Drivers with obstructive sleep apnea syndrome (OSAS) have an increased risk of motor vehicle crashes. Unfortunately, neither clinical nor polysomnographic features allow clinicians to reliably identify high-risk drivers. One potential means of identifying these drivers is with the use of driving simulators. Several investigators have shown that OSAS patients perform worse than healthy control drivers and results from our studies have demonstrated declines in driving performance during EEG-defined "microsleeps." The use of simulators, and in-vehicle detection and alerting devices may mitigate some of the suffering caused by these crashes.