There is an effort by the Federal Motor Carrier Safety Administration (FMCSA) to comprehensively revise the agency's rules aimed at making it harder for unfit drivers to either get medical clearance or evade detection. One area the agency is targeting is obstructive sleep apnea (OSA). During this upcoming August, the FMCSA will ask the medical review board (MRB), made up of a panel of physician advisors, on how it should proceed.
Since 2008, the MRB has supported stricter regulatory standards for OSA, by stating that all drives should be screened for OSA. The MRB recommended that a driver with a body-mass index (BMI) of 30 or more should not be allowed certification until that driver has had a sleep study. The MRB said that a diagnosis of OSA should not necessarily bar a driver from certification, but that certification should be conditioned on the OSA severity, its impact on driver's sleepiness, and whether the driver is getting treatment. It also recommended criteria for denying medical certification, including a crash associated with falling asleep at the wheel and failing to comply with prescribed OSA treatment.
Currently, there is confusion in the medical community about OSA because the MRB made the above recommendations in 2008 but the FMCSA has not made them into rules yet. Some examiners have adopted the MRB recommendations as requirements, while others are awaiting for more guidance from the FMCSA. Perhaps we will get that this summer.