Sleep Apnea And Truck Driving

Written By Emma Pauline Published on February 28, 2025 Trucking

Key Takeaways

Sleep apnea is common among truck drivers and can lead to serious health risks, including accidents, heart disease, and metabolic disorders.
FMCSA allows truck drivers with sleep apnea to hold a CDL, but they must follow treatment, especially CPAP therapy, to stay medically certified.
Drivers who fail to manage their sleep apnea risk temporary disqualification, while compliance with CPAP therapy can help them qualify for a 2-year DOT medical card.
Trucking companies play a key role in supporting sleep apnea management by offering screenings, CPAP assistance, and promoting proper rest for drivers.

What Is Sleep Apnea?

Sleep apnea is a sleep disorder that causes repeated interruptions in breathing during sleep. These interruptions, known as apneas, can last for several seconds and occur multiple times per hour. The most common types of sleep apnea include:

Obstructive Sleep Apnea (OSA) : The most prevalent form, caused by a physical blockage of the airway due to relaxed throat muscles.
Central Sleep Apnea (CSA): A neurological issue where the brain fails to send the proper signals to the muscles controlling breathing.
Complex Sleep Apnea Syndrome: A combination of both OSA and CSA.

Among truck drivers, obstructive sleep apnea is the most common due to factors such as obesity, neck circumference, and sedentary lifestyle.

How Sleep Apnea Affects Truck Drivers

Sleep apnea disrupts the sleep cycle, leading to excessive daytime sleepiness, lack of focus, and slower reaction times. For truck drivers, this can result in serious safety risks and long-term health complications.

Increased Risk of Accidents

Increased risk of accidents is one of the most dangerous effects of sleep apnea for truck drivers. Studies show that untreated sleep apnea makes drivers 250% more likely to be involved in crashes due to drowsiness and impaired reflexes.

Cognitive Impairment

Cognitive impairment affects a truck driver’s ability to stay alert and make quick decisions on the road. Sleep apnea reduces focus, slows reaction times, and increases the likelihood of mistakes, especially during long drives.

Hypertension and Heart Disease

Hypertension and heart disease are common among truck drivers with untreated sleep apnea. The condition raises blood pressure, increasing the risk of heart attacks, strokes, and other cardiovascular problems that can be life-threatening.

Metabolic Disorders

Metabolic disorders, including diabetes and obesity, become more likely when sleep apnea is left untreated. Poor sleep affects how the body processes insulin, making truck drivers more vulnerable to weight gain and other serious health issues.

Regulatory Disqualifications

Regulatory disqualifications can occur when truck drivers fail to manage their sleep apnea. FMCSA guidelines require medical screening, and untreated cases can lead to suspension or disqualification, putting a driver’s job and livelihood at risk.

FMCSA Regulations on Sleep Apnea

The FMCSA does not explicitly disqualify drivers diagnosed with sleep apnea, but it requires drivers to maintain proper treatment to ensure safe driving. Key regulations include:

Medical Certification Requirements: Drivers must pass a medical exam every two years. If sleep apnea is suspected, a medical examiner may require a sleep study.
Screening Criteria: Factors such as a BMI over 35, large neck circumference (>17 inches in men, >16 inches in women), high blood pressure, and chronic fatigue increase the likelihood of mandatory testing.
Treatment Compliance: Drivers diagnosed with sleep apnea must demonstrate compliance with Continuous Positive Airway Pressure (CPAP) therapy, maintaining at least 4 hours of nightly use for 70% of nights. Non-compliance can result in temporary disqualification.

Recognizing Sleep Apnea Symptoms in Truck Drivers

Truck drivers experiencing any of the following symptoms should seek medical evaluation for sleep apnea:

Loud snoring
Choking or gasping for air during sleep
Excessive daytime sleepiness
Morning headaches
Difficulty concentrating
Mood changes or irritability
High blood pressure

Ignoring these symptoms can lead to chronic health issues and potential career-threatening consequences.

Treatment Options for Truck Drivers with Sleep Apnea

Effective treatment allows truck drivers to continue working while improving their overall health and safety. The most recommended treatment options include:

CPAP Therapy

The Continuous Positive Airway Pressure (CPAP) machine is the gold standard for sleep apnea treatment. It delivers a continuous flow of air to keep the airway open, preventing apneas.

