Sleep apnea causes impairment in performance and is associated with an increased risk of motor vehicle crashes compared to the general population of drivers. Despite this increase risk, the actual number of accidents is still quite low, although the implications are significant in commercial vehicle drivers. It is difficult for physicians to assess risk and ability to drive in many patients with sleep apnea yet physicians are often mandated to make these assessments with obvious implications on patients. Since many patients may never have a crash, it is not practical or feasible to restrict all untreated patients from driving, unless they operate commercial vehicles. Thresholds of disease severity that prompt driving restriction need to be established for sleep apnea much like they have been for alcohol. Until more data emerges, continued educational efforts about sleep apnea are needed to convince government and insurance bodies to provide appropriate resources for diagnosis and treatment of sleep apnea since apnea risk is minimized with successful apnea treatment.