Updated November 5, 2026 · By Andy Leleux, sleep technologist · For information only: only your doctor can assess your situation
Moderate or severe apnea with sleepiness = unfit to drive
Annex 6 of the Royal Decree of March 23, 1998 on driver's licenses lists sleep apnea among the causes of pathological sleepiness. As long as the sleepiness is not under control, you are unfit to drive. With effective treatment that you use consistently, you can be declared fit one month after starting treatment.
What the law says
The thresholds in Annex 6
The text defines moderate obstructive sleep apnea as an apnea-hypopnea index (AHI) of 15 to 29 per hour, and severe as 30 or more. In both cases it pairs the condition with excessive daytime sleepiness. For pathological sleepiness and sleep apnea, it calls for a neurological opinion on fitness to drive.
In practice:
- ● Moderate or severe apnea with pathological sleepiness: unfit to drive
- ● Moderate or severe apnea that is effectively treated, with medical follow-up: can be declared fit after 1 month, for up to 2 years
- ● After those 2 years, if no symptoms return: fitness with no time limit is possible, still with follow-up and treatment used as prescribed
While you wait for a diagnosis, the EU directive on driver's licenses notes that you may be advised not to drive if moderate or severe sleep apnea is suspected.
What you risk
A license holder who no longer meets the medical standards must hand the license back within four days to the authority that issued it (Article 24 of the Road Traffic Act). You get it back by presenting a certificate of fitness to drive. Driving anyway is punishable under Article 30: 8 days to 2 years in prison and a fine of €200 to €2,000, increased by the statutory surcharge, or either one of these penalties. The court can also order a driving ban.
Group 1 and Group 2
Group 1: private driving
License categories AM, A1, A2, A, B, B+E and G
- → Moderate or severe apnea with sleepiness: unfit until treatment is effective
- → The certificate is issued by a doctor of your choice, GP or specialist
- → If in doubt, they refer you to an accredited center (in Wallonia, the DAC)
Group 2: professional driving
Trucks, buses, taxis, ambulances, school transport, driving instructors...
- → Fitness is assessed by an accredited medical center: Medex, occupational health, or a center chosen by the employer
- → The standards are stricter than for Group 1
- → If your fitness is questioned for Group 1, it is automatically questioned for Group 2
Your doctor's role
The "Model VII" certificate
The doctor you see, GP or specialist, can record their decision on an official certificate, Model VII: fit, fit with conditions, or unfit. You take it to your municipality, which adjusts your license accordingly. Doing so is your responsibility.
If in doubt, the doctor refers you to an accredited center, in Wallonia the DAC (the driving fitness department of AWSR, the Walloon road safety agency), whose doctor decides on a Model XII certificate.
What the Order of Physicians says
According to the National Council of the Order of Physicians (Ordre des médecins, opinion of July 13, 2013), a doctor who has made the patient aware of their responsibility, had them sign the certificate to acknowledge receipt, and noted this in their file cannot be held liable for an accident, provided they followed Annex 6. A doctor who believes the patient is a danger on the road may inform the public prosecutor.
How do you become fit to drive again?
Being unfit to drive is not permanent. Once your treatment is effective and you use it consistently, here are the steps:
Start an effective treatment
CPAP, oral appliance therapy or surgery, depending on severity and your doctor's advice. CPAP is the standard treatment for moderate to severe apnea.
See the treatmentsShow that the treatment works
Your CPAP report shows your residual AHI and hours of use. Above all, the doctor checks that the sleepiness has gone.
Reading your CPAP reportGet the fitness certificate
No sooner than one month after starting effective treatment, the doctor can declare you fit on Model VII, for up to 2 years.
Have your license updated
Take the certificate to your municipality. Before it expires, check in with your doctor again: after 2 years without symptoms, fitness can be granted with no time limit.
Sources
- AWSR, Driving Fitness Department (DAC), "Votre patient est-il apte à conduire ?", brochure for doctors, December 2024 (Annex 6 of the Royal Decree of March 23, 1998). In French.
- Autosécurité, "Normes minimales concernant l'aptitude physique et psychique à la conduite d'un véhicule à moteur", document FM2000, January 2020. In French.
- Road Traffic Act (loi relative à la police de la circulation routière), Articles 24 and 30.
Useful contacts
DAC (AWSR)
Driving fitness department, Wallonia. Free of charge.
Sleep centers
Diagnosis and treatment of sleep apnea
The NIHDI (INAMI/RIZIV) CPAP convention
How CPAP is reimbursed in Belgium
Sleep apnea and high blood pressure
How the two are linked, and what treatment changes
Sleep apnea and type 2 diabetes
How apnea affects blood sugar
Not diagnosed yet?
Do you snore loudly, or fight to stay awake at the wheel? Take a screening test, then talk to your doctor.
