited to:

  • Those who have experienced a single-vehicle crash
  • His or her answers to a validated sleep questionnaire or other validated screening tool
  • Loud snoring, daytime sleepiness, witness of the driver stopping breathing or having obstructed breathing
  • Small recessed jaw
  • A neck size greater than 17 inches for males and 15.5 inches for females
  • Age 42 or older
  • A BMI of 28 or more
  • A small airway passage
  • A family history of sleep apnea, and
  • Male or postmenopausal female

Methods of diagnoses include testing at a sleep lab or an approved at-home test. However, examiners have the leeway to recommend testing in a sleep lab.

The preferred method of treatment was CPAP and certain surgeries. Dental appliances were ruled out because they felt it would was too hard to prove demonstrated compliance and long-term benefits.

Stay tuned to to see how this pans out, but don’t hold your breath…