The federal government has been flirting with obstructive sleep apnea (OSA) for over 20 years now. In 2000, FMCSA published its first medical advisory criteria declaring untreated OSA a respiratory dysfunction that could spell disqualification for drivers unwilling to stick with the required treatment. Since then, Congress and FMCSA waffled on how best to address this issue. FMCSA has published and revoked guidance and rulemakings. Congress has passed laws restricting some federal action and introduced legislation requiring others. Meanwhile, many in the industry have charted their own course, adopting policies and programs addressing OSA and working with medical examiners and sleep and fatigue management companies to mitigate its impact.

Many predict the federal government will get back into the OSA game, pointing to a draft medical examiner handbook published a year ago and federal legislation introduced in 2020, which would require FMCSA to refire the rulemaking engines. With the Biden administration not expected to continue the light regulatory touch used by the Trump administration, STC believes it may finally be able to reliably read the tea leaves and offers this advice, don't sleep on OSA. Expect a rulemaking process by FMCSA that could result in specific driver screening and treatment related rules.