Quick answer
Most people with sleep apnea can keep driving, especially once it is treated. In Canada, provincial licensing authorities decide fitness to drive, and most use national medical standards. Under those standards, untreated obstructive sleep apnea with an AHI below 30 and no daytime sleepiness does not stop you driving. Severe sleep apnea (AHI of 30 or more), or a crash linked to sleepiness, can restrict your licence until treatment is shown to work, usually with CPAP data. Whatever your diagnosis, do not drive when you feel drowsy.
At a glance
Key takeaways
Licensing authorities, not your doctor, make the final decision about your licence.
Treated sleep apnea rarely stops people from driving. Keep your CPAP usage data, because it is the usual proof of treatment.
In most provinces, health professionals must report patients whose condition makes driving dangerous; in Alberta and Nova Scotia reporting is discretionary.
Untreated sleep apnea is linked to a two- to ten-fold higher risk of crashes, so getting tested and treated protects you and others.
Why sleep apnea matters for driving
Sleep apnea breaks up sleep through the night, which can leave you sleepy and slower to react during the day. A Canadian Thoracic Society and Canadian Sleep Society position paper reports that untreated obstructive sleep apnea carries a two- to ten-fold higher risk of collisions compared with people without it (Ayas and colleagues, 2014). Effective treatment lowers that risk. See daytime sleepiness and sleep apnea.
What the national driving standard says
The Canadian Council of Motor Transport Administrators (CCMTA) publishes national medical standards for drivers. Provinces are not legally required to adopt them, but most licensing authorities have. The sleep apnea standard, as published by RoadSafetyBC, applies to all drivers:
- Untreated obstructive sleep apnea with an AHI below 30 and no daytime sleepiness: eligible to drive.
- Severe obstructive sleep apnea (AHI of 30 or more): not eligible to drive unless it is successfully treated, or a sleep specialist judges the risk to be low.
- A crash linked to falling asleep or sleepiness in the past five years: you must show that your sleep apnea is successfully treated.
In B.C., proof of treatment can be a CPAP or BiPAP data download prepared by a respiratory therapist, or testing that shows your AHI is 30 or less with treatment. Each province applies the standard in its own way, so check with your licensing authority.
How to show your CPAP treatment is working
Licensing authorities and doctors usually look for objective CPAP data rather than your own report. The Canadian Medical Association’s Driver’s Guide and the Canadian Thoracic Society describe the minimum as CPAP use of at least 4 hours a day on 70% of days, over at least 30 days within the past 90 days (Ayas and colleagues, 2014). Your machine records this automatically. Our CPAP support team can help you download and understand your usage report. See CPAP adherence and usage data.
Do doctors have to report sleep apnea?
Rules differ by province. In most provinces, physicians and some other health professionals must report patients with a medical condition that may make driving dangerous; in others it is up to their judgment (Canadian Medical Protective Association). A sleep apnea diagnosis alone does not usually trigger a report. Reports are typically about untreated or poorly controlled sleep apnea with significant sleepiness.
| Province | Reporting by health professionals | Licensing authority |
|---|---|---|
| British Columbia | Mandatory only if a patient keeps driving after being warned not to (source) | RoadSafetyBC |
| Alberta | Discretionary (encouraged, not required) (source) | Government of Alberta |
| Saskatchewan | Mandatory (source) | SGI |
| Manitoba | Mandatory for physicians and optometrists (source) | Manitoba Public Insurance |
| Ontario | Mandatory for listed conditions, including untreated or unsuccessfully treated OSA with AHI of 30 or more and daytime sleepiness (source) | Ministry of Transportation, Driver Medical Review Office |
| New Brunswick | Mandatory: physicians and nurse practitioners must report under section 309.1 of the Motor Vehicle Act; reports made in good faith are protected (NB Motor Vehicle Act) | Registrar of Motor Vehicles |
| Nova Scotia | Discretionary (source) | Registry of Motor Vehicles |
| Prince Edward Island | Mandatory: physicians must report under section 233 of the Highway Traffic Act (PEI Highway Traffic Act) | Registrar of Motor Vehicles |
| Newfoundland and Labrador | Mandatory (source) | Motor Registration Division |
Commercial drivers
In Canada, Class 1 to 4 licences are commercial licences. The national sleep apnea standard applies to all drivers, but commercial drivers have more frequent medical reviews. In Saskatchewan, for example, Class 1 to 4 drivers need a medical report every five years up to age 45, every three years from 46 to 65, and every year from 66 (SGI). The Canadian Thoracic Society recommends a stricter assessment for commercial drivers, with yearly checks of CPAP use, and a sleep assessment within about four weeks of referral where possible (Ayas and colleagues, 2014). If you drive for work and think you may have sleep apnea, getting tested and treated promptly protects your livelihood as well as your safety.
What to do if you think you have sleep apnea
- Do not drive when you feel sleepy. Pull over somewhere safe if you feel drowsy.
- Get tested. Take our two-minute sleep apnea quiz, then consider a home sleep apnea test.
- Start and stick with treatment. Most people who use CPAP consistently can keep driving.
- Keep your records. Save your sleep study report and CPAP usage data in case your licensing authority or doctor asks for them.
Sources
- RoadSafetyBC. 18 – Sleep disorders: CCMTA medical standards. https://www2.gov.bc.ca/gov/content/transportation/driving-and-cycling/roadsafetybc/medical-fitness/medical-prof/med-standards/18-sleep-disorders
- Ayas N and colleagues. Obstructive sleep apnea and driving: a Canadian Thoracic Society and Canadian Sleep Society position paper. Canadian Respiratory Journal (2014). https://pmc.ncbi.nlm.nih.gov/articles/PMC4128516/
- Canadian Medical Protective Association. Do you need to report your patient’s fitness to drive?. https://www.cmpa-acpm.ca/en/advice-publications/browse-articles/2019/do-you-need-to-report-your-patients-fitness-to-drive
- Canadian Medical Association. CMA Driver’s Guide: reporting. https://driversguide.ca/sections/reporting-when-and-why
- Government of Ontario. Reporting for driver medical review. https://www.ontario.ca/page/reporting-driver-medical-review
- Government of Alberta. Report a driver fitness concern. https://www.alberta.ca/report-a-driver-fitness-concern
- Manitoba Public Insurance. Information for health care professionals. https://www.mpi.mb.ca/information-for-health-care-professionals/
- Government of Newfoundland and Labrador. Medical standards and mandatory reporting. https://www.gov.nl.ca/motorregistration/existing-drivers/driver-records-and-suspended-drivers/medical-standards-and-mandatory-reporting/
- SGI. Class 1-4 medical standards. https://sgi.sk.ca/pro-driver/-/knowledge_base/pro-drivers/class-1-4-medical-standards
- Government of New Brunswick. Motor Vehicle Act, RSNB 1973, c M-17, s. 309.1. https://laws.gnb.ca/en/document/cs/M-17
Disclaimer
This page is general health information, not medical advice, and it does not replace an assessment by a qualified health professional. Virtual Sleep Care does not currently serve Quebec, Yukon, the Northwest Territories or Nunavut. This page is general information, not legal advice. Licensing rules change; confirm current requirements with your provincial licensing authority.