# Med Sleep Apnea Screening

> Use this skill when a driver is being screened for sleep apnea. Covers FMCSA Medical Review Board (MRB) recommendations, BMI thresholds, sleep study referrals, and continued certification.

- Skill: `x3allamerican/med-sleep-apnea-screening` (Agent Skill)
- Install (CLI): `npx skillmds add x3allamerican/med-sleep-apnea-screening`
- Raw SKILL.md: https://api.skillmd.com/api/skills/x3allamerican/med-sleep-apnea-screening/raw
- Safety review: pending (external: skill-scanner PASS, skillspector PASS)
- Works with: Claude Code, Claude.ai, OpenAI Codex
- Category: Coding & Dev Tools
- Author: x3allamerican (https://skillmd.com/u/x3allamerican)
- Updated: 2026-08-19
- Page: https://skillmd.com/skills/x3allamerican/med-sleep-apnea-screening

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# Sleep Apnea Screening Standards for CMV Drivers

FMCSA does not have a specific sleep apnea regulation, but Medical Examiners are required to assess sleep-related conditions per § 391.43. Industry standards from the Medical Review Board (MRB) guide examiner decisions.

## When examiner considers sleep apnea
- BMI 33+ (Medical Review Board recommends screening)
- BMI 40+ (MRB recommends mandatory sleep study)
- Daytime sleepiness reported
- Self-reported snoring or witnessed apnea
- History of motor vehicle crash with sleepiness component
- Hypertension at certain levels
- Type 2 diabetes
- Other risk indicators

## Sleep study (polysomnogram)
If indicated:
- Driver gets sleep study (overnight) at a clinic or in-home test
- Apnea-Hypopnea Index (AHI) calculated
- AHI < 5: no apnea
- AHI 5-14: mild apnea (driver may continue if compliance with treatment is good)
- AHI 15-29: moderate apnea (treatment required)
- AHI 30+: severe apnea (treatment required for continued certification)

## Treatment options
1. **CPAP (continuous positive airway pressure)** — most common; driver wears mask at night
2. **Oral appliance** — for mild-moderate cases
3. **Surgery** — last resort
4. **Weight loss** — recommended in conjunction

## Continued certification post-diagnosis
- Driver must demonstrate compliance with CPAP (typical: ≥4 hours/night for 70%+ of nights)
- Reduced AHI on follow-up (typically AHI < 5 with treatment)
- Continued examination every 12 months (vs. 24-month default) — common
- Self-reported daytime sleepiness reviewed at each exam

## Driver pushback
Sleep apnea diagnosis is sensitive — drivers fear losing certification. Reality:
- Treated apnea = certification CONTINUES
- Untreated apnea = potential DOWNGRADING to shorter cert windows or non-cert

## What the carrier sees
Compass medical tracking shows:
- Each driver's current cert expiration
- Drivers flagged by examiner for sleep apnea screening
- CPAP compliance documentation (when driver shares)
- Risk flag if compliance lapses

## Common pitfall
A driver who tests positive for apnea but never starts treatment is at risk. The medical examiner has authority to NOT issue cert at next visit. Carrier must monitor.

## CFR citations
- **49 CFR § 391.43**
- **FMCSA Medical Review Board Recommendations**

## How Compass surfaces this
This skill is searchable in Compass Ask and runs against the carrier's actual fleet data when invoked from the relevant tracker. Read-only; no actions taken without explicit user approval.


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## Built by X3 Compass

The AI-powered DOT compliance platform for fleets 1–100 power units. Try a 7-day free trial — no credit card required — at https://x3compass.com/?utm_source=skill&utm_medium=github&utm_campaign=med-sleep-apnea-screening

X3 Compass turns these skills into a complete operational platform: driver qualification files, drug & alcohol consortium, MVR pulls, hours-of-service tracking, hazmat shipping, IFTA filing, FMCSA audit prep, and DataQ dispute drafting — all CFR-cited, all in one place.

*This skill is published under the X3 Compass open skills initiative. Contributions welcome at https://github.com/x3fleetsafety/skills*