Sleep Apnea and the CDL

Happy Monday to you all. It’s Nov. 17, 2025.

Today in History:

In 2009, Major Malik Hasan yelled “Allahu Akbar!” then opened fire at Fort Hood, Texas, killing 13, injuring 30.

In 2007, China’s first lunar satellite entered lunar orbit.

In 1995, André Dallaire tried to assassinate Canadian Prime Minister Jean Chrétien.

Birthdays today include Canadian rocker Bryan Adams, Art Garfunkel, and Ike Turner.

This morning, I note with interest the excellent piece from Jamie Wilson yesterday, on the subject of sleep apnea. That’s a subject near and dear to me. I advise that you go and read it for some background, if you haven’t already.

I suppose most of you don’t know that until a few months ago, I used to drive 18-wheelers for a living. You may also not be aware that the Federal DOT, by way of the FMCSA, is taking the subject of sleep apnea seriously, to the point of revoking your ability to drive such rigs with apnea that isn’t being treated. And finally, I’m sure you are unaware that I was so diagnosed a couple of years back. That means, like Jamie, I, too, have a machine that I hook myself to each night. So I suppose that, like her, I can also speak to the subject with some degree of authority, here.

What Jamie doesn’t mention about the CPAP machine is that they are usually controlled by a computer, which is hooked to a cell phone internally. It records your sleep on a daily basis. It sends all the information on a daily basis to a central location on the internet, where it can be examined later by doctors who can revoke your ability to drive if they’re not satisfied with what the computer in the CPAP is telling them about how you’re sleeping, and for how long.

Some makers of CPAP systems make compliance reports a bit easier to send to the DOT doctors.  And the qualifications are less than some drivers' fears make them. MaTrack, which, among other things, provides a fleet tracking service for trucking companies, says:

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.

Meanwhile, according to Zippia, there are over 1,356,501 commercial driver's licenses (CDLs) currently issued in the United States. Alexa tells me that roughly 5% of Americans have been diagnosed with sleep apnea. Assuming that the percentages hold true for people with a CDL, that means that 67825 drivers have been diagnosed. I won't bother running the numbers, but it’s easy to see the problem here.

A good deal of ink has been used on the subject of illegals who can’t read English, with CDLs of questionable origins a danger. I wrote a two-parter on that subject myself just recently. Many since that bit started a few years back have been removed from service, with the usual suspects making loud noises about how unfair it is to remove illegals from their livelihood, and safety issues be damned.

I’m going to suggest that the issue is pretty much on the same level as the subject of sleep apnea in terms of public safety. Yet, the people complaining about removing non-English speakers from the road say little to nothing about people who deal with sleep apnea being similarly removed from service. No, I am not suggesting that the government should ignore sleep apnea, but the difference between the reactions of the two subjects on the part of some is telling, I think.

There is a fair amount of fear on the part of some drivers that if you are diagnosed, you'll lose your ability to drive. While that's not precisely true, there are a couple of concerns. First, it is often the case that a driver ends up sleeping while being loaded or unloaded. Most warehouses won't let you sleep on the property once that process is complete, so you must drive to an increasingly hard-to-find sleeping spot.

This, in turn, affects your CPAP report, which is reported to the doctors and to the government in turn. Understand that the issue isn't that you're dealing with apnea; the issue is getting a certain number of hours of undisturbed rest, which, under the situation I've just described, never happens. One of the many wonderful things that happens when you're in the trucking business, and trust me, it's not one of the things I miss. 

The other concern is that many drivers don't get diagnosed because of the fear of complications, such as what I described above. They don't want to lose their jobs. 

There's a lot of work to do in this area. 

I conclude with the idea that science doesn't have all the answers on this topic, and I doubt they ever will. As an example, I note that for all that science understands about what we call sleep disorders, science is yet completely unable to explain why people even sleep at all. This is far from "settled science," therefore, if there ever can be such a thing.

I expect to see revisions of the regulations on this topic in the next year or so, as understanding of the topic improves. All we can do is hope they get it right. 

That's it for today. Have a great one. In fact, have two. The great ones are usually a bit small. I'll look forward to you being here tomorrow. Oh, and bring your friends.

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