Pros: Highly effective, improves alertness, and meets FMCSA compliance requirements.
Cons: Some drivers find it uncomfortable, but modern CPAP devices are compact and travel-friendly.

Lifestyle Modifications

Many drivers can reduce the severity of sleep apnea through lifestyle changes, such as:

Weight Loss: Losing even 10-15% of body weight can significantly improve airway function.
Exercise: Regular physical activity improves lung capacity and overall health.
Avoiding Alcohol and Sedatives: These substances relax throat muscles, worsening apnea episodes.
Adjusting Sleep Position: Sleeping on the side rather than the back prevents airway collapse.

Oral Appliances

For drivers with mild to moderate sleep apnea, a mandibular advancement device (MAD) can be an alternative to CPAP. It repositions the jaw to keep the airway open.

Pros: Portable, easier to use than CPAP.
Cons: Less effective for severe cases.

Surgery (For Severe Cases)

In extreme cases, procedures such as uvulopalatopharyngoplasty (UPPP) or hypoglossal nerve stimulation can be considered. However, surgery is usually a last resort.

Can You Have a CDL With Sleep Apnea?

Yes, you can have a CDL with sleep apnea, but you must follow treatment to stay medically certified. The FMCSA requires proof of CPAP use for at least 4 hours per night on 70% of nights to maintain eligibility.

If sleep apnea is untreated or causes excessive drowsiness, a driver can face temporary disqualification. Compliance with treatment ensures you can keep your CDL and continue driving legally.

How Truck Drivers Can Stay Compliant with Sleep Apnea Treatment

To maintain FMCSA compliance and ensure continued employment, truck drivers diagnosed with sleep apnea should:

Follow CPAP Therapy Guidelines: Use the device at least 4 hours per night on 70% of nights to meet FMCSA requirements.
Track CPAP Compliance Data: Modern CPAP devices store usage data, which can be submitted to medical examiners.
Get Regular Checkups: Annual checkups help monitor the condition and ensure continued compliance.
Notify Employers Proactively: Communicating with the employer about treatment can prevent misunderstandings and employment risks.
Use Portable CPAP Machines: Travel-friendly CPAP machines are available for long-haul drivers who need flexibility.

Can You Get a 2-Year DOT Medical Card with Sleep Apnea?

A 2-year DOT medical card is possible with sleep apnea, but only if the condition is well-managed. The FMCSA does not ban drivers with sleep apnea, but they must follow treatment and prove compliance.

Medical Certification for Sleep Apnea

Drivers with sleep apnea usually receive a one-year medical card instead of two years. This ensures they are following treatment and remain fit to drive.

Treatment Requirements

Drivers must use a CPAP machine for at least 4 hours per night on 70% of nights to stay compliant. Regular CPAP use helps maintain alertness and reduces health risks.

Disqualification for Non-Compliance

Drivers who skip treatment or fail to provide CPAP usage records can face temporary disqualification. Severe, untreated sleep apnea can lead to a complete medical disqualification.

How to Get a 2-Year DOT Medical Card

A 2-year DOT card is possible if a driver shows consistent CPAP use and no signs of drowsiness. Most medical examiners require at least one year of documented compliance before approving a two-year certification.

The Role of Trucking Companies in Sleep Apnea Management

Trucking companies play a crucial role in addressing sleep apnea among drivers. Best practices include:

Providing Sleep Apnea Screening: Employers should encourage drivers to undergo testing if symptoms are present.
Offering CPAP Assistance Programs: Some companies assist drivers in obtaining CPAP machines and ensuring compliance.
Allowing Adequate Rest Breaks: Encouraging proper rest and scheduling sufficient sleep time improves driver safety.
Educating Drivers: Awareness programs help drivers understand the risks of sleep apnea and seek treatment early.

Conclusion

Sleep apnea is a serious condition that affects truck drivers’ health and road safety, but it can be managed with proper treatment. Following FMCSA guidelines, using CPAP therapy, and maintaining compliance help drivers continue their careers without risks.

Ignoring sleep apnea can lead to accidents, health problems, and disqualification from driving. Truck drivers who seek treatment and follow medical requirements can stay safe, healthy, and legally certified to drive.